Psychosocial consequences of living kidney donation: a prospective multicentre study on health-related quality of life, donor-recipient relationships and regret

Lieke Wirken*, Henriet van Middendorp, Christina W. Hooghof, Jan-Stephan F. Sanders, Ruth E. Dam, Karlijn A. M. I. van der Pant, Judith M. Wierdsma, Hiske Wellink, Elly M. van Duijnhoven, Andries J. Hoitsma, Luuk B. Hilbrands, Andrea W. M. Evers

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background Previous studies have indicated decreased health-related quality of life (HRQoL) shortly after kidney donation, returning to baseline in the longer term. However, a subgroup of donors experiences persistent HRQoL problems. To identify which HRQoL aspects are impacted most by the donation and to identify at-risk donors, more specific insight into psychosocial donation consequences is needed.

Methods The current study examined the HRQoL course, donor-perceived consequences of donation for donors, recipients and donor-recipient relationships, and regret up to 12months post-donation in donors from seven Dutch transplantation centres. Kidney donor candidates (n=588) completed self-report questionnaires early in the screening procedure, of which 361 (61%) donated their kidney.

Results Data for 230 donors (64%) with complete assessments before donation and 6 and 12months post-donation were analysed. Results indicated that donor physical HRQoL was comparable at all time points, except for an increase in fatigue that lasted up to 12months post-donation. Mental HRQoL decreased at 6months post-donation, but returned to baseline at 12months. Donors reported large improvements in recipient's functioning and a smaller influence of the recipient's kidney disease or transplantation on the donor's life over time. A subgroup experienced negative donation consequences with 14% experiencing regret 12months post-donation. Predictors of regret were more negative health perceptions and worse social functioning 6months post-donation. The strongest baseline predictors of higher fatigue levels after donation were more pre-donation fatigue, worse general physical functioning and a younger age.

Conclusions Future research should examine predictors of HRQoL after donation to improve screening and to provide potential interventions in at-risk donors.

Original languageEnglish
Pages (from-to)1045-1055
Number of pages11
JournalNephrology Dialysis Transplantation
Issue number6
Publication statusPublished - Jun 2019


  • course
  • donation consequences
  • health-related quality of life
  • living kidney donors
  • regret


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