MENTAL AND PSYCHOSOCIAL HEALTH OF LIVING KIDNEY DONORS IN TRIBHUVAN UNIVERSITY TEACHING HOSPITAL, NEPAL: GRATITUDE, CONTENMENT AND APPREHENSION

Introduction:

Living kidney donation is the main source of organ for renal transplantation in our country. Living kidney donation has complex ethical, moral, social and medical issues. It is mandatory to assure that it does not increase the risk to donor’s physical, psychological and mental health as a consequence of nephrectomy. Post donation follow up is usually focused in surgical and medical outcomes of nephrectomy. However, their psychosocial and mental health after kidney donation is not usually evaluated which may impact the donors quality of life.

Methods:

We conducted a cross-sectional observational study of Living kidney donors (LKD) at Department of nephrology and transplantation, Tribhuvan university teaching hospital (TUTH. Participants were provided with 3 sets of questionnaires. Short form 36 questionnaire (SF 36) was used to assess the health-related quality of life (HRQoL) in various domains of psychosocial health. Hospital anxiety and depression scale (HADS) was used to screen for anxiety and depression. A self-constructed questionnaire regarding various aspects pertinent to kidney donation was provided to respondents to evaluate their experience and attitude towards renal transplantation. Patients pre donation and post donation characteristics were recorded for age, gender, marital status, relationship with the recipient, duration from transplantation, age at transplantation, education status, occupation, income, graft state and recipient status. Data was analyzed by, statistical package for social sciences (SPSS) version 22 for windows. Mean and standard deviation was used for continuous variables and proportion used for categorical variables. Chi square test was used to determine association between two categorical variables. Independent t test was used for continuous variables. Statistical significance was considered for p value<0.05.

Results:

A total of 147 Living kidney donors participated in the study. The mean age of the cohort was 44.26 + 11.76 years. Mean age of donation of the cohort was 44.26 + 11.64 years. The post duration of follow up ranged from 6-164 months with mean duration of 51.85 + 37.96 months. The cohort consisted of 102(69.4%) female donors, 12(8.1%) were not schooled, 95(64.6%) were earning members, 90(61.2%) were engaged in some work or vocation.91 donors were genetically related, 53 were emotionally related. Overall, the donors (98%) were satisfied and were experiencing good post donation life. Regret over donation was low (6.8%), voluntary willful donation was high (75%) and majority (87.8%) would advocate others for Living kidney donation. 33% donors were bothered by the financial implications of donation. Prevalence of anxiety was 27.9% and depression was 6.1%. Female, non-earners, lower education status, unemployed status and parental donors were associated with these conditions. Donors HrQol was same or better in all domains of quality of life compared to population norm. Female donors scored lower in scales of physical functioning and vitality. Elder donors scored lower in physical functioning, bodily pain, general health, and physical component score.

Conclusions:

Living kidney donation is an act of personal austerity guided by the acts of benignity and non-maleficence toward the donor. Overall living kidney donors had good quality of life, psychosocial and mental health. But there were factors related to feeling of ambivalence, regret and anxiety among some donors. It is necessary to increase the pool of potential living kidney donors and expedite the legislation and organization required for cadaveric kidney donation for it to be structured and systematic

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.