SpringerLink
Log in

The Psychosocial Evaluation of Live Donors

  • Chapter
  • First Online:
Psychosocial Care of End-Stage Organ Disease and Transplant Patients

Abstract

Live organ donation is an essential and thriving part of organ transplantation. The transplant community allows live donors to express their autonomy by taking risk to themselves to benefit the recipient and to help ease the ever-increasing waitlist. Medical and psychosocial outcomes for the first post-donation decade have been encouraging for kidney and liver donors. Lung, pancreas, small intestine, and uterine donations have also been studied, but to a lesser extent. Kidney donation remains the most common type of live organ donation with altruistic or non-directed donation from strangers growing. At present non-directed donation of other solid organs is controversial given the increased medical and surgical risk. This chapter will review the procedures to evaluate these unique candidates as well as the risks and outcomes of live organ donation. The psychosocial team is important in this process to ensure a careful selection of organ donors and positive donor outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
EUR 29.95
Price includes VAT (Germany)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
EUR 149.79
Price includes VAT (Germany)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
EUR 192.59
Price includes VAT (Germany)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free ship** worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. University of Chicago Medicine [Internet]. Archive of press releases 2010. Available from: http://www.uchospitals.edu/news/2010/20100507-smith.html

  2. World Health Organization (WHO) Global Knowledge Base on Transplantation [Internet]. Available from: http://www.who.int/transplantation/gkt/statistics/en/

  3. LaPointe Rudow D. Experiences of the live organ donor: lessons learned pave the future. Narrat Inq Bioeth. 2012;12(1):45–54.

    Article  Google Scholar 

  4. Tong A, Chapman JR, Wong G, de Bruijn J, Craig JC. Screening and follow-up of living kidney donors: a systematic review of clinical practice guidelines. Transplantation. 2011;92(9):962–72.

    PubMed  Google Scholar 

  5. LaPointe RD, Hays R, Baliga P, Cohen DJ, Cooper M, Danovitch GM, et al. Consensus conference on best practices in live kidney donation: recommendations to optimize education, access, and care. Am J Transplant. 2015;15(4):914–22.

    Article  Google Scholar 

  6. Organ Procurement and Transplantation Network (OPTN). Policies on live donation. Available from: https://optn.transplant.hrsa.gov/media/1200/optn_policies.pdf

  7. Duerinckx N, Timmerman L, Van Gogh J, van Busschbach J, Ismail SY, Massey EK, Dobbels F. ELPAT psychological care for living donors and recipients working group. Predonation psychosocial evaluation of living kidney and liver donor candidates: a systematic literature review. Transpl Int. 2014;27(1):2–18.

    Article  Google Scholar 

  8. Adams PL, Cohen DJ, Danovitch GM, Edington RM, Gaston RS, Jacobs CL, et al. The nondirected live-kidney donor: ethical considerations and practice guidelines: a National Conference Report. Transplantation. 2002;74(4):582–9.

    Article  Google Scholar 

  9. Zargooshi J. Iranian kidney donors: motivations and relations with recipients. J Urol. 2001;165(2):386–92.

    Article  CAS  Google Scholar 

  10. Jowsey SG, Jacobs C, Gross CR, Hong BA, Messersmith EE, Gillespie BW, RELIVE Study Group, et al. Emotional well-being of living kidney donors: findings from the RELIVE study. Am J Transplant. 2014;14(11):2535–44.

    Article  CAS  Google Scholar 

  11. Dew MA, Butt Z, Liu Q, Simpson MA, Zee J, Ladner DP, et al. Prevalence and predictors of patient-reported long-term mental and physical health after donation in the adult-to-adult living-donor liver transplantation cohort study. Transplantation. 2018;102(1):105–18.

    Article  Google Scholar 

  12. Dew MA, DiMartini AF, DeVito Dabbs AJ, Zuckoff A, Tan HP, McNulty ML, et al. Preventive intervention for living donor psychosocial outcomes: feasibility and efficacy in a randomized controlled trial. Am J Transplant. 2013;13(10):2672–84.

    Article  CAS  Google Scholar 

  13. Timmerman L, Timman R, Laging M, Zuidema WC, Beck DK, IJzermans JN, et al. Predicting mental health after living kidney donation: the importance of psychological factors. Br J Health Psychol. 2016;21(3):533–54.

    Article  Google Scholar 

  14. Smith GC, Trauer T, Kerr PG, Chadban SJ. Prospective psychosocial monitoring of living kidney donors using the short Form-36 health survey: results at 12 months. Transplantation. 2004;78(9):1384–9.

