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Kaul A, Bhaduaria D, Behera MR, Kushwaha R, Prasad N, Yachha M, Patel M, Kalitha J. Psycho-social health and quality of life among kidney donors following transplantation. Transpl Immunol 2022; 74:101649. [PMID: 35777614 DOI: 10.1016/j.trim.2022.101649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/09/2022] [Accepted: 06/09/2022] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Living kidney donation is a complex psychological experience for donors. The present study examined the psychosocial impact of kidney donation on donors. METHODS The retrospective study included 506 donors who donated a kidney between 2010 and 2018 at a transplant centre in India. These donors responded via a donor insight questionnaire about their hospital anxiety, and their possible level of depression. The information included socio-demographic form with multiple information. The health survey was used periodically evaluate the psychosocial impact among donors following donation, including the transplant outcomes. RESULTS The majority of donors were females (79.4%). There was a significant improvement in the quality of life among donors (SF-36) following the donation of a kidney, especially among those donors who maintained good graft functions themselves as well as those who were informed about good kidney function in transplanted recipients. These donors showed a lesser degree of depressive and anxiety scores (HAD score 3.5 and BDI II 4.8) than donors who had problems themselves and/or whose donated kidneys did not function well. Most living donors (89.1%) felt that the act of donation had a positive impact on their lives and those donors would encourage others to donate a kidney. Overall, the graft outcomes impacted the donor's state of mind. CONCLUSION The study showed a very positive impact of the acknowledgment of the donor by the recipient, especially those donors whose kidney transplants were well functioning. The state of depression, anxiety, and psycho-social outcomes correlated with the graft outcomes. Donors showed positive insight towards donation, with inner conscience still conclusively willing to donate and encourage others.
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Affiliation(s)
- A Kaul
- Department of Nephrology, Sanjay Gandhi Post Graduate institute of Medical Science, Lucknow, India.
| | - D Bhaduaria
- Department of Nephrology, Sanjay Gandhi Post Graduate institute of Medical Science, Lucknow, India
| | - M Ranjan Behera
- Department of Nephrology, Sanjay Gandhi Post Graduate institute of Medical Science, Lucknow, India
| | - Ravi Kushwaha
- Department of Nephrology, Sanjay Gandhi Post Graduate institute of Medical Science, Lucknow, India
| | - N Prasad
- Department of Nephrology, Sanjay Gandhi Post Graduate institute of Medical Science, Lucknow, India
| | - M Yachha
- Department of Nephrology, Sanjay Gandhi Post Graduate institute of Medical Science, Lucknow, India
| | - M Patel
- Department of Nephrology, Sanjay Gandhi Post Graduate institute of Medical Science, Lucknow, India
| | - J Kalitha
- Department of Neurology, Sanjay Gandhi Post Graduate institute of Medical Science, Lucknow, India
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Turksal E, Alper I, Sergin D, Yuksel E, Ulukaya S. [The effects of preoperative anxiety on anesthetic recovery and postoperative pain in patients undergoing donor nephrectomy]. Rev Bras Anestesiol 2020; 70:271-277. [PMID: 32653228 DOI: 10.1016/j.bjan.2020.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 02/19/2020] [Accepted: 03/20/2020] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES It is suggested that 38-45% of patients experience preoperative anxiety. We observe that patients undergoing living donor nephrectomy suffer from anxiety. Preoperative anxiety may complicate a patient's recovery from anesthesia and postoperative pain control. This study investigates the preoperative anxiety rate and its effect on anesthetic recovery and postoperative pain in patients undergoing donor nephrectomy. METHODS Forty-eight individuals undergoing living-related renal donor nephrectomy were included in this analytic prospective observational cohort study. Their preoperative anxiety was measured with the STAI-I and STAI-II inventories. The relationships between anxiety scores with data regarding demographics, recovery from anesthesia, and postoperative pain scores were investigated. RESULTS The findings were remarkable in that the anxiety scores of living renal donors were significantly correlated with their recovery variables, which are spontaneous respiration time, sufficient respiration time, extubation time, and PACU discharge time (p<0.01). Anxiety scores were significantly positively correlated with the pain scores of the 30th minute, 1st, 2nd, 4th, 8th, 12th, 24th hours, and the total amounts of analgesic administered in 24hours (p<0.05). A significantly negative correlation was also determined between anxiety scores and patients' satisfaction. CONCLUSION Our study showed that patients undergoing living-related donor nephrectomy with high anxiety levels had late recovery times and high postoperative pain scores. Thus, determining those patients with high preoperative anxiety level is crucial to providing patients with satisfactory emerging from anesthesia and the control of their postoperative pain during donor nephrectomy.
