Impact of Perioperative Complications on Living Kidney Donor Health-Related Quality of Life and Mental Health: Results From a Prospective Cohort Study

Carlos Garcia-Ochoa, Liane S Feldman, Chris Nguan, Mauricio Monroy-Caudros, Jennifer B Arnold, Lianne Barnieh, Neil Boudville, Meaghan S Cuerden, Christine Dipchand, John S Gill, Martin Karpinski, Scott Klarenbach, Greg Knoll, Charmaine E Lok, Matthew Miller, G V Ramesh Prasad, Jessica M Sontrop, Leroy Storsley, Amit X Garg, Carlos Garcia-Ochoa, Liane S Feldman, Chris Nguan, Mauricio Monroy-Caudros, Jennifer B Arnold, Lianne Barnieh, Neil Boudville, Meaghan S Cuerden, Christine Dipchand, John S Gill, Martin Karpinski, Scott Klarenbach, Greg Knoll, Charmaine E Lok, Matthew Miller, G V Ramesh Prasad, Jessica M Sontrop, Leroy Storsley, Amit X Garg

Abstract

Background: Although living kidney donation is safe, some donors experience perioperative complications.

Objective: This study explored how perioperative complications affected donor-reported health-related quality of life, depression, and anxiety.

Design: This research was a conducted as a prospective cohort study.

Setting: Twelve transplant centers across Canada.

Patients: A total of 912 living kidney donors were included in this study.

Measurements: Short Form 36 health survey, Beck Depression Inventory and Beck Anxiety Inventory.

Methods: Living kidney donors were prospectively enrolled predonation between 2009 to 2014. Donor perioperative complications were graded using the Clavien-Dindo classification system. Mental and physical health-related quality of life was assessed with the 3 measurements; measurements were taken predonation and at 3- and 12-months postdonation.

Results: Seventy-four donors (8%) experienced a perioperative complication; most were minor (n = 67 [91%]), and all minor complications resolved before hospital discharge. The presence (versus absence) of a perioperative complication was associated with lower mental health-related quality of life and higher depression symptoms 3-month postdonation; neither of these differences persisted at 12-month. Perioperative complications were not associated with any changes in physical health-related quality of life or anxiety 3-month postdonation.

Limitations: Minor complications may have been missed and information on complications postdischarge were not collected. No minimal clinically significant change has been defined for kidney donors across the 3 measurements.

Conclusions: These findings highlight a potential opportunity to better support the psychosocial needs of donors who experience perioperative complications in the months following donation.

Trial registration: NCT00319579 and NCT00936078.

Keywords: depression; health-related quality of life; living kidney donation.

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: A.X.G. received operating grant support from the CIHR, which included partnership funding from Astellas for data collection. L.S.F. received investigator-initiated research grants from Merck and Johnson & Johnson and an educational grant from Medtronic.

© The Author(s) 2021.

Figures

Figure 1.
Figure 1.
Physical Component Summary (A) and Mental Component Summary (B) measured predonation and at 3- and 12-months postdonation, in those with perioperative complications (n = 74) and those without perioperative complications (n = 838).
Figure 2.
Figure 2.
Beck Depression Inventory (A) and Beck Anxiety Inventory (B) measured predonation and at 3 and 12 months postdonation, in those with perioperative complications (n = 74) and those without perioperative complications (n = 838).

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