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Differences Between Centers in Psychosocial Evaluations for Living Kidney Donors Do Not Influence Outcome: Results From an Observational Multicenter Study

Rather little is known about how psychosocial evaluations for living kidney donation (LKD) are performed. We aimed to explore whether Swiss transplant centers (STCs) vary regarding the rate of living kidney donors refused for psychosocial reasons, the psychosocial evaluation process, and the charact...

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Autores principales: Ludwig, Gundula, Geiger, Irene, Götzmann, Lutz, Jordan, Katja-Daniela, Döbbel, Susanne, Klaghofer, Richard, Salathé, Michelle, Stillhard, Urs, Meinlschmidt, Gunther, Kiss, Alexander, Venetz, Jean-Pierre, Steiger, Jürg, Hirt-Minkowski, Patricia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9722624/
https://www.ncbi.nlm.nih.gov/pubmed/36505899
http://dx.doi.org/10.1097/TXD.0000000000001400
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author Ludwig, Gundula
Geiger, Irene
Götzmann, Lutz
Jordan, Katja-Daniela
Döbbel, Susanne
Klaghofer, Richard
Salathé, Michelle
Stillhard, Urs
Meinlschmidt, Gunther
Kiss, Alexander
Venetz, Jean-Pierre
Steiger, Jürg
Hirt-Minkowski, Patricia
author_facet Ludwig, Gundula
Geiger, Irene
Götzmann, Lutz
Jordan, Katja-Daniela
Döbbel, Susanne
Klaghofer, Richard
Salathé, Michelle
Stillhard, Urs
Meinlschmidt, Gunther
Kiss, Alexander
Venetz, Jean-Pierre
Steiger, Jürg
Hirt-Minkowski, Patricia
author_sort Ludwig, Gundula
collection PubMed
description Rather little is known about how psychosocial evaluations for living kidney donation (LKD) are performed. We aimed to explore whether Swiss transplant centers (STCs) vary regarding the rate of living kidney donors refused for psychosocial reasons, the psychosocial evaluation process, and the characteristics of the donors. METHODS. We investigated 310 consecutive candidates for LKD in 4 of 6 existing STC during mandatory psychosocial evaluations. We registered (i) sociodemographic data, (ii) the type of the decision-making process regarding LKD (ie, snap decision, postponed, deliberate, other), (iii) the evaluator’s perception of the donor’s emotional bonding and his/her conflicts with the recipient, (iv) the donor’s prognosis from a psychosocial perspective, (v) time taken for the psychosocial evaluation, and (vi) its result (eligible, eligible with additional requirements, not eligible). RESULTS. Centers had comparable proportions of noneligible donors (2.9%–6.0%) but differed significantly in the percentage of donors accepted with additional requirements (3.4%–66%, P < 0.001). Significant differences emerged between centers regarding the time needed for evaluation (75–160 min [interquartile range (IQR) 75–180 min] per single exploration, P < 0.001), the perception of the donor’s emotional bonding (visual analogue scale [VAS] 8–9 [IQR 6–10], P < 0.001), his/her conflicts with the recipient (VAS 1.5–2 [IQR 0–3], P = 0.006), the donor’s psychosocial prognosis (VAS 8–9 [IQR 7–10], P < 0.001), and the type of decision concerning LKD (59%–82% with snap decision “yes,” P = 0.008). However, despite differences in the psychosocial evaluation process, the rates of patients accepted for transplantation (eligible and eligible with additional requirements versus noneligible) were comparable across STC (P = 0.72). CONCLUSIONS. Our results emphasize that it is more important to establish clear guidelines to identify potential psychosocial risks than to stringently standardize the procedure for psychosocial evaluation of living kidney donors.