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Affiliation(s)
- Erbil Turksal
- Ankara Kecioren Education and Research Hospital, Department of Anesthesiology and Reanimation, Ankara, Turquia.
| | - Isik Alper
- Ege University, Faculty of Medicine, Department of Anesthesiology and Reanimation, İzmir, Turquia
| | - Demet Sergin
- Ege University, Faculty of Medicine, Department of Anesthesiology and Reanimation, İzmir, Turquia
| | - Esra Yuksel
- Ege University, Faculty of Medicine, Department of Anesthesiology and Reanimation, İzmir, Turquia
| | - Sezgin Ulukaya
- Ege University, Faculty of Medicine, Department of Anesthesiology and Reanimation, İzmir, Turquia
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Turksal E, Alper I, Sergin D, Yuksel E, Ulukaya S. The effects of preoperative anxiety on anesthetic recovery and postoperative pain in patients undergoing donor nephrectomy. BRAZILIAN JOURNAL OF ANESTHESIOLOGY (ENGLISH EDITION) 2020. [PMID: 32653228 PMCID: PMC9373665 DOI: 10.1016/j.bjane.2020.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background and objectives It is suggested that 38-45% of patients experience preoperative anxiety. We observe that patients undergoing living donor nephrectomy suffer from anxiety. Preoperative anxiety may complicate a patient’s recovery from anesthesia and postoperative pain control. This study investigates the preoperative anxiety rate and its effect on anesthetic recovery and postoperative pain in patients undergoing donor nephrectomy. Methods Forty-eight individuals undergoing living-related renal donor nephrectomy were included in this analytic prospective observational cohort study. Their preoperative anxiety was measured with the STAI-I and STAI-II inventories. The relationships between anxiety scores with data regarding demographics, recovery from anesthesia, and postoperative pain scores were investigated. Results The findings were remarkable in that the anxiety scores of living renal donors were significantly correlated with their recovery variables, which are spontaneous respiration time, sufficient respiration time, extubation time, and PACU discharge time (p < 0.01). Anxiety scores were significantly positively correlated with the pain scores of the 30th minute, 1st, 2nd, 4th, 8th, 12th, 24th hours, and the total amounts of analgesic administered in 24 hours (p < 0.05). A significantly negative correlation was also determined between anxiety scores and patients’ satisfaction. Conclusion Our study showed that patients undergoing living-related donor nephrectomy with high anxiety levels had late recovery times and high postoperative pain scores. Thus, determining those patients with high preoperative anxiety level is crucial to providing patients with satisfactory emerging from anesthesia and the control of their postoperative pain during donor nephrectomy.
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Affiliation(s)
- Erbil Turksal
- Ankara Kecioren Education and Research Hospital, Department of Anesthesiology and Reanimation, Ankara, Turquia.
