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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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Shi Y, Zhang H, Nie Z, Fu Y. Quality of life, anxiety and depression symptoms in living related kidney donors: a cross‑sectional study. Int Urol Nephrol 2023; 55:2335-2343. [PMID: 36881268 DOI: 10.1007/s11255-023-03542-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 02/24/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVES Few studies have examined the quality of life of living kidney donors in mainland China. The data on anxiety and depression of living kidney donors was also scant. This study aimed to investigate quality of life, anxiety, and depression and identify their influencing factors among living kidney donors in mainland China. METHODS A cross-sectional study included 122 living kidney donors from a kidney transplantation center in China. The abbreviated World Health Organization Quality of Life questionnaire, Generalized Anxiety Disorder 2-item and Patient Health Questionnaire 2-item were used to assess the quality of life, anxiety and depression symptoms, respectively. RESULTS Our study found that the physical related quality of life of our donors was poorer than that of the domestic general population. Among 122 donors, 43.4% and 29.5% of them were found to have anxiety and depression symptoms, respectively. Poor health condition of recipient was identified as not only negative factors affecting all domains of quality of life, but also closely related to anxiety and depression of kidney donors. Donors with proteinuria were more likely to have a poor psychological, social related quality of life, as well as anxiety and depression symptoms. CONCLUSIONS Living kidney donation has an impact on the physical and mental health of donors. Both the physical and mental health of living kidney donors should not be ignored. More attention and support should be given to donors with proteinuria and donors whose relative recipient suffering poor health condition.
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Affiliation(s)
- Yuexian Shi
- School of Nursing, Peking University, Beijing, 100191, China
| | - Haiming Zhang
- National Clinical Research Center for Digestive Diseases and Beijing Key Laboratory of Tolerance Induction and Organ Protection in Transplantation, Beijing Friendship Hospital, Capital Medical University, 100050, Beijing, People's Republic of China
| | - Zhaoling Nie
- Department of Liver Transplantation, Tianjin First Center Hospital, Tianjin, 300192, China
| | - Yingxin Fu
- Kidney Transplant department (Liver transplant department), Transplant Center, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital, The Second Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China.
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Sedlár M, Grežo M. Willingness to participate in biobanking: The roles of Big Five personality traits and interpersonal trusting beliefs. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022. [DOI: 10.1016/j.paid.2022.111770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Assessment of cognitive functioning after living kidney donation: A cross-sectional pilot study. PLoS One 2022; 17:e0264284. [PMID: 35213618 PMCID: PMC8880950 DOI: 10.1371/journal.pone.0264284] [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: 10/03/2021] [Accepted: 02/07/2022] [Indexed: 11/24/2022] Open
Abstract
Background Chronic kidney disease (CKD) has emerged as a risk factor for cognitive impairment. Living kidney donation results in reduction of the donors’ renal function. This is considered acceptable in general but possible associations with cognitive function have not yet been studied. Methods Sixty living kidney donors (LKD), who had donated between 2003 and 2012 at Hannover Medical School, underwent neurocognitive testing including attentional and memory testing. In a cross-sectional design results were compared with data of healthy controls (n = 40) and with norm data given in the respective test manuals adjusted for age, sex, and education. Results The median age of the LKD was 58 (range 39–70) years and the median time since donation was 7 (range 4–14) years. The LKD did not differ from controls in most of the cognitive test results and a composite attention test sum score. However, LKD did worse than controls in tests of working memory, parallel processing of stimuli, and sustained attention. No differences were found regarding quality of life. In LKD cognitive test results correlated significantly only with educational level but not with time since transplantation, eGFR, somatic comorbidity, quality of life and levels of fatigue, distress, depression, and anxiety. Conclusions Our data show a fairly normal performance of LKD in most attentional and memory tests. However, our pilot study also suggests some cognitive impairment in attention tests in LKD which would need to be confirmed in longitudinal prospective studies.
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Yen CC, Lin CP, Su YT, Tsu CH, Chang LM, Sun ZJ, Lin BS, Wu JS. The Characteristics and Motivations of Taiwanese People toward Advance Care Planning in Outpatient Clinics at a Community Hospital. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062821. [PMID: 33802074 PMCID: PMC7999986 DOI: 10.3390/ijerph18062821] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/24/2021] [Accepted: 03/01/2021] [Indexed: 11/16/2022]
Abstract
Advance care planning (ACP) provides access to complete advance decisions (ADs). Despite the legalization of ACP in Taiwan, it is underutilized in community settings. The objective of this study is to describe the service at a community hospital in Southern Taiwan. We retrospectively analyzed participants who were engaged in ACP consultations from January 2019 to January 2020. The characteristics, motivations, content, and satisfaction of participants are reported. Factors associated with refusing life-sustaining treatments (LST) or artificial nutrition/hydration (ANH) were analyzed using multivariate logistic regression. Of the 178 participants, 123 completed the ACP. The majority were female (64.2%), aged 61 on average and more than 80% had never signed a do-not-resuscitate order. In the ADs, most participants declined LST (97.2%) and ANH (96.6%). Family-related issues (48.9%) were the most prevalent motivations. Rural residence (OR 8.6, p = 0.005), increased age (OR 7.2, p = 0.025), and reluctance to consent to organ donation (OR 5.2, p = 0.042) correlated with refusing LST or ANH. Participants provided a positive feedback regarding overall satisfaction (good, 83%) compared to service charge (fair/poor, 53%). The study demonstrated high AD completion when refusing LST or ANH. These findings may facilitate the development of ACP as a community-based service.
