Predictors for longer-term health-related quality of life of living kid­­ney donors: A prospective multicenter study

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L. Wirken, H. van Middendorp, C.W. Hooghof, J.S.F Sanders, R.E. Dam, K.A.M.I van Donselaar-van der Pant, E.C.M. Berendsen, H. Wellink, P. Ulrichts, A.J. Hoitsma, L.B. Hilbrands, A.W.M. Evers

Chair(s): dr. Marion J. Siebelink, programmamanager Transplantatie Centrum, UMC Groningen & dr. Raechel J. Toorop, transplantatiechirurg, UMC Utrecht

Thursday 10 march 2016

9:00 - 9:10h at Zaal 14

Categories: Parallelsessie (donatie)

Parallel session: Parallelsessie IX - Donatie en Allocatie

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Background:
Longer-term post-donation health-related quality of life (HRQoL; i.e., physical, psychological, and social-relational functioning) is comparable to that before donation and to that of the general population for the majority of living kidney donors. However, a small subgroup of donors experiences worse longer-term functioning after donation, for example showing symptoms of depression, anxiety, or persistent fatigue. Current guidelines for psychosocial screening procedures are often not evidence-based, resulting from a scarcity of research identifying possible predictors for worse longer-term functioning after donation. The current study examined an encompassing account of predictors for longer-term HRQoL of living kidney donors, including the expert opinion of transplant professionals within the screening process.

Methods:
HRQoL of living kidney donors was assessed before, and six and twelve months after donation in 230 donors from seven Dutch transplantation centers. Potential socio-demographic, psychological, social, and physical predictors were assessed before donation. Also, risk estimation questionnaires were filled out by transplant professionals (nephrologists, coordinating nurses, social workers, and psychologists) after the first consultation with the donors.

Results:
Being single, worse pre-donation physical and psychological functioning and specifically higher levels of fatigue, were related to worse longer-term physical functioning after donation. The donor-recipient relationship, worse pre-donation physical and psychological functioning, and lower levels of social support were related to worse psychological functioning after donation. Also, higher risk estimations of transplant professionals were related to worse longer-term post-donation functioning.

Conclusion:
The risk factors for worse longer-term HRQoL identified in the current study could be used to optimize screening procedures for living kidney donors. Furthermore, interventions for donors at risk could focus on these risk factors to prevent worse longer-term outcomes in donors with a high risk profile.