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2015 ; 16
(ä): 164
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Resilience and quality of life in 161 living kidney donors before nephrectomy and
in the aftermath of donation: a naturalistic single center study
#MMPMID26475323
Erim Y
; Kahraman Y
; Vitinius F
; Beckmann M
; Kröncke S
; Witzke O
BMC Nephrol
2015[Oct]; 16
(ä): 164
PMID26475323
show ga
BACKGROUND: Due to the shortage of cadaveric organs, living kidney donation has
begun to serve as the most crucial organ pool. Transplant centers have a
legitimate interest in expanding the pool of donors. A psychosocial evaluation is
established in transplantation centers to prevent donors from possible emotional
harm in the aftermath of donation. We explored if the resilience questionnaire is
an appropriate measure of the mental stability. To standardize procedures of
psychosocial evaluation and to optimize donor recruitment, we present our
evaluation protocol and analyze the causes of exclusion from donation. METHOD: In
a naturalistic design, we compared resilience and quality of life in eligible and
excluded donors at the time point of donation. Potential living kidney donors (N
= 161) participated in the obligatory psychosomatic evaluation. Quality of life
(World Health Organization Quality of Life, WHOQOL-Bref) and resilience
(Resilience Scale, RS-12) were measured. Three months after nephrectomy donors
quality of life was screened in a follow-up. RESULTS: In the evaluation interview
donors were classified as eligible (n = 142) or excluded (n = 12). Nonrelated
donors (n = 3) were excluded from donation significantly more often (p < .011).
Eligible donors (M = 78.42, SD = 10.19) had higher values for resilience than
excluded donors (M = 72.7, SD = 8.18, p < .04), who showed values comparable to
the norm. In all domains of quality of life, eligible donors had significantly
higher values than healthy normals (p < .001). After donation health-related
quality of life decreased, but was comparable to the norm. A regression analysis
showed that resilience was a significant predictor for all dimensions of quality
of life before donation (R(2)?= 10.2-24.6 %). Post-donation quality of life was
significantly correlated with pre-donation resilience scores (p < .05).
CONCLUSIONS: The resilience score predicts high mental quality of life before and
after donation. Therefor it can be implemented as a self-rating instrument to
further objectify donor's mental stability. Despite the stressful life event of
donation, donor candidates presented high resilience and high levels of quality
of life. Therefor our findings support health care providers` intentions to
improve living donation. In the group of excluded donors nonrelated persons were
overrepresented. Guidelines for the admission of nonrelated donors are currently
unclear and need to be optimized.