Psychiatric history in living kidney donor candidates

To critically discuss recent studies of living kidney donor candidates with a past or current psychiatric history and to offer guidance for the psychosocial evaluation of such donors.

A global consensus has been developed that active, significant mental illness and substance abuse are absolute contraindications to organ donation due to diminished ability to make a well informed, rational decision about donation or to maintain health status after donation. However, to date, there has been little information published on the suitability for donation and the long-term psychosocial and medical outcomes after donation in donors with mental health issues, especially relatively milder psychiatric disorders, or past significant psychiatric history.

To resolve the ethical dilemma of whether living donor candidates with mental health issues should be allowed to donate as is their right or be considered a vulnerable group in need of protection, we need more information. Information should include careful evaluation, possible intervention and follow-up to optimize donation.