    Article  Google Scholar 

  15. Meyer K, Wahl AK, Bjørk IT, Wisløff T, Hartmann A, Andersen MH. Long-term, self-reported health outcomes in kidney donors. BMC Nephrol. 2016;17:8.

    Article  Google Scholar 

  16. Rodrigue JR, Vishnevsky T, Fleishman A, Brann T, Evenson AR, Pavlakis M, Mandelbrot DA. Patient-reported outcomes following living kidney donation: a single center experience. J Clin Psychol Med Settings. 2015;22(2–3):160–8.

    Article  Google Scholar 

  17. Sotiropoulos GC, Radtke A, Molmenti EP, Schroeder T, Baba HA, Frilling A, et al. Long-term follow-up after right hepatectomy for adult living donation and attitudes toward the procedure. Ann Surg. 2011;254(5):694–700.

    Article  Google Scholar 

  18. Jacobs CL, Gross CR, Messersmith EE, Hong BA, Gillespie BW, Hill-Callahan P, RELIVE Study Group, et al. Emotional and financial experiences of kidney donors over the past 50 years: the RELIVE study. Clin J Am Soc Nephrol. 2015;10(12):2221–31.

    Article  Google Scholar 

  19. Clemens KK, Thiessen-Philbrook H, Parikh CR, Yang RC, Karley ML, Boudville N, et al. DONOR nephrectomy outcomes research (DONOR) network. Psychosocial health of living kidney donors: a systematic review. Am J Transplant. 2006;6(12):2965–77.

    Article  CAS  Google Scholar 

  20. Timmerman L, Laging M, Timman R, Zuidema WC, Beck DK, IJzermans JN, et al. The impact of the donors’ and recipients’ medical complications on living kidney donors’ mental health. Transpl Int. 2016;29(5):589–602.

    Article  Google Scholar 

  21. Maple H, Chilcot J, Weinman J, Mamode N. Psychosocial wellbeing after living kidney donation – a longitudinal, prospective study. Transpl Int. 2017;30(10):987–1001.

    Article  Google Scholar 

  22. Ladner DP, Dew MA, Forney S, Gillespie BW, Brown RS Jr, Merion RM, et al. Long-term quality of life after liver donation in the adult to adult living donor liver transplantation cohort study (A2ALL). J Hepatol. 2015;62(2):346–53.

    Article  Google Scholar 

  23. Papachristou C, Walter M, Frommer J, Klapp BF. Decision-making and risk-assessment in living liver donation: how informed is the informed consent of donors? A qualitative study. Psychosomatics. 2010;51(4):312–9.

    Article  Google Scholar 

  24. Tong A, Chapman JR, Wong G, Kanellis J, McCarthy G, Craig JC. The motivations and experiences of living kidney donors: a thematic synthesis. Am J Kidney Dis. 2012;60(1):15–26.

    Article  Google Scholar 

  25. Serur D, Bretzlaff G, Christos P, Desrosiers F, Charlton M. Solicited kidney donors: are they coerced? Nephrology (Carlton). 2015;20(12):952–5.

    Article  Google Scholar 

  26. Chang A, Anderson EE, Turner HT, Shoham D, Hou SH, Grams M. Identifying potential kidney donors using social networking web sites. Clin Transpl. 2013;27(3):E320–6.

    Article  Google Scholar 

  27. Thiessen C, Jaji Z, Joyce M, Zimbrean P, Reese P, Gordon EJ, Kulkarni S. Opting out: a single-centre pilot study assessing the reasons for and the psychosocial impact of withdrawing from living kidney donor evaluation. J Med Ethics. 2017;43(11):756–61.

    Article  Google Scholar 

  28. Butt Z, Dew MA, Liu Q, Simpson MA, Smith AR, Zee J, et al. Psychological outcomes of living liver donors from a multicenter prospective study: results from the adult-to-adult living donor liver transplantation cohort Study2 (A2ALL-2). Am J Transplant. 2017;17(5):1267–77.

    Article  CAS  Google Scholar 

  29. Surman OS, Fukunishi I, Allen T, Hertl M. Live organ donation: social context, clinical encounter, and psychology of communication. Psychosomatics. 2005;46:1.

    Article  Google Scholar 

  30. Schweitzer J, Seidel-Wiesel M, Verres R, et al. Psychologicalconsultation before living kidney donation: finding out and handling problem cases. Transplantation. 2003;76:1464–70.

    Article  Google Scholar 

  31. Shenoy A, Iacoviello B, Klipstein K, Filipovic Z, LaPointe Rudow D. Formative evaluation of the Living Donor Assessment Tool (LDAT): a review of cases histories, poster session, Academy of Psychosomatic Medicine, Fort Lauderdale, November 13th, 2014.

