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Massey EK, Rule AD, Matas AJ. Living Kidney Donation: A Narrative Review of Mid- and Long-term Psychosocial Outcomes. Transplantation 2024:00007890-990000000-00794. [PMID: 38886889 DOI: 10.1097/tp.0000000000005094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
Living kidney donors make a significant contribution to alleviating the organ shortage. The aim of this article is to provide an overview of mid- and long-term (≥12 mo) living donor psychosocial outcomes and highlight areas that have been understudied and should be immediately addressed in both research and clinical practice. We conducted a narrative review by searching 3 databases. A total of 206 articles were included. Living donors can be divided into those who donate to an emotionally or genetically related person, the so-called directed donors, or to an emotionally or genetically unrelated recipient, the so-called nondirected donors. The most commonly investigated (bio)psychosocial outcome after living donation was health-related quality of life. Other generic (bio)psychological outcomes include specific aspects of mental health such as depression, and fatigue and pain. Social outcomes include financial and employment burdens and problems with insurance. Donation-specific psychosocial outcomes include regret, satisfaction, feelings of abandonment and unmet needs, and benefits of living kidney donation. The experience of living donation is complex and multifaceted, reflected in the co-occurrence of both benefits and burden after donation. Noticeably, no interventions have been developed to improve mid- or long-term psychosocial outcomes among living donors. We highlight areas for methodological improvement and identified 3 areas requiring immediate attention from the transplant community in both research and clinical care: (1) recognizing and providing care for the minority of donors who have poorer long-term psychosocial outcomes after donation, (2) minimizing donation-related financial burden, and (3) studying interventions to minimize long-term psychosocial problems.
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Affiliation(s)
- Emma K Massey
- Erasmus Medical Center Transplant Institute, University Medical Center Rotterdam, Department of Internal Medicine, Rotterdam, Zuid Holland, the Netherlands
| | - Andrew D Rule
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN
| | - Arthur J Matas
- Department of Surgery, Transplantation Division, University of Minnesota, Minneapolis, MN
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2
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Zuchowski M, Mamode N, Draper H, Gogalniceanu P, Norton S, Chilcot J, Auburn T, Clarke A, Williams L, Burnapp L, McCrone P, Maple H. Exploring Staff Attitudes Towards Unspecified Kidney Donors in the United Kingdom: Results From the BOUnD Study. Transpl Int 2023; 36:11258. [PMID: 37359823 PMCID: PMC10285071 DOI: 10.3389/ti.2023.11258] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/23/2023] [Indexed: 06/28/2023]
Abstract
Unspecified kidney donation (UKD) has made substantial contributions to the UK living donor programme. Nevertheless, some transplant professionals are uncomfortable with these individuals undergoing surgery. This study aimed to qualitatively explore the attitudes of UK healthcare professionals towards UKD. An opportunistic sample was recruited through the Barriers and Outcomes in Unspecified Donation (BOUnD) study covering six UK transplant centres: three high volume and three low volume centres. Interview transcripts were analysed using inductive thematic analysis. The study provided comprehensive coverage of the UK transplant community, involving 59 transplant professionals. We identified five themes: staff's conception of the ethics of UKD; presence of the known recipient in the donor-recipient dyad; need for better management of patient expectations; managing visceral reactions about the "typical" unspecified kidney donor; complex attitudes toward a promising new practice. This is the first in-depth qualitative study of attitudes of transplant professionals towards UKD. The data uncovered findings with strong clinical implications for the UKD programme, including the need for a uniform approach towards younger candidates that is adhered to by all transplant centres, the need to equally extend the rigorous assessment to both specified and unspecified donors, and a new approach to managing donor expectations.
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Affiliation(s)
- Mira Zuchowski
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Department of Transplantation, Guy’s and St Thomas’ NHS Foundation Trust, King’s College London, London, United Kingdom
| | - Nizam Mamode
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Heather Draper
- Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Peter Gogalniceanu
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Sam Norton
- Department of Transplantation, Guy’s and St Thomas’ NHS Foundation Trust, King’s College London, London, United Kingdom
| | - Joseph Chilcot
- Department of Transplantation, Guy’s and St Thomas’ NHS Foundation Trust, King’s College London, London, United Kingdom
| | - Timothy Auburn
- School of Psychology, University of Plymouth, Plymouth, United Kingdom
| | - Alexis Clarke
- School of Psychology, University of Plymouth, Plymouth, United Kingdom
| | - Lynsey Williams
- School of Psychology, University of Plymouth, Plymouth, United Kingdom
| | - Lisa Burnapp
- Directorate of Organ and Tissue Donation and Transplantation, NHS Blood and Transplant, Watford, United Kingdom
| | - Paul McCrone
- Institute for Lifecourse Development, University of Greenwich, London, United Kingdom
| | - Hannah Maple
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
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3
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Fox AN, Liapakis A, Batra R, Bittermann T, Emamaullee J, Emre S, Genyk Y, Han H, Jackson W, Pomfret E, Raza M, Rodriguez-Davalos M, Rubman Gold S, Samstein B, Shenoy A, Taner T, Roberts JP. The use of nondirected donor organs in living donor liver transplantation: Perspectives and guidance. Hepatology 2022; 75:1579-1589. [PMID: 34859474 DOI: 10.1002/hep.32260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 12/13/2022]
Abstract
Interest in anonymous nondirected living organ donation is increasing in the United States and a small number of transplantation centers are accumulating an experience regarding nondirected donation in living donor liver transplantation. Herein, we review current transplant policy, discuss emerging data, draw parallels from nondirected kidney donation, and examine relevant considerations in nondirected living liver donation. We aim to provide a consensus guidance to ensure safe evaluation and selection of nondirected living liver donors and a schema for just allocation of nondirected grafts.
