12th Congress of the Polish Transplantation Society
Renal transplantation
Living-Donor Versus Deceased-Donor Kidney Transplantation: Comparison of Psychosocial Consequences for Recipients

https://doi.org/10.1016/j.transproceed.2016.01.075Get rights and content

Highlights

  • No important differences in functioning of kidneys transplanted from living and deceased donors have been observed.

  • Duration of an illness and dialysis do not influence a quality of life in LD patients group.

  • LD post-transplant patients declare higher quality of life.

  • The LD organ recipients have a greater sense of happiness and of self-efficacy.

  • Result confirms the important role of social competences in the process of post-transplant adaptation.

Abstract

Introduction

Health benefits of a living-donor kidney transplantation are numerous and well known. There is, however, a dearth of knowledge on postoperative quality of life among the living-donor (LD) compared to deceased-donor (DD) transplant recipients.

Materials and Methods

The study involved 89 patients after renal transplantation: 48 from LDs and 41 from DDs. Interview data indirectly indicated the patients' health, whereas physiological parameters directly pinpointed the patients' health and the graft function. All study participants completed questionnaires to measure quality of life and the specificity of emotional and cognitive functioning.

Results

LD kidney recipients were younger than DD recipients (40 years vs. 49 years). LD and DD transplantation patients were similar in health status assessed by indirect methods (data from an interview) and direct methods (laboratory tests results). They, however, differed in their psychosocial functioning. LD patients had a greater sense of happiness (P < .01) and of self-efficacy (P = .07). Moreover, these patients were more actively involved in their social lives (P < .02) and were more satisfied with their social relationships (P = .07). LD recipients also had a higher quality of life in terms of mental functioning (P < .01) and satisfaction with their environments (P < .01). Additionally, there were significant correlations between quality of life and the quality of cognitive and emotional functioning in the group of LD recipients. The perceived impact of health on physical and professional activity and daily routines was similar in LD and DD groups.

Conclusions

LD post-transplantation patients may derive greater psychosocial benefits from this form of treatment. This effect is not dependent on somatic parameters (comparable data from an interview and laboratory tests results). This study suggests that patients should be assisted by a multidisciplinary healthcare team, and receive continuous support from relatives during the post-transplantation adaptation process. This facilitates the patients' postoperative quality of life.

Section snippets

Purpose

The benefits of kidney transplantation for the patients' QOL are well-known [14], [20]. However, only few studies compare transplantation outcomes for patients receiving a kidney from a living donor (LD) or a deceased donor (DD). In this study we aim to investigate differences between these two groups of patients in terms of their somatic, psychological, and social functioning. Consequently, we will be able to describe the psychosocial characteristics of the LD transplant recipients.

Material and Methods

The study was conducted between February 2015 and June 2015 among randomly selected renal transplantation patients who were under the care of the Department of Transplantation Medicine and Nephrology. We collected data on basic demographics, medical data indicating health status (laboratory tests results), and patients' self-reports about QOL and psychological functioning (questionnaires).

Medical Data Among LD and DD Kidney Recipients

The most common cause of kidney disease in both groups was glomerulonephritis and autosomal dominant polycystic kidney disease, diagnosed at a similar stage. Waiting time for kidney transplantation (KT) was shorter in the LD group (P < .05); in this group it was more often the first transplantation (P < .01). During the pre-dialysis period, KT was performed in 23% of recipients from the LD group in relation to 4.8% of recipients from the DD group. Post-transplantation complications and total

Discussion

The present study yielded interesting results. There were no significant differences in laboratory parameters between a group of recipients from LDs and from DDs. Determination of health benefits from receiving a transplant from a LD over a DD are usually performed in large samples and long after the transplantation. The lack of this difference in our study can probably be traced back to a small sample size and varied time since transplantation or by the high quality of medical care and good

Conclusions

The quality of patient's life after transplantation is strongly connected to the somatic condition, yet not fully dependent on it. Self-efficacy and social support are important aspects as well. Positive psychological effects of transplantation depend on the form of donation. Patients receiving a kidney from a living person declare a greater sense of happiness. Patients after kidney transplantation may achieve a high QOL if they receive systemic support. This systemic support should include:

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