| | - Isik Alper
- Ege University, Faculty of Medicine, Department of Anesthesiology and Reanimation, İzmir, Turquia
| | - Demet Sergin
- Ege University, Faculty of Medicine, Department of Anesthesiology and Reanimation, İzmir, Turquia
| | - Esra Yuksel
- Ege University, Faculty of Medicine, Department of Anesthesiology and Reanimation, İzmir, Turquia
| | - Sezgin Ulukaya
- Ege University, Faculty of Medicine, Department of Anesthesiology and Reanimation, İzmir, Turquia
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Holscher CM, Leanza J, Thomas AG, Waldram MM, Haugen CE, Jackson KR, Bae S, Massie AB, Segev DL. Anxiety, depression, and regret of donation in living kidney donors. BMC Nephrol 2018; 19:218. [PMID: 30180815 PMCID: PMC6122576 DOI: 10.1186/s12882-018-1024-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 08/28/2018] [Indexed: 01/04/2023] Open
Abstract
Background Previous studies have reported a wide range of prevalence of post-donation anxiety, depression, and regret in living kidney donors (LKDs). It is also unclear what risk factors are associated with these outcomes. Methods We screened 825 LKDs for anxiety and depression using 2-item GAD-2 and PHQ-2 scales and asked about regret. Results Overall, 5.5% screened positive for anxiety, 4.2% for depression, and 2.1% reported regretting their donation. While there was moderate correlation between positive anxiety and depression screens (r = 0.52), there was no correlation between regret and positive screens (r < 0.1 for both). A positive anxiety screen was more likely in LKDs with a positive depression screen (adjusted relative risk [aRR] 13.72, 95% confidence interval [CI] 6.78–27.74, p < 0.001). Similarly, a positive depression screen was more likely in LKDs with a positive anxiety screen (aRR 19.50, 95% CI 6.94–54.81, p < 0.001), as well as in those whose recipients experienced graft loss (aRR 5.38, 95% CI 1.29–22.32, p = 0.02). Regret was more likely in LKDs with a positive anxiety screen (aRR 5.68, 95% CI 1.20–26.90, p = 0.03). This was a single center cross-sectional study which may limit generalizability and examination of causal effects. Also, due to the low prevalence of adverse psychosocial outcomes, we may lack power to detect some associations between donor characteristics and anxiety, depression, or regret. Conclusions Although there is a low prevalence of anxiety, depression, and regret of donation among LKDs, these are interrelated conditions and a positive screen for one condition should prompt evaluation for other conditions.
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Affiliation(s)
- Courtenay M Holscher
- Department of Surgery, Johns Hopkins University School of Medicine, 2000 E. Monument St., Baltimore, MD, 21205, USA.
| | - Joseph Leanza
- Department of Surgery, Johns Hopkins University School of Medicine, 2000 E. Monument St., Baltimore, MD, 21205, USA
| | - Alvin G Thomas
- Department of Surgery, Johns Hopkins University School of Medicine, 2000 E. Monument St., Baltimore, MD, 21205, USA
| | - Madeleine M Waldram
- Department of Surgery, Johns Hopkins University School of Medicine, 2000 E. Monument St., Baltimore, MD, 21205, USA
| | - Christine E Haugen
- Department of Surgery, Johns Hopkins University School of Medicine, 2000 E. Monument St., Baltimore, MD, 21205, USA
| | - Kyle R Jackson
- Department of Surgery, Johns Hopkins University School of Medicine, 2000 E. Monument St., Baltimore, MD, 21205, USA
| | - Sunjae Bae
- Department of Surgery, Johns Hopkins University School of Medicine, 2000 E. Monument St., Baltimore, MD, 21205, USA.,Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Allan B Massie
- Department of Surgery, Johns Hopkins University School of Medicine, 2000 E. Monument St., Baltimore, MD, 21205, USA.,Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Dorry L Segev
- Department of Surgery, Johns Hopkins University School of Medicine, 2000 E. Monument St., Baltimore, MD, 21205, USA.,Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA
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Wu MK, Hsu LW, Huang KT, Lin CC, Wang CC, Lin TL, Li WF, Goto S, Chen CL, Chen CC. Assessment of relevant factors with respect to psychosocial properties in potential living donor candidates before liver transplantation. Neuropsychiatr Dis Treat 2018; 14:1999-2005. [PMID: 30122933 PMCID: PMC6087020 DOI: 10.2147/ndt.s165270] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Living donor liver transplantation (LDLT) has been developed as one of gold standard treatments for end-stage liver disease. Mental health is a required selection criterion for adult living liver donors and may influence the quality of life after operation. PATIENTS AND METHODS A total of 1,210 potential living donor