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Affiliation(s)
- Chih-Chieh Yen
- Division of Hematology/Oncology, Department of Internal Medicine, Douliou Branch, National Cheng Kung University Hospital, Yunlin 640, Taiwan;
- Institute of Clinical Medicine, School of Medicine, National Cheng Kung University, Tainan 704, Taiwan
| | - Cheng-Pei Lin
- Institute of Community Health Care, School of Nursing, National Yang Ming Chiao Tung University, Taipei 112, Taiwan;
| | - Yu-Ting Su
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan;
| | - Chiu-Hua Tsu
- Department of Social Work, Douliou Branch, National Cheng Kung University Hospital, Yunlin 640, Taiwan;
| | - Li-Mei Chang
- Department of Nursing, Douliou Branch, National Cheng Kung University Hospital, Yunlin 640, Taiwan;
| | - Zih-Jie Sun
- Division of Family Medicine, Department of Internal Medicine, Douliou Branch, National Cheng Kung University Hospital, Yunlin 640, Taiwan; (Z.-J.S.); (B.-S.L.)
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
- Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
| | - Bing-Sheng Lin
- Division of Family Medicine, Department of Internal Medicine, Douliou Branch, National Cheng Kung University Hospital, Yunlin 640, Taiwan; (Z.-J.S.); (B.-S.L.)
| | - Jin-Shang Wu
- Division of Family Medicine, Department of Internal Medicine, Douliou Branch, National Cheng Kung University Hospital, Yunlin 640, Taiwan; (Z.-J.S.); (B.-S.L.)
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
- Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
- Correspondence:
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Zuchowski M, Mamode N, Draper H, Gogalniceanu P, Norton S, Chilcot J, Clarke A, Williams L, Auburn T, Maple H. Experiences of completed and withdrawn unspecified kidney donor candidates in the United Kingdom: An inductive thematic analysis from the BOUnD study. Br J Health Psychol 2021; 26:958-976. [DOI: 10.1111/bjhp.12514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 12/23/2020] [Indexed: 01/24/2023]
Affiliation(s)
- Mira Zuchowski
- Department of Psychology Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - Nizam Mamode
- Department of Transplantation Guy's and St Thomas' NHS Foundation Trust London UK
| | - Heather Draper
- Health Sciences Warwick Medical School University of Warwick Coventry UK
| | - Peter Gogalniceanu
- Department of Transplantation Guy's and St Thomas' NHS Foundation Trust London UK
| | - Sam Norton
- Department of Psychology Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - Joseph Chilcot
- Department of Psychology Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - Alexis Clarke
- School of Psychology University of Plymouth Plymouth UK
| | | | | | - Hannah Maple
- Department of Transplantation Guy's and St Thomas' NHS Foundation Trust London UK
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The Spanish Version of the Fear of Kidney Failure Questionnaire: Validity, Reliability, and Characterization of Living Donors With the Highest Fear of Kidney Failure. Transplant Direct 2021; 7:e655. [PMID: 33490380 PMCID: PMC7817340 DOI: 10.1097/txd.0000000000001100] [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: 09/28/2020] [Revised: 10/23/2020] [Accepted: 10/26/2020] [Indexed: 11/26/2022] Open
Abstract
Background. Measures of fear of progression or recurrence of illnesses have been criticized for neglecting cross-cultural validity. Therefore, we assessed the psychometric properties of the Spanish version of the Fear of Kidney Failure Questionnaire (FKFQ), to determine whether postdonation fear of kidney failure (FKF) influenced the donors’ psychosocial status, and define variables that characterized donors with high FKFQ scores. Methods. We included 492 participants (211 donors) in a multicenter, 11-year, retrospective, cross-sectional study. Donors were classified with a Latent Class Analysis of the FKFQ-item scores and characterized with a multivariable logistic regression analysis. We calculated the risk ratio based on predicted marginal probabilities. Results. The Spanish version of the FKFQ showed acceptable psychometric properties. FKF was uncommon among donors, but we detected a small subgroup (n = 21, 9.9%) with high FKF (mean FKFQ score = 14.5, 3.1 SD). Compared with other donors, these donors reported higher anxiety and depression (38% and 29% of potential anxiety and depressive disorders), worse quality of life, and less satisfaction with the donation. Donors with high FKFQ scores were characterized by higher neuroticism combined with postdonation physical symptoms that interfered with daily activities. Conclusions. The FKFQ was cross-culturally valid, and thus, it may be used to assess the FKF in Spanish-speaking donors. New interventions that promote positive affectivity and evidence-based treatments for worry could be adapted for treating FKF.
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Rodrigue JR, Fleishman A, Schold JD, Morrissey P, Whiting J, Vella J, Kayler LK, Katz DA, Jones J, Kaplan B, Pavlakis M, Mandelbrot DA. Patterns and predictors of fatigue following living donor nephrectomy: Findings from the KDOC Study. Am J Transplant 2020; 20:181-189. [PMID: 31265199 DOI: 10.1111/ajt.15519] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/23/2019] [Accepted: 06/11/2019] [Indexed: 01/25/2023]
Abstract
This study sought to identify the prevalence, pattern, and predictors of clinical fatigue in 193 living kidney donors (LKDs) and 20 healthy controls (HCs) assessed at predonation and 1, 6, 12, and 24 months postdonation. Relative to HCs, LKDs had significantly higher fatigue severity (P = .01), interference (P = .03), frequency (P = .002), and intensity (P = .01), and lower vitality (P < .001), at 1-month postdonation. Using published criteria, significantly more LKDs experienced clinical fatigue at 1 month postdonation, compared to HCs, on both the Fatigue Symptom Inventory (60% vs. 37%, P < .001) and SF-36 Vitality scale (67% vs. 16%, P < .001). No differences in fatigue scores or clinical prevalence were observed at other time points. Nearly half (47%) reported persistent clinical fatigue from 1 to 6 months postdonation. Multivariable analyses demonstrated that LKDs presenting for evaluation with a history of affective disorder and low vitality, those with clinical mood disturbance and anxiety about future kidney failure after donation, and those with less physical activity engagement were at highest risk for persistent clinical fatigue 6 months postdonation. Findings confirm inclusion of fatigue risk in existing OPTN informed consent requirements, have important clinical implications in the care of LKDs, and underscore the need for further scientific examination in this population.
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Affiliation(s)
- James R Rodrigue
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Aaron Fleishman
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Jesse D Schold
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio
| | - Paul Morrissey
- Transplant Center, Rhode Island Hospital, Providence, Rhode Island
| | - James Whiting
- Maine Transplant Center, Maine Medical Center, Portland, Maine
| | - John Vella
- Maine Transplant Center, Maine Medical Center, Portland, Maine
| | - Liise K Kayler
- Montefiore Einstein Center for Transplantation, Bronx, New York.,Regional Center of Excellence for Transplantation & Kidney Care, Erie County Medical Center, University of Buffalo, Buffalo, New York
| | - Daniel A Katz
- Organ Transplantation Program, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Jody Jones
- Organ Transplantation Program, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Bruce Kaplan
- Department of Medicine, University of Arizona, Tucson, Arizona.,School for the Science of Health Care Delivery, Arizona State University, Phoenix, Arizona
| | - Martha Pavlakis
- The Transplant Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
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Nöhre M, Pollmann I, Mikuteit M, Weissenborn K, Gueler F, de Zwaan M. Partnership Satisfaction in Living Kidney Donors. Front Psychiatry 2018; 9:353. [PMID: 30123146 PMCID: PMC6085414 DOI: 10.3389/fpsyt.2018.00353] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 07/16/2018] [Indexed: 12/13/2022] Open
Abstract
Due to organ shortage, living kidney donation is gaining increasing importance. Medical progress enables a successful transplantation between unrelated individuals, even individuals with AB0-incompatibilities. Spouses are the largest group of living kidney donors. The aim of this study was to assess partnership status and partnership satisfaction in living kidney donors. In the cross-sectional study we investigated 361 living kidney donors. The time since donation ranged between 1 and 38 years. The partnership satisfaction was assessed with the German version of the Quality of Marriage Index. We compared the donor sample with a representative German population sample (n = 1995). In addition, we compared donors who have donated to their partner (spouse donors) to those who have donated to someone else (non-spouse donors). In comparison to the population sample significantly more kidney donors were living in a relationship (82 vs. 60%). Most donors reported an unchanged (76.6%) or improved (20.5%) relationship to the recipient since transplantation. A significantly higher partnership satisfaction could be found in the donor sample compared to the population sample which was mainly due to a higher partnership satisfaction of the spouse donors compared to the non-spouse donors. High partnership satisfaction in living kidney donors might be an indicator for a successful selection process before transplantation. Alternatively, kidney donation might have a stabilizing or even positive impact on the partnership. Due to the design of our study causative interpretations cannot be made. Therefore, prospective studies are required to assess partnership satisfaction before and after living kidney donation.
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Affiliation(s)
- Mariel Nöhre
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Iris Pollmann
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Marie Mikuteit
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany.,Department of Neurology, Hannover Medical School, Hannover, Germany.,Department of Nephrology, Hannover Medical School, Hannover, Germany
| | | | - Faikah Gueler
- Department of Nephrology, Hannover Medical School, Hannover, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
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