Emotional well-being of living kidney donors: findings from the RELIVE Study

Abstract

Following kidney donation, short-term quality of life outcomes compare favorably to US normative data but long-term effects on mood are not known. In the Renal and Lung Living Donors Evaluation Study (RELIVE), records from donations performed 1963-2005 were reviewed for depression and antidepressant use predonation. Postdonation, in a cross-sectional cohort design 2010-2012, donors completed the Patient Health Questionnaire (PHQ-9) depression screening instrument, the Life Orientation Test-Revised, 36-Item Short Form Health Survey and donation experience questions. Of 6909 eligible donors, 3470 were contacted and 2455 participated (71%). The percent with depressive symptoms (8%; PHQ-9>10) was similar to National Health and Nutrition Examination Survey participants (7%, p=0.30). Predonation psychiatric disorders were more common in unrelated than related donors (p=0.05). Postdonation predictors of depressive symptoms included nonwhite race OR=2.00, p=0.020), younger age at donation (OR=1.33 per 10 years, p=0.002), longer recovery time from donation (OR=1.74, p=0.0009), greater financial burden (OR=1.32, p=0.013) and feeling morally obligated to donate (OR=1.23, p=0.003). While cross-sectional prevalence of depression is comparable to population normative data, some factors identifiable around time of donation, including longer recovery, financial stressors, younger age and moral obligation to donate may identify donors more likely to develop future depression, providing an opportunity for intervention.

Keywords: Clinical research; depression; donors and donation; donors and donation: donor follow-up; donors and donation: living; kidney transplantation; kidney transplantation: living donor; nephrology, social sciences; practice, health services and outcomes research.

Conflict of interest statement

Disclosure:

The authors of this manuscript have no conflicts of interest to disclose as described by the American Journal of Transplantation.

© Copyright 2014 The American Society of Transplantation and the American Society of Transplant Surgeons.

Figures

Figure 1

Histogram of Patient Health Questionnaire-9 Depression Scores in kidney donors 5 to 48 years after donation.

Figure 2

History of depression at donation from medical record review and self-reported depression based on the Patient Health Questionnaire-9 survey an average of 17 years after donation. Note: 72 donors with unknown history of depression at donation and 14 donors with missing Patient Health Questionnaire-9 scores are not shown in this figure.