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Affiliation(s)
- Alyson N Fox
- Columbia University Irving Medical Center (CUIMC) Center for Liver Disease and Transplanation NY Presbyterian HospitalColumbia University Vagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
| | - AnnMarie Liapakis
- Yale-New Haven Health Transplanation CenterYale University School of MedicineNew HavenConnecticutUSA
| | - Ramesh Batra
- Yale-New Haven Health Transplanation CenterYale University School of MedicineNew HavenConnecticutUSA
| | - Therese Bittermann
- Penn Transplant InstitutePenn MedicinePerelman School of Medicine Unniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Juliet Emamaullee
- University of Southern California (USC) Transplant InstituteKeck School of Medicine of USCLos AngelesCaliforniaUSA
| | - Sukru Emre
- Yale-New Haven Health Transplanation CenterYale University School of MedicineNew HavenConnecticutUSA
| | - Yuri Genyk
- University of Southern California (USC) Transplant InstituteKeck School of Medicine of USCLos AngelesCaliforniaUSA
| | - Hyosun Han
- University of Southern California (USC) Transplant InstituteKeck School of Medicine of USCLos AngelesCaliforniaUSA
| | - Whitney Jackson
- Colorado Center for Transplantation Care, Research and EducationUniversity of Colorado School of MedicineAuroraColoradoUSA
| | - Elizabeth Pomfret
- Colorado Center for Transplantation Care, Research and EducationUniversity of Colorado School of MedicineAuroraColoradoUSA
| | - Muhammad Raza
- Keck School of Medicine of University of Southern CaliforniaLos AngelesCaliforniaUSA
| | | | - Susan Rubman Gold
- Yale-New Haven Health Transplanation CenterYale University School of MedicineNew HavenConnecticutUSA
| | - Benjamin Samstein
- Weill Cornell Medicine Center for Liver Disease and Transplantation NY Presbyterian HospitalWeill Cornell School of MedicineNew YorkNew YorkUSA
| | - Akhil Shenoy
- Columbia University Irving Medical Center (CUIMC) Center for Liver Disease and Transplanation NY Presbyterian HospitalColumbia University Vagelos College of Physicians and SurgeonsNew YorkNew YorkUSA
| | - Timucin Taner
- Mayo Clinic Transplant CenterMayo Clinic College of MedicineRochesterMinnesotaUSA
| | - John P Roberts
- Organ Transplant ProgramUniversity of California San Francisco (UCSF) HealthUCSF School of MedicineSan FranciscoCaliforniaUSA
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4
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Bailey P, Vergis N, Allison M, Riddell A, Massey E. Psychosocial Evaluation of Candidates for Solid Organ Transplantation. Transplantation 2021; 105:e292-e302. [PMID: 33675318 DOI: 10.1097/tp.0000000000003732] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Transplant candidates should undergo an assessment of their mental health, social support, lifestyle, and behaviors. The primary aims of this "psychosocial evaluation" are to ensure that transplantation is of benefit to life expectancy and quality of life, and to allow optimization of the candidate and transplant outcomes. The content of psychosocial evaluations is informed by evidence regarding pretransplant psychosocial predictors of transplant outcomes. This review summarizes the current literature on pretransplant psychosocial predictors of transplant outcomes across differing solid organ transplants and discusses the limitations of existing research. Pretransplant depression, substance misuse, and nonadherence are associated with poorer posttransplant outcomes. Depression, smoking, and high levels of prescription opioid use are associated with reduced posttransplant survival. Pretransplant nonadherence is associated with posttransplant rejection, and nonadherence may mediate the effects of other psychosocial variables such as substance misuse. There is evidence to suggest that social support is associated with likelihood of substance misuse relapse after transplantation, but there is a lack of consistent evidence for an association between social support and posttransplant adherence, rejection, or survival across all organ transplant types. Psychosocial evaluations should be undertaken by a trained individual and should comprise multiple consultations with the transplant candidate, family members, and healthcare professionals. Tools exist that can be useful for guiding and standardizing assessment, but research is needed to determine how well scores predict posttransplant outcomes. Few studies have evaluated interventions designed to improve psychosocial functioning specifically pretransplant. We highlight the challenges of carrying out such research and make recommendations regarding future work.
