2024-Living Kidney Donation,psychosocial outcome

Living kidney donors make a significant contribution to alleviating the organ shortage. The aim of this article
is to provide an overview of mid- and long-term (≥12 mo) living donor psychosocial outcomes and highlight areas that have
been understudied and should be immediately addressed in both research and clinical practice. We conducted a narrative
review by searching 3 databases. A total of 206 articles were included. Living donors can be divided into those who donate
to an emotionally or genetically related person, the so-called directed donors, or to an emotionally or genetically unrelated
recipient, the so-called nondirected donors. The most commonly investigated (bio)psychosocial outcome after living donation
was health-related quality of life. Other generic (bio)psychological outcomes include specific aspects of mental health
such as depression, and fatigue and pain. Social outcomes include financial and employment burdens and problems with
insurance. Donation-specific psychosocial outcomes include regret, satisfaction, feelings of abandonment and unmet needs,
and benefits of living kidney donation. The experience of living donation is complex and multifaceted, reflected in the cooccurrence
of both benefits and burden after donation. Noticeably, no interventions have been developed to improve mid- or
long-term psychosocial outcomes among living donors. We highlight areas for methodological improvement and identified
3 areas requiring immediate attention from the transplant community in both research and clinical care: (1) recognizing and
providing care for the minority of donors who have poorer long-term psychosocial outcomes after donation, (2) minimizing
donation-related financial burden, and (3) studying interventions to minimize long-term psychosocial problems