Differences in emotional responses in living and deceased donor kidney transplant patients

Abstract

BackgroundThe psychological functioning of living donor (LD) and deceased donor (DD) recipients are important factors for emotional adjustment to transplantation. This study investigated differences in medical, sociodemographic and emotional factors between these two groups.MethodsA total of 241 kidney transplant recipients (68 LD, 173 DD) completed questionnaires on emotional and behavioural responses to transplantation, including quality of life, anxiety and depression, social support and experience with immunosuppressive medication.ResultsOverall, LD recipients were younger, better educated, more often employed and had a shorter duration of dialysis prior to transplantation. Findings indicate that LD recipients expressed more guilt towards the donor than DD recipients. In addition, more LD recipients experienced clinically significant levels of anxiety. Both groups experienced high levels of negative effects of immunosuppressant medication. No differences between LD and DD recipients were found for gender, relationship status, time since transplantation or transplant rejection treatment during the last 12 months. In addition, perceived social support and quality of life were comparable between the two groups.ConclusionsFeelings of guilt and anxiety may be an important focus for interventions to improve emotional adjustment to transplantation, especially in LD recipients.

Comparative Examination of the Life Quality in Hemodialysis Patients and Kidney Transplant Recipients in the Educational-Medical Centers of Ahvaz

“…The psychological problems that transplant patients were allocated to in Table 1 show a significant difference between the two groups (P = 0.030). That is because recipients had experienced clinically significant levels of anxiety and experienced high levels of negative effects of immunosuppressant medication (21).…”

High depression rates among pediatric renal replacement therapy patients: A cross‐sectional study

“…26,27 Another study, also in adults, found similar levels of depression between deceased and living donor recipients, although higher levels of anxiety in living donor recipients related to more guilt toward the donor. 28 The studies analyzing the impact of donor source are therefore inconsistent and the reasons of our findings in pediatric patients need to be elucidated.…”

Immunsuppressiva-Adhärenz nach Transplantation

“…Fehlende soziale Unterstützung stellt darin -abhängig vom Organ eine Kontraindikation zur Transplantation dar [41]. Alleinlebende Patienten scheinen gefährdeter zu sein, als die, die gemeinsam mit anderen in einem Haushalt wohnen [42,43]. Ladin et al [41] kommen in einem rezenten systematischen Review mit Metaanalyse jedoch zu dem Schluss, dass das Ausmaß an sozialer Unterstützung und der Familienstand eine nur geringe und inkonsistente Assoziation mit der Immunsuppressiva-Adhärenz und auch dem Transplantatüberleben zeigen.…”

“…Denhaerynck et al [30] sehen mögliche Gründe dafür darin, dass bei Spenden von genetisch verwandten Personen vom Empfänger eine hohe immunologische Übereinstimmung angenommen wird und aus dieser Annahme heraus eine geringere Notwendigkeit für die Einnahme der immunsuppressiven Medikation abgeleitet wird. Außerdem haben Empfänger von Lebendspenden häufig kürzere oder gar keine Zeit an der Dialyse verbracht und damit einen geringeren Leidensdruck, was einen Risikofaktor für Non-Adhärenz darstellt [30], obwohl Studien zeigen konnten, dass Schuldgefühle und Verantwortungsgefühl nach Lebendspende höher sind als nach postmortaler Spende [43].…”