Narrative ReviewThe Dynamics of Recipient-Donor Relationships in Living Kidney Transplantation
Section snippets
Social Support for Living Kidney Transplantation
A number of health studies placed a significant amount of emphasis on the extent of social support afforded to patients both as an indicator of their ability to endure some form of treatment intervention and to generate security and confidence.3, 4, 5, 6 However, that social support can cause stress, as well as allay it, receives less attention. It is not safe to assume that a patient has sufficient social support just because he or she is married. Social support also can be conditional on the
Characteristics of Relationships in Living Kidney Transplantations
A mutually acceptable pattern of attachment entails complementary thought processes, interpersonal behaviors, and corresponding moods.7 Within the context of the donor-recipient relationship, there would be a need to identify episodes of interaction with attention to whether both parties believed they were understood by the other and the appropriateness of the time frame and manner of response. We also need to understand the nature of response, counterresponses from the other party, and
Review of the Literature
We searched MEDLINE, the Cochrane Library, EMBASE, Cinhahl, World Wide Web, Royal College of Nursing journals, PsychINFO, and ASSIA by using the key words “psychosocial issues in donors of live kidney transplant” and “psychosocial issues in recipients of live kidney transplant.” Only articles in English were included. Priority was given to studies that were prospective and articles in the last 20 years. We avoided case reports or reports in abstract form, incomplete information, and duplicate
Critique of the Literature
We found 35 studies of psychosocial issues in live kidney donors and 13 studies of psychosocial issues in live kidney recipients, indicating a preference of researches to study psychosocial issues in live kidney donors. We believe living kidney transplant recipients are also an important group, and more studies should be done to better understand the psychosocial issues in this group. It also was interesting that the majority of studies were retrospective. We believe more prospective studies
Discussion
The reasoning behind living organ donation is often complex and varies from one individual to another. However, the main motivating factors appear to be the stress and anxiety of subjecting a loved one to prolonged dialysis therapy and the emotional and physical deterioration equated with long-term dialysis therapy. The key to gaining insight into the nature of a patient’s relationship with the donor in the present, along with their ability to form and retain attachments, lies in their past
Conclusion
It is already becoming apparent that the issue of living kidney donation is more complex than merely the need to determine whether a patient is being coerced.5 Physicians routinely address this issue privately with donors and offer them the opportunity of a pseudo-medical exclusion if they so wish.6 They need to be clear that the act of donation is a collaborative interaction that presents the recipient with a chance of a better quality of life.
We suggest that transplant centers carry out
Acknowledgements
Support: None.
Financial Disclosure: None.
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Cited by (38)
Withdrawal of the Decision to Donate Kidney by Living Related Donors: A Single-center Study in Japan
2018, Transplantation ProceedingsCitation Excerpt :Our study has also highlighted the need to pay more attention to the donor-recipient relationship and the lifestyle of the recipient. A recent systematic review of the dynamics of donor-recipient relationships in the context of living kidney transplantation revealed a lack of consensus on the structure and method for psychosocial screening before and after transplantation and donation in living kidney transplantation [26]. Given the diversity of the WG in this study, a screening methodology is needed that can flexibly adapt to an individualized context.
Donor and Recipient Views on Their Relationship in Living Kidney Donation: Thematic Synthesis of Qualitative Studies
2017, American Journal of Kidney DiseasesCitation Excerpt :Despite calls for research to focus on the donor-recipient dyad,17,25,27 our review has identified that although many studies address the donor-recipient relationship among broad psychosocial outcomes, there is a paucity of studies that have directly examined in detail the impact of living kidney donation on the relationship between the donor and recipient. Furthermore, to our knowledge, no study has examined the donor-recipient relationship from the perspective of both the donor and the recipient (ie, both parties involved in the relationship), with the majority of studies being conducted from the donor’s perspective25-27 and conducted postdonation. Whereas many current donor guidelines specifically address this issue of posttransplantation expectations and the donor-recipient relationship,20-24 recipient guidelines do not address this explicitly.49-51
The subjective experience of patients undergoing transplantation and implantation
2016, Evolution PsychiatriqueHaving a sibling as donor: Patients' experiences immediately before allogeneic hematopoietic stem cell transplantation
2014, European Journal of Oncology NursingCitation Excerpt :As far as we know, there is little knowledge about HSCT patients' experiences of having a sibling as donor. However, in studies of recipients of kidneys from living related donors, who are in a comparable situation to recipients of sibling stem cell donors, there are several descriptions of gratitude, guilt, willingness to repay the donor, responsibility, being indebted to and worried about the donor (Gill and Lowes, 2008; Sanner, 2003; Sajjad et al., 2007), similar to the findings revealed in our study. Before HSCT the patients may experience some sort of control of the situation at one moment and be overshadowed the next by a sense of no control at all and being powerless.
Current status of uterus transplantation in primates and issues for clinical application
2013, Fertility and SterilityCitation Excerpt :Furthermore, living-to-living UT involves an invasive procedure for all candidate donors compared with simple hysterectomy owing to removal of vascular pedicles that are as long as possible. Donors generally also have risks concerning physical and mental health (184); therefore, it is necessary to support donors to prevent mental problems, such as a sense of loss due to loss of the uterus, a symbolic female organ (185, 186). In addition, there are some data showing that hysterectomy decreases sexual satisfaction, interest, arousal, and orgasm and increases sexual dysfunction (187–189).
Dyadic adjustment and psychological concordance of kidney transplant recipients and donors after spousal transplantation
2012, Transplantation Proceedings
Originally published online as doi:10.1053/j.ajkd.2007.07.029 on October 3, 2007.