Predicting post-donation family dysfunction in living kidney donors

Area of Science:

• Transplantation Medicine
• Psychosocial Health
• Family Dynamics

Background:

• Psychosocial assessment of living related-kidney donors (LRKT) is vital.
• Limited prospective data exist on post-transplant family functioning from the donor's perspective.
• Identifying at-risk donors pre-transplant is key for timely intervention.

Purpose of the Study:

• To identify preoperative psychosocial predictors of post-donation family dysfunction in LRKT donors.
• To identify clinical predictors of changes in family functioning after LRKT.
• To facilitate early, targeted interventions for high-risk LRKT donors.

Main Methods:

• 106 Japanese LRKT donors were analyzed.
• Family functioning assessed using the Family Assessment Device (FAD) pre- and post-donation (1 year).
• Binomial logistic regression identified predictors of family function deterioration.

Main Results:

• Most donors maintained stable family functioning.
• 17.2% of donors with good preoperative functioning experienced significant deterioration 1 year post-LRKT.
• Higher pre-LRKT FAD Affective Involvement scores and worse-than-anticipated post-LRKT life satisfaction predicted deterioration.

Conclusions:

• Pre-LRKT evaluation of family dynamics is critical.
• Inappropriate emotional connections and unmet expectations are potent predictors of donor-perceived family dysfunction.
• Comprehensive care addressing role changes and postoperative realities is essential for supporting high-risk LRKT donors.