Long-term follow-up of living kidney donors: Quality of life after donation

The University of Minnesota has been a strong advocate of living donor kidn ey transplants. The benefits for living donor recipients have been well doc umented. The relative low risk of physical complications during donation ha s also been well documented, Less well understood is the psychosocial risk to donors. Most published reports have indicated an improved sense of well- being and a boost in self-esteem for living kidney donors. However, there h ave been some reports of depression and disrupted family relationships afte r donation, even suicide after a recipient's death. To determine the qualit y of life of our donors, we sent a questionnaire to 979 who had donated a k idney between August 1, 1984, and December 31, 1996, Of the 60% who respond ed, the vast majority had an excellent quality of life. As a group, they sc ored higher than the national norm on the SF-36, a standardized quality of life health questionnaire. However, 4% were dissatisfied and regretted the decision to donate. Further, 4% found the experience extremely stressful an d 8% very stressful. We used multivariate analysis to identify risk factors for this poor psychosocial outcome and found that relatives other than fir st degree (odds ratio=3.5, P=0.06) and donors whose recipient died within 1 year of transplant (odds ratio=3.3, P=0.014) were more likely to say they would not donate again if it were possible. Further, donors who had periope rative complications (odds ratio=3.5, P=0.007) and female donors (odds rati o=1.8, P=0.1.) were more likely to find the overall experience more stressf ul. Overall, the results of this study are over-whelmingly positive and hav e encouraged us to continue living donor kidney transplants.