candidates for liver transplantation (LT) underwent psychosocial evaluation that included a semi-structured interview, multi-choice self-reported inventory (Beck Depression Inventory-2nd edition [BDI-II], Beck Anxiety Inventory [BAI]), and the family APGAR (Adaptability, Partnership, Growth, Affection, Resolve) index. The test results were compared by family relationships, and subgroups were classified based on the donation type: 1) parents to children, 2) grown children to parents, 3) siblings to siblings, 4) spouses to spouses, and 5) other relatives to other relatives. RESULTS The BDI-II (P < 0.001) and BAI differed considerably according to the donation type in potential donor candidates. Compared with other subgroups, parents donating to their children suffered the most severe psychological stress before LDLT and exhibited more depressive (P < 0.001) and anxiety symptoms. However, the stress associated with grown children donating to their parents, siblings, and spouses was not significantly higher than it was for other relatives. Furthermore, a significant negative correlation existed between family APGAR scores and the severity of depression and anxiety (P < 0.001) among potential donor candidates. CONCLUSION These results indicate the importance of understanding potential donor candidates' psychological characteristics before LT. Greater anxiety and depression may be exhibited by parent donors due to the distress from fears of death or illness of the recipients, or their guilty feeling for their child. Additionally, family dysfunction also revealed more depression and anxiety. Such donor candidates should be given more extensive pre-donation counseling for minimizing pre-LDLT psychological stress.
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Affiliation(s)
- Ming-Kung Wu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan,
| | - Li-Wen Hsu
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan,
| | - Kuang-Tzu Huang
- Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Che Lin
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan,
| | - Chih-Chi Wang
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan,
| | - Ting-Lung Lin
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan,
| | - Wei-Feng Li
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan,
| | - Shigeru Goto
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan,
| | - Chao-Long Chen
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan,
| | - Chien-Chih Chen
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan,
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Pérez-San-Gregorio MÁ, Martín-Rodríguez A, Luque-Budia A, Conrad R. Concerns, Mental Health, and Quality of Life in Living Kidney Donation-Parent Donor Candidates Worry Less about Themselves. Front Psychol 2017; 8:564. [PMID: 28443056 PMCID: PMC5387064 DOI: 10.3389/fpsyg.2017.00564] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 03/27/2017] [Indexed: 01/10/2023] Open
Abstract
Even though the majority of living kidney donor candidates appear in good mental health and show few concerns little is known concerning the influence of the type of donor-recipient relationship on donor candidates' specific concerns with regard to kidney donation. 136 donor candidates at Virgen del Rocío University Hospital of Seville filled in the Scale of Concerns Regarding Living Kidney Donation of whom 105 donor candidates and their corresponding recipients (105 patients with End-Stage Renal Disease) were further evaluated with regard to mental health (Hospital Anxiety and Depression Scale, Beck Depression Inventory-II) and quality of life (SF-36 Health Survey). As hypothesized recipients scored higher on depression and lower on quality of life. Donor candidates intending to donate to their children were significantly less concerned about risks of donation for themselves compared to donor candidates donating to siblings. Our findings highlight the importance of the type of donor-recipient relationship to understand specific concerns of donor candidates and optimize psychosocial assessment and support. From an evolutionary perspective parents lack of concern about their own well-being can be seen as an altruistic behavior to increase children's fitness at the (potential) expense of their own fitness.
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Affiliation(s)
| | - Agustín Martín-Rodríguez
- Department of Personality, Assessment, and Psychological Treatment, University of SevilleSeville, Spain
| | - Asunción Luque-Budia
- Liaison Mental Health Services, University Hospital Virgen del RocíoSeville, Spain
| | - Rupert Conrad
- Department of Psychosomatic Medicine and Psychotherapy, University of BonnBonn, Germany
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