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Affiliation(s)
- Pippa Bailey
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Renal and Transplant Service, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Nikhil Vergis
- Liver Services Department, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
- Department of Metabolism Digestion and Reproduction, Imperial College London, UK
| | - Michael Allison
- Cambridge Liver Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Amy Riddell
- Renal and Transplant Service, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
- University of Exeter Medical School, Exeter, UK
| | - Emma Massey
- Department of Internal Medicine, Nephrology and Transplantation, Erasmus Medical Center, Rotterdam, The Netherlands
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Massey EK, Pronk MC, Zuidema WC, Weimar W, van de Wetering J, Ismail SY. Positive and negative aspects of mental health after unspecified living kidney donation: A cohort study. Br J Health Psychol 2021; 27:374-389. [PMID: 34296497 PMCID: PMC9291094 DOI: 10.1111/bjhp.12549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 06/16/2021] [Indexed: 11/28/2022]
Abstract
Objectives Unspecified donors give a kidney to a stranger with end‐stage kidney failure. There has been little research on the long‐term impact of unspecified donation on mental health outcomes. The aim of this study was to assess the positive and negative aspects of mental health among unspecified donors. Design We invited all unspecified donors who donated a kidney between 2000 and 2016 at our centre to participate in an interview and to complete validated questionnaires. Methods We measured positive mental health using the Dutch Mental Health Continuum‐Short Form (MHC‐SF), psychological complaints using the Symptoms Checklist‐90 (SCL‐90) and psychiatric diagnoses using the Mini‐International Neuropsychiatric Interview (M.I.N.I.) Screen for all donors and the M.I.N.I. Plus on indication. Results Of the 134 eligible donors, 114 participated (54% female; median age 66 years), a median of 6 years post‐donation. Scores on emotional and social well‐being subscales of the MHC‐SF were significantly higher than in the general population. Psychological symptoms were comparable to the general population. Thirty‐two per cent of donors had a current or lifetime psychiatric diagnosis. Psychological symptoms did not significantly change between the pre‐donation screening and the post‐donation study. Conclusions We concluded that, with the appropriate screening, unspecified donation is a safe procedure from a psychological perspective.
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Affiliation(s)
- Emma K Massey
- Department of Internal Medicine, Erasmus MC Transplant Institute, University Medical Center, Rotterdam, The Netherlands
| | - Mathilde C Pronk
- Department of Internal Medicine, Erasmus MC Transplant Institute, University Medical Center, Rotterdam, The Netherlands
| | - Willij C Zuidema
- Department of Internal Medicine, Erasmus MC Transplant Institute, University Medical Center, Rotterdam, The Netherlands
| | - Willem Weimar
- Department of Internal Medicine, Erasmus MC Transplant Institute, University Medical Center, Rotterdam, The Netherlands
| | - Jacqueline van de Wetering
- Department of Internal Medicine, Erasmus MC Transplant Institute, University Medical Center, Rotterdam, The Netherlands
| | - Sohal Y Ismail
- Department of Psychiatry, Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
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6
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Experiencing one's own body and body image in living kidney donors-A sociological and psychological study. PLoS One 2021; 16:e0249397. [PMID: 33857150 PMCID: PMC8049271 DOI: 10.1371/journal.pone.0249397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 03/17/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The aim of the study was to perform an in-depth exploratory analysis of the experience and image of one's body among living kidney donors. METHOD The research was carried out using mixed methodology. The study on experiencing one's own body was carried out using the sociological methodology of the grounded theory (qualitative research). This method was supplemented with psychometric measurement-the Body Esteem Scale (quantitative research). The basic research method was the in-depth interview. Using this method, a group of 25 living kidney donors who had not experienced any serious health or psychological problems after donation was examined. The participants of the study came from three transplant centers in Poland. RESULTS The data from the sociological interviews indicate that the donors: 1. do not experience radical changes in the functioning of their body; 2. maintain full control over it and do not feel the absence of a kidney in the body; 3. consciously and reflectively take care of their body after donation. In addition, the sociological research indicates that caring for one's own body also includes the transferred organ. The kidney donors experience a kind of bodily identity extension, including the recipient's body. However, the personal and social identity of the studied kidney donors is not disturbed in any way. The psychometric data correspond to the sociological results and indicate: 1. a lack of extreme emotional assessments about one's body; 2. awareness of one's own body and consistency of its image; 3. reduced emotional assessment of body zones directly related to the surgery; 4. differences in body image between the sexes. CONCLUSIONS The research results presented in the text indicate not only the possibility, but also the need for triangulation of research methods in the study of the experience and image of one's own body in living kidney donors. The proposed research approach employing mixed methodology within the fields of sociology and psychology for researching the phenomenon of living kidney donation is not very common.
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7
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Tomer N, Small A, Mirza O, Palese M. Evidence of Resilience in Kidney Donors: A New York Statewide Cohort Analysis. Transplant Proc 2021; 53:803-807. [PMID: 33551185 DOI: 10.1016/j.transproceed.2021.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 12/08/2020] [Accepted: 01/08/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Donor nephrectomy (DN) is a procedure performed to provide recipients with a kidney to treat end-stage renal disease. The following analysis evaluated depression diagnosis in DN patients compared to controls. METHODS DN patients and matched controls were identified between 2000 and 2009 from the Statewide Planning and Research Cooperative System database. Cohorts were tracked for depression incidence. Multivariable logistic regression was used to determine independent predictors of a postoperative depression diagnosis. RESULTS The total study cohort included 2108 DN cases and 2108 controls. In both donors and controls, the baseline rate of depression was 0.95% (n = 20). The 5-year incidence of depression diagnosis after exposure increased in both cohorts (donors: 2.5%, n = 53; controls: 7.2%, n = 152; P < .001). The 5-year relative risk for developing depression was 2.65 (CI 1.59-4.42, P = .0002) in donors and 7.60 (CI 4.79-12.07, P < .001) in controls. On multivariable regression, being a donor was associated with reduced risk of developing postoperative depression (OR = 0.322, CI 0.233-0.445, P < .001), and the greatest risk factor for postoperative depression was a prior depressive diagnosis (OR = 7.811, CI 3.814-15.997, P < .001). CONCLUSION Our analysis shows that the strongest risk factor for depression was a prior diagnosis of depression. However, willingness to undergo donor nephrectomy is associated with less subsequent depression than the control population, suggesting that kidney donors may be a more resilient cohort.
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Affiliation(s)
- Nir Tomer
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Alexander Small
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Omar Mirza
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Michael Palese
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY.
