Psychological and Psychopathological Aspects of Kidney Transplantation: A Systematic Review

Abstract

Kidney transplantation is a serious event that involves profound psychological, relational and social changes both for the patient and his family context. Assessment of personality profile, awareness of disease, family and social support of the patient candidate for kidney transplantation are necessary because factors not adequately considered, can influence the success of the transplant and alter the psychological stability of the patient. The present study aims to provide a systematic review of the literature of the last twelve years (2006-2018), focusing in particular on patient's readiness level and illness management and on possible psychopathology. Sixty-two studies were examined. Based on the Downs and Black checklist, most studies (n = 32) were of high quality; 15 of which related to lifestyle, health education, and therapeutic adherence in post-renal transplantation, 17 studies concerned the possible existence of psychopathology and cognitive impairment of renal deceased transplanted subjects. The literature used has shown that the population of kidney transplant patients is exposed to a high risk of psychiatric disorders with repercussions on the quality of life and the risk of rejection. Therefore, an adequate pre-transplant psychosocial assessment is necessary, which allows a more indepth knowledge of the candidate to plan coping strategies and possible posttransplant psychotherapy.

Validation and Adaptation of the “Modified Transplant Symptom Occurrence and Symptom Distress Scale” for Kidney Transplant Recipients

“…In addition, the physical functioning of QOL varies according to the duration of the immunosuppressive therapy after the transplantation. Participants in this study spent an average of five years or more after kidney transplantation, all of which showed few physical side effects, supporting previous findings [ 32 ]. Therefore, further studies are needed to determine whether the use of MTSOSD-59R is appropriate for long-term period recipients.…”

“…This is particularly evident when the QOL focuses on physical functions. A kidney transplant is a serious ongoing event that causes changes in psychological, relational, and social roles in the patient and his family [ 32 ]. Thus, the duration of immunosuppressant medication may be an important reference point for the use of MTSOSD-59R.…”

“…In previous studies, prominent adverse symptoms experienced were mainly physical, such as moon face or increased sweating, but this study found more psychological factors related to functioning, such as fatigue or lack of energy [ 6 , 33 ]. For kidney transplant recipients, emotional and psychological aspects are more associated with quality of life than physical adjustment [ 32 , 34 ]. In other words, the general weakness and psychosocial factors were the presenting and distressing symptoms, consistent with the results of this study.…”

General Approach to the Clinical Care of Solid Organ Transplant Recipients with COVID-19 Infection

“…Thus, the transplant team should assess mental health during their patient encounters and provide referrals or interventions as appropriate during this unprecedented challenge. In transplant recipients with COVID-19, depression, anxiety, and sleep disturbances associated with COVID-19 can worsen non-adherence to immunosuppressive therapy and increase the risk of allograft rejection [ 58 ]. Melatonin is an effective drug for anxiety and sleep disturbances, which might also be beneficial for clinical outcomes of patients with COVID-19 due to its anti-inflammatory and anti-oxidant properties [ 59 , 60 ].…”

Does oral health-related quality of life of patients after solid organ transplantation indicate a response shift? Results of a systematic review

“…The quality of life of patients with SOT, including kidney (KTx), liver (LTx), lung (LuTx) and heart (HTx), is complex, and different physical, psychological, (psycho-)social and environmental parameters are of relevance [2]. Organ transplantation is a life-changing experience for patients and their relatives, making cognitive and emotional integration of the received organ a mandatory condition [3]. In general, health-related quality of life (HRQoL) is improved after SOT; however, anxiety, depression and psychosocial impairment are frequently occurring problems, making psychosocial support interventions recommended [2,4,5].…”