The University of Minnesota has been a strong advocate of living donor kidney transplants. The benefits for living donor recipients have been well documented. The relative low risk of physical complications during donation has also been well documented. Less well understood is the psychosocial risk to donors. Most published reports have indicated an improved sense of well-being and a boost in self-esteem for living kidney donors. However, there have been some reports of depression and disrupted family relationships after donation, even suicide after a recipient's death. To determine the quality of life of our donors, we sent a questionnaire to 979 who had donated a kidney between August 1, 1984, and December 31, 1996. Of the 60% who responded, the vast majority had an excellent quality of life. As a group, they scored higher than the national norm on the SF-36, a standardized quality of life health questionnaire. However, 4% were dissatisfied and regretted the decision to donate. Further, 4% found the experience extremely stressful and 8% very stressful. We used multivariate analysis to identify risk factors for this poor psychosocial outcome and found that relatives other than first degree (odds ratio=3.5, P=0.06) and donors whose recipient died within 1 year of transplant (odds ratio=3.3, P=0.014) were more likely to say they would not donate again if it were possible. Further, donors who had perioperative complications (odds ratio=3.5, P=0.007) and female donors (odds ratio=1.8, P=0.1) were more likely to find the overall experience more stressful. Overall, the results of this study are overwhelmingly positive and have encouraged us to continue living donor kidney transplants.

Long-term follow-up of living kidney donors: quality of life after donation.

Organ transplantation has evolved rapidly from the first early successes1 to the current widespread use of donated organs for the treatment of end-stage kidney, heart, and liver failure. With limited supplies of organs and an increasing demand for them, however, many patients who need transplants do not receive them (Figure 1).2 Each year, about 3000 patients in the United States die while waiting for an organ transplant, and about 100,000 potential candidates for transplantation die before they are placed on a waiting list.2 There is an 11 percent annual increase in the number of patients placed on waiting lists for . . .

Strategies for making more organs available for transplantation

Psychosocial health of living kidney donors: a systematic review

Although transplantation is the best treatment for many people with end-stage renal disease, the gap between the number of organ donors and the number of potential recipients continues to widen.1 Patients are often treated with dialysis for years while awaiting transplants, and many die.1 At the University of Chicago, between 10 and 20 percent of patients with available living donors cannot receive transplants from them because of ABO incompatibility. We propose to increase the supply of organs by using kidneys from living donors who are ABO-incompatible with the intended recipients but are ABO-compatible with other recipients. Through an exchange arrangement . . .

Ethics of a paired-kidney-exchange program.

ContextDespite the advantages of living donor transplantation, evidence suggests that some potential recipients with living donors have psychological concerns that prevent them from pursuing living donation. Addressing these concerns through education may increase the rates of living donation.ObjectiveTo understand the psychological barriers and educational needs of potential kidney recipients regarding living donation.Subjects and DesignQualitative focus group study of kidney transplant recipients, donors, and family members to explore their assessment of the advantages of dialysis and deceased donor transplantation over living donation, their concerns about living donation, and what types of living donation education would be most helpful.ResultsKidney recipients reported that they might not pursue living donation because they felt guilty and indebted to the donor, did not want to harm or inconvenience the donor, did not want to accept a kidney that a family member might need later, and did not want to ...

Living donation decision making: Recipients' concerns and educational needs

https://www.ajkd.org/article/S0272-6386(86)80030-0/pdf

Corbin Peterson

Papers

Living-Related Kidney Donors: A Multicenter Study of Donor Education, Socioeconomic Adjustment, and Rehabilitation