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8
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Malekshahi A, MortezaNejad HF, Taromsari MR, Gheshlagh RG, Delpasand K. An evaluation of the current status of kidney transplant in terms of the type of receipt among Iranian patients. RENAL REPLACEMENT THERAPY 2020. [DOI: 10.1186/s41100-020-00314-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Introduction
With the increasing prevalence and incidence of chronic renal failure leading to advanced kidney disease (ESRD), the use of renal transplant therapy is increasing globally. The aim of this study was to determine the status of kidney transplant in patients during a period of 4–5 years.
Materials and methods
In this retrospective, analytical study, patients undergoing renal transplant at one of the hospitals in northern Iran were studied. The data was collected using a checklist assessing the required information, including the age, sex, place of residence, source of the kidney for transplant (living related, living non-related, deceased), kidney receiving method (donated, purchased), and wait time for a kidney transplant.
Results
A total of 228 patients were included in the study, of which 73.7% were male and 26.3% were female. The average wait time for kidney transplant was 386.22 days. The mean age of patients was 32.7 ± 10.7 years. In addition, living non-related (66.2%) and deceased (14%) were the most and least frequent sources of kidney transplant, respectively. Moreover, 51.8% of all transplanted kidneys were purchased.
Conclusion
Over the past 5 years, there has been a decrease in wait time for kidney transplant in Rasht, Iran. Factors, such as being female, lower age, and living in urban areas, are related to a shorter wait time for kidney transplant. The most common types of kidney transplant are from non-related donors and purchased.
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9
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Menjivar A, Torres X, Manyalich M, Fehrman-Ekholm I, Papachristou C, de Sousa-Amorim E, Paredes D, Hiesse C, Yucetin L, Oppenheimer F, Kondi E, Peri JM, Kvarnström N, Ballesté C, Dias L, Frade IC, Lopes A, Diekmann F, Revuelta I. Psychosocial risk factors for impaired health-related quality of life in living kidney donors: results from the ELIPSY prospective study. Sci Rep 2020; 10:21343. [PMID: 33288792 PMCID: PMC7721886 DOI: 10.1038/s41598-020-78032-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 11/06/2020] [Indexed: 01/10/2023] Open
Abstract
Living kidney donors' follow-up is usually focused on the assessment of the surgical and medical outcomes. Whilst the psychosocial follow-up is advocated in literature. It is still not entirely clear which exact psychosocial factors are related to a poor psychosocial outcome of donors. The aim of our study is to prospectively assess the donors' psychosocial risks factors to impaired health-related quality of life at 1-year post-donation and link their psychosocial profile before donation with their respective outcomes. The influence of the recipient's medical outcomes on their donor's psychosocial outcome was also examined. Sixty donors completed a battery of standardized psychometric instruments (quality of life, mental health, coping strategies, personality, socio-economic status), and ad hoc items regarding the donation process (e.g., motivations for donation, decision-making, risk assessment, and donor-recipient relationship). Donors' 1-year psychosocial follow-up was favorable and comparable with the general population. So far, cluster-analysis identified a subgroup of donors (28%) with a post-donation reduction of their health-related quality of life. This subgroup expressed comparatively to the rest, the need for more pre-donation information regarding surgery risks, and elevated fear of losing the recipient and commitment to stop their suffering.
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Affiliation(s)
- Ana Menjivar
- Medical School, University of Barcelona, Barcelona, Spain.,Laboratori Experimental de Nefrologia I Trasplantament (LENIT), Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Xavier Torres
- Psychiatry and Clinical Psychology Service, Institut Clinic de Neurociencies, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Marti Manyalich
- Medical School, University of Barcelona, Barcelona, Spain.,Transplant Assessorial Unit, Medical Direction, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Ingela Fehrman-Ekholm
- Karolinska Institutet, Transplantation Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Christina Papachristou
- Department for Internal Medicine and Psychosomatics, Charité, University Medicine, Berlin, Germany.,School of Psychology, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - Erika de Sousa-Amorim
- Department of Nephrology and Renal Transplant, Hospital Clinic of Barcelona, Barcelona, Spain
| | - David Paredes
- Medical School, University of Barcelona, Barcelona, Spain.,Donation and Transplant Coordination Section, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Christian Hiesse
- Service de Néphrologie et de Transplantation Rénale, Hôpital Foch, Suresnes Cedex, France
| | - Levent Yucetin
- Organ Transplant Coordination, Antalya Medical Park Hospital, Antalya, Turkey
| | - Federico Oppenheimer
- Laboratori Experimental de Nefrologia I Trasplantament (LENIT), Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Department of Nephrology and Renal Transplant, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Entela Kondi
- Medical School, University of Barcelona, Barcelona, Spain.,Transplant Assessorial Unit, Medical Direction, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Josep Maria Peri
- Psychiatry and Clinical Psychology Service, Institut Clinic de Neurociencies, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Niclas Kvarnström
- Department of Transplantation, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Chloë Ballesté
- Medical School, University of Barcelona, Barcelona, Spain
| | - Leonidio Dias
- Nephrology and Transplant Departments, Hospital Geral de Santo António, Porto, Portugal
| | - Inês C Frade
- Liaison-Psychiatry and Health Psychology Unit, Hospital Geral de Santo António, Porto, Portugal
| | - Alice Lopes
- Liaison-Psychiatry and Health Psychology Unit, Hospital Geral de Santo António, Porto, Portugal
| | - Fritz Diekmann
- Laboratori Experimental de Nefrologia I Trasplantament (LENIT), Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Department of Nephrology and Renal Transplant, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Ignacio Revuelta
- Medical School, University of Barcelona, Barcelona, Spain. .,Laboratori Experimental de Nefrologia I Trasplantament (LENIT), Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. .,Department of Nephrology and Renal Transplant, Hospital Clinic of Barcelona, Barcelona, Spain.