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spelling pubmed-97226242022-12-09 Differences Between Centers in Psychosocial Evaluations for Living Kidney Donors Do Not Influence Outcome: Results From an Observational Multicenter Study Ludwig, Gundula Geiger, Irene Götzmann, Lutz Jordan, Katja-Daniela Döbbel, Susanne Klaghofer, Richard Salathé, Michelle Stillhard, Urs Meinlschmidt, Gunther Kiss, Alexander Venetz, Jean-Pierre Steiger, Jürg Hirt-Minkowski, Patricia Transplant Direct Kidney Transplantation Rather little is known about how psychosocial evaluations for living kidney donation (LKD) are performed. We aimed to explore whether Swiss transplant centers (STCs) vary regarding the rate of living kidney donors refused for psychosocial reasons, the psychosocial evaluation process, and the characteristics of the donors. METHODS. We investigated 310 consecutive candidates for LKD in 4 of 6 existing STC during mandatory psychosocial evaluations. We registered (i) sociodemographic data, (ii) the type of the decision-making process regarding LKD (ie, snap decision, postponed, deliberate, other), (iii) the evaluator’s perception of the donor’s emotional bonding and his/her conflicts with the recipient, (iv) the donor’s prognosis from a psychosocial perspective, (v) time taken for the psychosocial evaluation, and (vi) its result (eligible, eligible with additional requirements, not eligible). RESULTS. Centers had comparable proportions of noneligible donors (2.9%–6.0%) but differed significantly in the percentage of donors accepted with additional requirements (3.4%–66%, P < 0.001). Significant differences emerged between centers regarding the time needed for evaluation (75–160 min [interquartile range (IQR) 75–180 min] per single exploration, P < 0.001), the perception of the donor’s emotional bonding (visual analogue scale [VAS] 8–9 [IQR 6–10], P < 0.001), his/her conflicts with the recipient (VAS 1.5–2 [IQR 0–3], P = 0.006), the donor’s psychosocial prognosis (VAS 8–9 [IQR 7–10], P < 0.001), and the type of decision concerning LKD (59%–82% with snap decision “yes,” P = 0.008). However, despite differences in the psychosocial evaluation process, the rates of patients accepted for transplantation (eligible and eligible with additional requirements versus noneligible) were comparable across STC (P = 0.72). CONCLUSIONS. Our results emphasize that it is more important to establish clear guidelines to identify potential psychosocial risks than to stringently standardize the procedure for psychosocial evaluation of living kidney donors. Lippincott Williams & Wilkins 2022-11-04 /pmc/articles/PMC9722624/ /pubmed/36505899 http://dx.doi.org/10.1097/TXD.0000000000001400 Text en Copyright © 2022 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Kidney Transplantation
Ludwig, Gundula
Geiger, Irene
Götzmann, Lutz
Jordan, Katja-Daniela
Döbbel, Susanne
Klaghofer, Richard
Salathé, Michelle
Stillhard, Urs
Meinlschmidt, Gunther
Kiss, Alexander
Venetz, Jean-Pierre
Steiger, Jürg
Hirt-Minkowski, Patricia
Differences Between Centers in Psychosocial Evaluations for Living Kidney Donors Do Not Influence Outcome: Results From an Observational Multicenter Study
title Differences Between Centers in Psychosocial Evaluations for Living Kidney Donors Do Not Influence Outcome: Results From an Observational Multicenter Study
title_full Differences Between Centers in Psychosocial Evaluations for Living Kidney Donors Do Not Influence Outcome: Results From an Observational Multicenter Study
title_fullStr Differences Between Centers in Psychosocial Evaluations for Living Kidney Donors Do Not Influence Outcome: Results From an Observational Multicenter Study
title_full_unstemmed Differences Between Centers in Psychosocial Evaluations for Living Kidney Donors Do Not Influence Outcome: Results From an Observational Multicenter Study
title_short Differences Between Centers in Psychosocial Evaluations for Living Kidney Donors Do Not Influence Outcome: Results From an Observational Multicenter Study
title_sort differences between centers in psychosocial evaluations for living kidney donors do not influence outcome: results from an observational multicenter study
topic Kidney Transplantation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9722624/
https://www.ncbi.nlm.nih.gov/pubmed/36505899
http://dx.doi.org/10.1097/TXD.0000000000001400
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