    Google Scholar 

  32. Weng LC, Huang HL, Tsai HH, Lee WC. Predictors of decision ambivalence and the differences between actual living liver donors and potential living liver donors. PLoS One. 2017;12(5):e0175672.

    Article  Google Scholar 

  33. Erim Y, Beckmann M, Kroencke S, Schulz KH, Tagay S, Valentin-Gamazo C, et al. Sense of coherence and social support predict living liver donors’ emotional stress prior to living-donor liver transplantation. Clin Transpl. 2008;22(3):273–80.

    Article  Google Scholar 

  34. Lai YC, Lee WC, Juang YY, Yen LL, Weng LC, Chou HF. Effect of social support and donation-related concerns on ambivalence of living liver donor candidates. Liver Transpl. 2014;20(11):1365–71.

    Article  Google Scholar 

  35. Erim Y, Beckmann M, Valentin-Gamazo C, Malago M, Frilling A, Schlaak J, et al. Selection of donors for adult living-donor liver donation: results of the assessment of the first 205 donor candidates. Psychosomatics. 2008;49(2):143–51.

    Article  Google Scholar 

  36. LaPointe RD, Iacoviello BM, Charney D. Resilience and personality traits among living liver and kidney donors. Prog Transplant. 2014;24(1):82–90.

    Article  Google Scholar 

  37. Erim Y, Kahraman Y, Vitinius F, Beckmann M, Kröncke S, Witzke O. Resilience and quality of life in 161 living kidney donors before nephrectomy and in the aftermath of donation: a naturalistic single center study. BMC Nephrol. 2015;16:164.

    Article  Google Scholar 

  38. Bramstedt KA. Alcohol abstinence criteria for living liver donors and their organ recipients. Curr Opin Organ Transplant. 2008;13(2):207–10.

    Article  Google Scholar 

  39. Heldt J, Torrey R, Han D, Baron P, Tenggardjaja C, McLarty J, et al. Donor smoking negatively affects donor and recipient renal function following living donor nephrectomy. Adv Urol. 2011;2011:929263.

    Article  Google Scholar 

  40. Rodrigue JR, Guenther R, Kaplan B, Mandelbrot DA, Pavlakis M, Howard RJ. Measuring the expectations of kidney donors: initial psychometric properties of the living donation expectancies questionnaire. Transplantation. 2008;85(9):1230–4.

    Article  Google Scholar 

  41. Wirken L, van Middendorp H, Hooghof CW, Sanders JF, Dam RE, van der Pant KAMI, et al. Pre-donation cognitions of potential living organ donors: the development of the donation cognition instrument in potential kidney donors. Nephrol Dial Transplant. 2017;32(3):573–80.

    Article  Google Scholar 

  42. Ismail SY, Timmerman L, Timman R, Luchtenburg AE, Smak Gregoor PJ, Nette RW, et al. A psychometric analysis of the Rotterdam renal replacement knowledge-test (R3K-T) using item response theory. Transpl Int. 2013;26(12):1164–72.

    Article  Google Scholar 

  43. Gordon EJ, Mullee J, Butt Z, Kang J, Baker T. Optimizing informed consent in living liver donors: evaluation of a comprehension assessment tool. Liver Transpl. 2015;21(10):1270–9.

    Article  Google Scholar 

  44. Massey EK, Timmerman L, Ismail SY, Duerinckx N, Lopes A, Maple H, et al. ELPAT psychosocial care for living donors and recipients working group. The ELPAT living organ donor psychosocial assessment tool (EPAT): from ‘what’ to ‘how’ of psychosocial screening – a pilot study. Transpl Int. 2018;31(1):56–70.

    Article  Google Scholar 

  45. Maldonado JR, Dubois HC, David EE, Sher Y, Lolak S, Dyal J, Witten D. The Stanford integrated psychosocial assessment for transplantation (SIPAT): a new tool for the psychosocial evaluation of pre-transplant candidates. Psychosomatics. 2012;53(2):123–32.

    Article  Google Scholar 

  46. Iacoviello BM, Shenoy A, Hunt J, Filipovic-Jewell Z, Haydel B, LaPointe Rudow D. A prospective study of the reliability and validity of the live donor assessment tool. Psychosomatics. 2017;58(5):519–26.

    Article  Google Scholar 

  47. Lapointe Rudow D, Swartz K, Phillips, et al. The psychosocial and independent living donor advocate evaluation and post-surgery care of living donors. J Clin Psychol Med Settings. 2015;22:136–49.

    Article  Google Scholar 

  48. LaPointe RD, Charlton M, Sanchez C, et al. Kidney and liver living donors: a comparison of experiences. Prog Transplant. 2005;15(2):185–91.