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10
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The Tangible Benefits of Living Donation: Results of a Qualitative Study of Living Kidney Donors. Transplant Direct 2020; 6:e626. [PMID: 33204824 PMCID: PMC7665258 DOI: 10.1097/txd.0000000000001068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/03/2020] [Accepted: 08/18/2020] [Indexed: 11/25/2022] Open
Abstract
The framework currently used for living kidney donor selection is based on estimation of acceptable donor risk, under the premise that benefits are only experienced by the recipient. However, some interdependent donors might experience tangible benefits from donation that cannot be considered in the current framework (ie, benefits experienced directly by the donor that improve their daily life, well-being, or livelihood).
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11
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Stubberud J, Holthe IL, Løvstad M, Schanke AK, Brandt A, Finnanger T. The feasibility and acceptability of goal management training of executive functions in children with spina bifida and acquired brain injury. Neuropsychol Rehabil 2020; 31:601-620. [PMID: 32065032 DOI: 10.1080/09602011.2020.1723649] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Executive dysfunction causes significant real-life disability for children with spina bifida (SB) and acquired brain injury (ABI), and efficient interventions are needed. Goal Management Training (GMT) is a cognitive rehabilitation intervention for improving executive function (EF) that has received empirical support in studies of adults with SB and ABI. The purpose of this study was to determine the feasibility and acceptability of a newly developed pediatric GMT protocol (pGMT). Thirteen children (7 boys, 10-16 years) with SB (n = 4), traumatic brain injury (n = 8), and encephalitis (n = 1) were included, based upon the presence of EF problems as described by parents. The participants received 21 h of pGMT, using inpatient intervention periods, followed by 4 h of pGMT outpatient guidance over 8 weeks. Notably, pGMT was found to be both feasible and acceptable, with satisfactory compliance for the children, parents and teachers, in addition to being considered acceptable by all participants. Furthermore, a reliable change in daily life EF was reported by the parents for 2 children. And, some children obtained scores below clinical cut-off on a measure of parent reported real-life EF after intervention. Hence, findings suggest that a randomized controlled trial of pGMT, with a larger sample size, should be conducted.
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Affiliation(s)
- Jan Stubberud
- TRS National Resource Centre for Rare Disorders, Nesoddtangen, Norway.,Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Ingvil L Holthe
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - Marianne Løvstad
- Department of Psychology, University of Oslo, Oslo, Norway.,Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - Anne-Kristine Schanke
- Department of Psychology, University of Oslo, Oslo, Norway.,Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - Anne Brandt
- Children's Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Torun Finnanger
- Children's Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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12
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Hamama-Raz Y, Ring L, Mahat-Shamir M, Ben-Ezra M. Death anxiety and psychological distress post-donation in non-directed living kidney donors. DEATH STUDIES 2019; 44:490-497. [PMID: 30907706 DOI: 10.1080/07481187.2019.1586793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The current study sought to assess death anxiety and psychological distress among kidney donors, in comparison to a control population. Seventy-eight non-directed living kidney donors were recruited through the Israeli voluntary kidney donation association. This sample was compared to 396 participants from a control population. The results revealed that non-directed living kidney donors had higher levels of death anxiety in comparison to the control population while their psychological distress was lower in comparison to the control population. The results of this study highlight the importance of relating to non-directed living kidney donors' death anxiety.
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Affiliation(s)
| | - Lia Ring
- School of Social Work, Ariel University, Ariel, Israel
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13
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Informative for Decision Making? The Spectrum and Consistency of Outcomes After Living Kidney Donation Reported in Trials and Observational Studies. Transplantation 2019; 103:284-290. [DOI: 10.1097/tp.0000000000002489] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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14
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Hanson CS, Chapman JR, Gill JS, Kanellis J, Wong G, Craig JC, Teixeira-Pinto A, Chadban SJ, Garg AX, Ralph AF, Pinter J, Lewis JR, Tong A. Identifying Outcomes that Are Important to Living Kidney Donors: A Nominal Group Technique Study. Clin J Am Soc Nephrol 2018; 13:916-926. [PMID: 29853616 PMCID: PMC5989678 DOI: 10.2215/cjn.13441217] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 03/14/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Living kidney donor candidates accept a range of risks and benefits when they decide to proceed with nephrectomy. Informed consent around this decision assumes they receive reliable data about outcomes they regard as critical to their decision making. We identified the outcomes most important to living kidney donors and described the reasons for their choices. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Previous donors were purposively sampled from three transplant units in Australia (Sydney and Melbourne) and Canada (Vancouver). In focus groups using the nominal group technique, participants identified outcomes of donation, ranked them in order of importance, and discussed the reasons for their preferences. An importance score was calculated for each outcome. Qualitative data were analyzed thematically. RESULTS Across 14 groups, 123 donors aged 27-78 years identified 35 outcomes. Across all participants, the ten highest ranked outcomes were kidney function (importance=0.40, scale 0-1), time to recovery (0.27), surgical complications (0.24), effect on family (0.22), donor-recipient relationship (0.21), life satisfaction (0.18), lifestyle restrictions (0.18), kidney failure (0.14), mortality (0.13), and acute pain/discomfort (0.12). Kidney function and kidney failure were more important to Canadian participants, compared with Australian donors. The themes identified included worthwhile sacrifice, insignificance of risks and harms, confidence and empowerment, unfulfilled expectations, and heightened susceptibility. CONCLUSIONS Living kidney donors prioritized a range of outcomes, with the most important being kidney health and the surgical, lifestyle, functional, and psychosocial effects of donation. Donors also valued improvements to their family life and donor-recipient relationship. There were clear regional differences in the rankings.
