Pre-transplant recipient-donor interaction: a prognostic indicator in living related kidney transplantation?

Based on the hypothesis that not only genetically determined immune characteristics, but also psychosocial and especially interpersonal factors may influence the outcome in living related kidney transplantation, we investigated the type of relationship between recipient and donor, and its association with graft prognosis. The study group consisted of 154 kidney transplant candidates and their selected donors. Donor and recipient were assessed prospectively prior to transplantation using an interactional task (Usandivaras Marbles Test) and assigned to one of four groups, according to their pattern of contact. Kidney survival was calculated for each test group, and results compared by life table methods and logistic regression. The group that showed progression from initial contact avoidance or enmeshment to contact with boundaries had a significantly better outcome than the other groups (no change or loss of contact with boundaries). Differences could not be related to other variables such as age, sex, sex difference, relationship, HLA-matching, and treatment.