Predicting mental health after living kidney donation: a single-center prospective cohort study

Abstract

Background: Living donor kidney transplantation offers advantages to patients, however, involves risks to donors. In order to promote donor safety, this study investigated factors predictive of mental health after donation, based on stress models of Lazarus (1999) and Ursin & Eriksen (2004). Methods: Living kidney donors (N=151) participated 2.5 months before, and 3 and 12 months after donation. Using multilevel linear models we examined whether appraisals, expectations (LDEQ), knowledge (R3K-T), social support (SSL), coping (COPE-Easy), and life events predicted psychological symptoms and wellbeing (BSI; PANAS; MHC-SF); and whether stress (DASS) mediated these relationships. Results: None of the factors predicted change in mental health. Lack of social support, expectations of negative health outcomes, lower appraisals of manageability, and an avoidant coping style were related to higher psychological symptoms. The latter three were mediated by stress. Lower social support, expectations of negative health outcomes, and lower positive appraisals of donation were related to lower level wellbeing. Conclusions: This study identified risk factors for negative psychological outcomes after living kidney donation that should guide assessment and care.