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Affiliation(s)
- Camilla S. Hanson
- Sydney School of Public Health and
- Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia
| | - Jeremy R. Chapman
- Centre for Transplant and Renal Research, Westmead Institute for Medical Research, The University of Sydney, Westmead, New South Wales, Australia
| | - John S. Gill
- Division of Nephrology, University of British Columbia, Vancouver, British Columbia, Canada
| | - John Kanellis
- Department of Nephrology, Monash Health and Centre for Inflammatory Diseases, Department of Medicine, Monash University, Clayton, Victoria, Australia
| | - Germaine Wong
- Sydney School of Public Health and
- Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia
- Centre for Transplant and Renal Research, Westmead Institute for Medical Research, The University of Sydney, Westmead, New South Wales, Australia
| | - Jonathan C. Craig
- Sydney School of Public Health and
- Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia
| | - Armando Teixeira-Pinto
- Sydney School of Public Health and
- Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia
| | - Steve J. Chadban
- Kidney Node, Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
- Renal Medicine, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Amit X. Garg
- Division of Nephrology, Department of Medicine, Western University, London, Ontario, Canada; and
| | - Angelique F. Ralph
- Sydney School of Public Health and
- Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia
| | - Jule Pinter
- Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia
- Division of Nephrology, Department of Medicine, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Joshua R. Lewis
- Sydney School of Public Health and
- Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia
| | - Allison Tong
- Sydney School of Public Health and
- Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia
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15
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Rodrigue JR, Schold JD, Morrissey P, Whiting J, Vella J, Kayler LK, Katz D, Jones J, Kaplan B, Fleishman A, Pavlakis M, Mandelbrot DA. Mood, body image, fear of kidney failure, life satisfaction, and decisional stability following living kidney donation: Findings from the KDOC study. Am J Transplant 2018; 18:1397-1407. [PMID: 29206349 PMCID: PMC5988866 DOI: 10.1111/ajt.14618] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 11/02/2017] [Accepted: 11/29/2017] [Indexed: 01/25/2023]
Abstract
Prior studies demonstrate that most living kidney donors (LKDs) report no adverse psychosocial outcomes; however, changes in psychosocial functioning at the individual donor level have not been routinely captured. We studied psychosocial outcomes predonation and at 1, 6, 12, and 24 months postdonation in 193 LKDs and 20 healthy controls (HCs). There was minimal to no mood disturbance, body image concerns, fear of kidney failure, or life dissatisfaction, indicating no incremental changes in these outcomes over time and no significant differences between LKDs and HCs. The incidence of any new-onset adverse outcomes postdonation was as follows: mood disturbance (16%), fear of kidney failure (21%), body image concerns (13%), and life dissatisfaction (10%). Multivariable analyses demonstrated that LKDs with more mood disturbance symptoms, higher anxiety about future kidney health, low body image, and low life satisfaction prior to surgery were at highest risk of these same outcomes postdonation. It is important to note that some LKDs showed improvement in psychosocial functioning from pre- to postdonation. Findings support the balanced presentation of psychosocial risks to potential donors as well as the development of a donor registry to capture psychosocial outcomes beyond the mandatory 2-year follow-up period in the United States.
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Affiliation(s)
- JR Rodrigue
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA,Harvard Medical School, Boston, MA
| | - JD Schold
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH
| | - P Morrissey
- Transplant Center, Rhode Island Hospital, Providence, RI
| | - J Whiting
- Maine Transplant Center, Maine Medical Center, Portland, ME
| | - J Vella
- Maine Transplant Center, Maine Medical Center, Portland, ME
| | - LK Kayler
- Montefiore Einstein Center for Transplantation, Bronx, NY,Regional Center of Excellence for Transplantation & Kidney Care, Erie County Medical Center, University of Buffalo, Buffalo, NY
| | - D Katz
- Organ Transplantation Program, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - J Jones
- Organ Transplantation Program, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - B Kaplan
- Department of Medicine, University of Arizona, Tucson, AZ,School for the Science of Health Care Delivery, Arizona State University, Phoenix, AZ
| | - A Fleishman
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA
| | - M Pavlakis
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA,Harvard Medical School, Boston, MA
| | - DA Mandelbrot
- Department of Medicine, University of Wisconsin, Madison, WI
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16
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Lanot A, Bouvier N, Chatelet V, Lecouf A, Tillou X, Hurault de Ligny B. [Outcome of living kidney donors for transplantation]. Nephrol Ther 2017; 13:448-459. [PMID: 29031488 DOI: 10.1016/j.nephro.2017.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 01/24/2017] [Accepted: 02/01/2017] [Indexed: 01/10/2023]
Abstract
Nowadays, several treatments exist to treat terminal chronic renal failure. Best results for the recipients are obtained with kidney transplantation concerning mortality and quality of life. Transplantation is also the cheaper option for society. Living kidney donation raises the issue of the becoming of the donor, an absolutely healthy subject who gets to a surgical procedure. The becoming of living kidney donors has been compared with the one of controls subjects in several studies. The evaluations focused on the complications of nephrectomy in the short and long-term: kidney failure, hypertension, proteinuria, possibility of pregnancy, quality of life, and mortality. The first results did not show any risk linked to kidney donation, compared to general population. However, since 2013, kidney donors were found at higher risk for kidney failure and even for mortality, compared with controls selected like donor candidates. The risk of kidney donation is nevertheless acceptable and minimal, on the condition of rigorous selection of candidates and regular follow-up.
