Recipient Graft Failure or Death Impact on Living Kidney Donor Quality of Life Based on the Living Organ Donor Network Database

Watson, Justin; Behnke, Martha; Fabrizio, Michael D.; McCune, Thomas R.

doi:10.1089/end.2013.0189

Cited by 13 publications

(7 citation statements)

References 33 publications

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“…Our data also showed an association between fatigue and recipient death. This is in line with previous research which has demonstrated that recipient death can produce a feeling of guilt [ 32 ] and influence LKD’s well-being [ 10 , 33 ]. In addition, there were donors who had experienced a negative change in the relationship with the recipient, which may be disappointing.…”

Section: Discussionsupporting

confidence: 92%

“…Unfortunately, this aspect could not be addressed in the present study but paying attention to those who donate to a recipient at high-risk may be appropriate. Adverse outcomes for the recipient have also been found to be associated with adverse psychosocial outcomes for LKD in previous studies [ 10 , 32 , 33 ]. However, for the donor population as a whole, the donors in our study did not blame themselves if the result was poor.…”

Section: Discussionmentioning

confidence: 87%

“…Various factors other than age have also shown associations with QOL and fatigue post-donation, such as relationship to the recipient, pre-donation expectations, donation-related experience, transplant outcome and support from health professionals, family and friends [ 2 , 3 , 9 , 10 ]. Furthermore, positive experiences and perceptions of support seem to be protective, while reduced QOL has been related to fatigue, pain, long recovery time and recipient graft-failure.…”

Section: Introductionmentioning

confidence: 99%

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Long-term, self-reported health outcomes in kidney donors

et al. 2016

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BackgroundThe wide use of healthy persons as kidney donors calls for awareness of risks associated with donation. Live kidney donation may impair quality of life (QOL) and result in fatigue. Long-term data on these issues are generally lacking in the donor population. Thus we aimed to investigate long-term self-reported health outcomes in a nationwide donor cohort.MethodsWe assessed self-reported QOL, fatigue and psychosocial issues after donation in 217 donors representing 63 % of those who donated 8–12 years ago. QOL was measured using the generic Short Form-36 Health Survey (SF-36), fatigue using the Multidimensional Fatigue Inventory (MFI) and psychosocial issues using donor specific questions. For each of the 8 domains of SF-36 and the 5 domains of MFI, we performed generalized linear regression.ResultsDonors scored high on QOL with mean scores between 63.9 and 91.4 (scale 1–100) for the 8 subscales. Recognition from family and friends was associated with higher QOL scores in four domains. There were no significant gender differences. Fatigue scores were generally low. Females generally scored higher than males on all five dimensions of fatigue, although significantly only on two. Recipient still alive was associated with lower scores on mental fatigue. Regretting donors scored higher than average on all domains of fatigue. Recipient death, worries about own health and worsened relationship with the recipient influenced willingness to donate in retrospect. Donor age did not affect long-term health outcomes.ConclusionsEight till 12 years after donation QOL scores were generally high and improved with recogniton from family and friends. Fatigue was independent of donor age and more pronounced in females and in those who regretted donation.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

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Long-term, self-reported health outcomes in kidney donors

et al. 2016

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“…The multivariable analysis demonstrated that recent recipient death predicted lower donor PCS and MCS scores. A recent study identified an intermittent dip in HRQOL for living kidney donors whose recipient died [42]. Similar to our findings, those recipients mostly recovered back to baseline.…”

Section: Discussionsupporting

confidence: 89%

Long-term quality of life after liver donation in the adult to adult living donor liver transplantation cohort study (A2ALL)

Ladner

Dew

Forney

et al. 2015

Journal of Hepatology

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Background and Aims. There are few long-term studies of health-related quality of life (HRQOL) in living liver donors. This study aimed to characterize donor HRQOL in the Adult to Adult Living Donor Liver Transplantation Study (A2ALL) up to 11 years post-donation. Methods. Between 2004-2013, HRQOL was assessed at evaluation, and 3 months and yearly post-donation in prevalent liver donors using the Short Form survey (SF-36), which provides a physical (PCS) and a mental component summary (MCS). Results. Of the 458 donors enrolled in A2ALL, 374 (82%) had SF-36 data. Mean age at evaluation was 38 (range 18-63), 47% were male, 93% white, and 43% had a bachelor’s degree or higher. MCS and PCS means were above the US population at all time points. However, at every time point there were some donors who reported poor scores (>1/2 standard deviation below the age and sex adjusted mean) (PCS: 5.3%-26.8%, MCS: 10.0%-25.0%). Predictors of poor PCS and MCS scores included recipient death within the two years prior to the survey and education less than a bachelor’s degree; poor PCS scores were also predicted by time since donation, Hispanic ethnicity, and at the 3-month post-donation time point. Conclusions. In summary, most living donors maintain above average HRQOL up to 11 years prospectively supporting the notion that living donation does not negatively affect HRQOL. However, targeted support for donors at risk for poor HRQOL may improve overall HRQOL outcomes for living liver donors.

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“…Perhaps the main finding of our study is that recipients’ death almost tripled the risk of the donor becoming lost to follow‐up. Recipient's death has been related to negative outcomes in donors such as reduced motivation and activity, guilt and regretting donation . Less severe complications such as recipient re‐hospitalizations have been also related to the increase of psychological distress in donors .…”

Section: Discussionmentioning

confidence: 99%

Death of recipients after kidney living donation triples donors’ risk of dropping out from follow-up: a retrospective study

et al. 2017

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Although kidney transplantation from the donation of a living donor is a safe treatment for end-stage renal disease, inferences about safety of living kidney donors might be biased by an informative censoring caused by the noninclusion of a substantial percentage of donors lost to follow-up. With the aim of assessing the presence of a potential informative censoring in living kidney donation outcomes of Catalan donors for a period of 12 years, 573 donors followed and lost to follow-up were compared. Losses of follow-up over time were also assessed by univariate and multivariate survival analysis, along with Cox regression. Younger and older ages, and the death of their recipient differentiated those donors who were lost to follow-up over time. The risk of dropping out from follow-up was more than twofold for the youngest and oldest donors, and almost threefold for those donors whose recipient died. Results of studies on postdonation outcomes of Catalan living kidney donors might have overlooked older and younger cases, and, remarkably, a percentage of donors whose recipient died. If these donors showed a higher incidence of psychological problems, conclusions about living donors' safety might be compromised thus emphasizing the necessity of sustained surveillance of donors and prompt identification of these cases.

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Recipient Graft Failure or Death Impact on Living Kidney Donor Quality of Life Based on the Living Organ Donor Network Database

Abstract: Donor QoL declines after recipient death but recovers with time. Graft failure resulted in decreased QoL without recovery. The LODN database identifies factors affecting LKD QoL and provides a model for a national registry.

Cited by 13 publications

References 33 publications

Long-term, self-reported health outcomes in kidney donors

Long-term, self-reported health outcomes in kidney donors

Long-term quality of life after liver donation in the adult to adult living donor liver transplantation cohort study (A2ALL)

Death of recipients after kidney living donation triples donors’ risk of dropping out from follow-up: a retrospective study

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