Depression and self-report disclosure after live related donor and cadaver renal transplants

Important psychological reactions are associated with renal transplantation in general. Differences in psychological adjustment between recipients of kidneys from cadavers (CRs) and recipients of kidneys from live related donors (LRRs), however, have been poorly researched. In this study 10 LRRs (mean age 35,7 years; mean number of years after transplant 4,5) were compared with 30 CRs (mean age 38,6 years; mean number of years after transplant 5,3). The prevalence of depression and self-disclosed stress-inducing factors which might have affected long-term psychological adjustment after the transplant were investigated. The psychological status of each patient was assessed by means of a clinical interview, a mental status examination, the Beck Depression Inventory and a self-report questionnaire. There were found to be no long-term statistically significant differences between the LRR and CR groups in terms of the prevalence of depression, although 20% of the patients overall were depressed to varying degrees. The CR group was more concerned about the psychological and personal characteristics of the donors and their families than the LRR group, who expressed concern about the future well-being of the donors. Many members of both groups expressed having experienced both fear of graft rejection, before and immediately after the transplant, and anxiety, which decreased with time. The therapeutic value of a positive psychological climate in the renal unit and of supportive family relationships was confirmed for both groups. In comparison with their existence while on dialysis, most of the patients, irrespective of donor type, ultimately enjoyed an enhanced quality of life.