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Affiliation(s)
- Antoine Lanot
- Service de néphrologie, dialyse et transplantation, CUMR, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France; Normandie université, Unicaen, UFR de médecine, 2 rue des rochambelles, 14032 Caen cedex, France.
| | - Nicolas Bouvier
- Service de néphrologie, dialyse et transplantation, CUMR, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France; Normandie université, Unicaen, UFR de médecine, 2 rue des rochambelles, 14032 Caen cedex, France
| | - Valérie Chatelet
- Service de néphrologie, dialyse et transplantation, CUMR, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France
| | - Angélique Lecouf
- Service de néphrologie, dialyse et transplantation, CUMR, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France
| | - Xavier Tillou
- Normandie université, Unicaen, UFR de médecine, 2 rue des rochambelles, 14032 Caen cedex, France; Service d'urologie, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France
| | - Bruno Hurault de Ligny
- Service de néphrologie, dialyse et transplantation, CUMR, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France; Normandie université, Unicaen, UFR de médecine, 2 rue des rochambelles, 14032 Caen cedex, France
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Brandel M, Vescovelli F, Ruini C. Beyond Ryff's scale: Comprehensive measures of eudaimonic well-being in clinical populations. A systematic review. Clin Psychol Psychother 2017; 24:O1524-O1546. [DOI: 10.1002/cpp.2104] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 05/24/2017] [Indexed: 01/08/2023]
Affiliation(s)
| | | | - Chiara Ruini
- Department of Psychology; University of Bologna; Bologna Italy
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18
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Stubberud J, Edvardsen E, Schanke AK, Lerdal A, Kjeverud A, Schillinger A, Løvstad M. Description of a multifaceted intervention programme for fatigue after acquired brain injury: a pilot study. Neuropsychol Rehabil 2017; 29:946-968. [DOI: 10.1080/09602011.2017.1344132] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Jan Stubberud
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - Espen Edvardsen
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - Anne-Kristine Schanke
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Anners Lerdal
- Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Nursing Science, University of Oslo, Oslo, Norway
| | | | - Andreas Schillinger
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - Marianne Løvstad
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
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Psychosocial assessment of living kidney donors: What implications have temperament and character for decision-making? Compr Psychiatry 2016; 67:1-8. [PMID: 27095327 DOI: 10.1016/j.comppsych.2016.02.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 02/04/2016] [Accepted: 02/08/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE We compared the personality of kidney donor candidates to non-donor controls and analyzed the personality profile of candidates psychosocially at risk. METHODS 49 consecutive living kidney donor candidates underwent an extensive psychosocial evaluation. Psychosocial risk factors concerning knowledge of donation risks (1), donor-recipient-relationship (2), and/or mental health (3) were rated on a 3-point rating scale (0=high risk, 2=no risk). Furthermore, candidates as well as 49 age-and gender-matched non-donor controls filled in questionnaires concerning psychological distress (Symptom Checklist 90-R) and personality (Temperament and Character Inventory). RESULTS There were no significant differences between candidates and controls concerning psychological distress or personality. Psychosocial assessment identified 13 candidates (26.5%) with increased psychosocial risk. This group displayed compared to candidates without psychosocial risk no difference concerning age, gender, formal education, donor-recipient relationship and psychological distress. However, this group scored significantly higher on reward dependence compared to suitable donors and controls (p<0.05). Reward dependence was associated with a lack of adequate knowledge on donation (r=-0.35, p<0.05). CONCLUSION Reward dependence has important implications for decision-making, because it is associated with an increased tendency to deny potential risks of donation. Careful identification and assessment of reward dependent donor candidates is needed to ensure a free-willed decision.
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20
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Timmerman L, Laging M, Timman R, Zuidema WC, Beck DK, IJzermans JN, Betjes MG, Busschbach JJ, Weimar W, Massey EK. The impact of the donors' and recipients' medical complications on living kidney donors' mental health. Transpl Int 2016; 29:589-602. [DOI: 10.1111/tri.12760] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 10/28/2015] [Accepted: 02/15/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Lotte Timmerman
- Department of Internal Medicine; Section Nephrology and Transplantation; Erasmus Medical Center Rotterdam; Rotterdam The Netherlands
| | - Mirjam Laging
- Department of Internal Medicine; Section Nephrology and Transplantation; Erasmus Medical Center Rotterdam; Rotterdam The Netherlands
| | - Reinier Timman
- Department of Psychiatry; Section Medical Psychology and Psychotherapy; Erasmus Medical Center Rotterdam; Rotterdam The Netherlands
| | - Willij C. Zuidema
- Department of Internal Medicine; Section Nephrology and Transplantation; Erasmus Medical Center Rotterdam; Rotterdam The Netherlands
| | - Denise K. Beck
- Department of Internal Medicine; Section Nephrology and Transplantation; Erasmus Medical Center Rotterdam; Rotterdam The Netherlands
| | - Jan N.M. IJzermans
- Department of General Surgery; Erasmus Medical Center Rotterdam; Rotterdam The Netherlands
| | - Michiel G.H. Betjes
- Department of Internal Medicine; Section Nephrology and Transplantation; Erasmus Medical Center Rotterdam; Rotterdam The Netherlands
| | - Jan J.V. Busschbach
- Department of Psychiatry; Section Medical Psychology and Psychotherapy; Erasmus Medical Center Rotterdam; Rotterdam The Netherlands
| | - Willem Weimar
- Department of Internal Medicine; Section Nephrology and Transplantation; Erasmus Medical Center Rotterdam; Rotterdam The Netherlands
| | - Emma K. Massey
- Department of Internal Medicine; Section Nephrology and Transplantation; Erasmus Medical Center Rotterdam; Rotterdam The Netherlands
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21
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Timmerman L, Timman R, Laging M, Zuidema WC, Beck DK, IJzermans JNM, Busschbach JJV, Weimar W, Massey EK. Predicting mental health after living kidney donation: The importance of psychological factors. Br J Health Psychol 2016; 21:533-54. [DOI: 10.1111/bjhp.12184] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 12/22/2015] [Indexed: 01/06/2023]
Affiliation(s)
- Lotte Timmerman
- Department of Internal Medicine; Section Nephrology & Transplantation; Erasmus Medical Center; Rotterdam The Netherlands
| | - Reinier Timman
- Department of Psychiatry; Section Medical Psychology and Psychotherapy; Erasmus Medical Center; Rotterdam The Netherlands
| | - Mirjam Laging
- Department of Internal Medicine; Section Nephrology & Transplantation; Erasmus Medical Center; Rotterdam The Netherlands
| | - Willij C. Zuidema
- Department of Internal Medicine; Section Nephrology & Transplantation; Erasmus Medical Center; Rotterdam The Netherlands
| | - Denise K. Beck
- Department of Internal Medicine; Section Nephrology & Transplantation; Erasmus Medical Center; Rotterdam The Netherlands
| | - Jan N. M. IJzermans
- Department of General Surgery; Erasmus Medical Center; Rotterdam The Netherlands
| | - Jan J. V. Busschbach
- Department of Psychiatry; Section Medical Psychology and Psychotherapy; Erasmus Medical Center; Rotterdam The Netherlands
| | - Willem Weimar
- Department of Internal Medicine; Section Nephrology & Transplantation; Erasmus Medical Center; Rotterdam The Netherlands
| | - Emma K. Massey
- Department of Internal Medicine; Section Nephrology & Transplantation; Erasmus Medical Center; Rotterdam The Netherlands
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22
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Erim Y, Kahraman Y, Vitinius F, Beckmann M, Kröncke S, Witzke O. Resilience and quality of life in 161 living kidney donors before nephrectomy and in the aftermath of donation: a naturalistic single center study. BMC Nephrol 2015; 16:164. [PMID: 26475323 PMCID: PMC4608317 DOI: 10.1186/s12882-015-0160-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 10/08/2015] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Due to the shortage of cadaveric organs, living kidney donation has begun to serve as the most crucial organ pool. Transplant centers have a legitimate interest in expanding the pool of donors. A psychosocial evaluation is established in transplantation centers to prevent donors from possible emotional harm in the aftermath of donation. We explored if the resilience questionnaire is an appropriate measure of the mental stability. To standardize procedures of psychosocial evaluation and to optimize donor recruitment, we present our evaluation protocol and analyze the causes of exclusion from donation. METHOD In a naturalistic design, we compared resilience and quality of life in eligible and excluded donors at the time point of donation. Potential living kidney donors (N = 161) participated in the obligatory psychosomatic evaluation. Quality of life (World Health Organization Quality of Life, WHOQOL-Bref) and resilience (Resilience Scale, RS-12) were measured. Three months after nephrectomy donors quality of life was screened in a follow-up. RESULTS In the evaluation interview donors were classified as eligible (n = 142) or excluded (n = 12). Nonrelated donors (n = 3) were excluded from donation significantly more often (p < .011). Eligible donors (M = 78.42, SD = 10.19) had higher values for resilience than excluded donors (M = 72.7, SD = 8.18, p < .04), who showed values comparable to the norm. In all domains of quality of life, eligible donors had significantly higher values than healthy normals (p < .001). After donation health-related quality of life decreased, but was comparable to the norm. A regression analysis showed that resilience was a significant predictor for all dimensions of quality of life before donation (R(2) = 10.2-24.6 %). Post-donation quality of life was significantly correlated with pre-donation resilience scores (p < .05). CONCLUSIONS The resilience score predicts high mental quality of life before and after donation. Therefor it can be implemented as a self-rating instrument to further objectify donor's mental stability. Despite the stressful life event of donation, donor candidates presented high resilience and high levels of quality of life. Therefor our findings support health care providers` intentions to improve living donation. In the group of excluded donors nonrelated persons were overrepresented. Guidelines for the admission of nonrelated donors are currently unclear and need to be optimized.
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Affiliation(s)
- Yesim Erim
- Department of Psychosomatic and Psychotherapeutic Medicine, University Hospital, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.
| | - Yeliz Kahraman
- Department of Psychosomatic and Psychotherapeutic Medicine, University Hospital, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.
| | - Frank Vitinius
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center, University of Cologne, Cologne, Germany.
| | - Mingo Beckmann
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
| | - Sylvia Kröncke
- Department of Medical Psychology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany.
| | - Oliver Witzke
- Department for Nephrology, Medical Faculty, University Duisburg-Essen, Essen, Germany.
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