    Article  Google Scholar 

  49. Castedal M, Andersson M, Polanska-Tamborek D, Friman S, Olausson M, Fehrman-Ekholm I. Long-term follow-up of living liver donors. Transplant Proc. 2010;42(10):4449–54.

    Article  CAS  Google Scholar 

  50. O’Keeffe LM, Ramond A, Oliver-Williams C, Willeit P, Paige E, Trotter P, et al. Mid- and long-term health risks in living kidney donors: a systematic review and meta-analysis. Ann Intern Med. 2018. doi:https://doi.org/10.7326/M17-1235. [Epub ahead of print].

    Article  Google Scholar 

  51. Hall EC, Boyarsky BJ, Deshpande NA, Garonzik-Wang JM, Berger JC, Dagher NN, Segev DL. Perioperative complications after live-donor hepatectomy. JAMA Surg. 2014;149(3):288–91.

    Article  Google Scholar 

  52. Abecassis MM, Fisher RA, Olthoff KM, et al. Complications of living donor hepatic lobectomy—a comprehensive report. Am J Transplant. 2012;12(5):1208–17.

    Article  CAS  Google Scholar 

  53. DiMartini AF, Dew MA, Butt Z, Simpson MA, Ladner DP, Smith AR, Hill-Callahan P, Gillespie BW. Patterns and predictors of sexual function after liver donation: the adult-to-adult living donor liver transplantation cohort study. Liver Transpl. 2015;21(5):670–82.

    Article  Google Scholar 

  54. Trotter JF, Gillespie BW, Terrault NA, Abecassis MM, Merion RM, Brown RS Jr, et al. Adult-to-adult living donor liver transplantation cohort study group. Laboratory test results after living liver donation in the adult-to-adult living donor liver transplantation cohort study. Liver Transpl. 2011;17(4):409–17.

    Article  Google Scholar 

  55. Dew MA, Butt Z, Humar A, DiMartini AF. Long-term medical and psychosocial outomes in living liver donors. Am J Transplant. 2017;17:880–92.

    Article  CAS  Google Scholar 

  56. Messersmith EE, Gross CR, Beil CA, Gillespie BW, Jacobs C, Taler SJ, RELIVE Study Group, et al. Satisfaction with life among living kidney donors: a RELIVE study of long-term donor outcomes. Transplantation. 2014;98(12):1294–300.

    Article  Google Scholar 

  57. DiMartini A, Dew MA, Liu Q, Simpson MA, Ladner DP, Smith AR, et al. Social and financial outcomes of living liver donation: a prospective investigation within the adult-to-adult living donor liver transplantation Cohort Study 2 (A2ALL-2). Am J Transplant. 2017;17(4):1081–96.

    Article  CAS  Google Scholar 

  58. Trotter JF, Hill-Callahan MM, Gillespie BW, Nielsen CA, Saab S, Shrestha R, et al. A2ALL study group. Severe psychiatric problems in right hepatic lobe donors for living donor liver transplantation. Transplantation. 2007;83(11):1506–8.

    Article  Google Scholar 

  59. Dew MA, DiMartini AF, Ladner DP, Simpson MA, Pomfret EA, Gillespie BW, et al. Psychosocial outcomes 3 to 10 years after donation in the adult to adult living donor liver transplantation cohort study. Transplantation. 2016;100(6):1257–69.

    Article  Google Scholar 

  60. Getchell LE, McKenzi SQ, Sontrop JM, Hayward JS, McCallum MK, Garg AX. Increasing the rate of living donor kidney transplantation in Ontario: donor- and recipient-identified barriers and solutions. Can J Kidney Health Dis. 2017;4:1–8.

    Article  Google Scholar 

  61. Orandi BJ, Luo X, Massie AB, Garonzik-Wang JM, Lonze BE, Ahmed R, et al. Survival benefit with kidney transplants from HLA-incompatible live donors. N Engl J Med. 2016;374(10):940–50.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, Columbia University Medical Center, New York, NY, USA

    Akhil Shenoy

Authors
  1. Akhil Shenoy
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Akhil Shenoy .

Editor information

Editors and Affiliations

  1. Stanford University School of Medicine, Stanford, CA, USA

    Yelizaveta Sher

  2. Stanford University School of Medicine, Stanford, CA, USA

    José R. Maldonado

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Shenoy, A. (2019). The Psychosocial Evaluation of Live Donors. In: Sher, Y., Maldonado, J. (eds) Psychosocial Care of End-Stage Organ Disease and Transplant Patients. Springer, Cham. https://doi.org/10.1007/978-3-319-94914-7_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-94914-7_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-94913-0

  • Online ISBN: 978-3-319-94914-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation