Psychological characteristics and associations between kidney transplant recipients and biologically related or unrelated living donors: a retrospective observational study

Background : Although recipients and donors in living kidney transplantation are exposed to psychological distress, including depression and anxiety during the pre-operative period, only a few studies have evaluated their psychological relationship. This study aimed at determining the psychological characteristics and correlation between transplant recipients and donors as well as at investigating it in relation to biologically related and unrelated donors. Methods : This retrospective study on living kidney transplantation at the Korea University Anam Hospital was conducted from April 2008 to June 2019. While participants’ personality patterns were assessed using the Minnesota Multiphasic Personality Inventory-2(MMPI-2), their mood states before transplantation were evaluated via both the State-Trait Anxiety Inventory (STAI) and The Center for Epidemiologic Studies Depression Scale (CES-D). Statistical analysis was performed using a paired t-test and Spearman’s correlation analyses. Results : The recipient group showed a significantly higher sub-score in hypochondriasis (t =-4.49, P=.0001), depression (t =-3.36, P=.0015), hysteria (t =-3.30, P=.0018), STAI-T (t =-2.14, P=0.0372), and CES-D (t =-3.93, P=.0003) than donor group. A comparison of the psychological association between the recipient and donor groups revealed a significant positive correlation in the STAI-S (r=.357, P=.009) and CES-D (r=.362, P=.008). When assessing the difference in correlation based on the biological relationship between the recipients and donors, there is a positive correlation in CES-D (r=.415, P=.0202) in biologically related donors and recipients. In biologically unrelated but emotionally related group, recipients’ STAI-S score and donors’ STAI-S (r=0.413, P=.163), STAI-T (r=.559, P=009) score is positively correlated, and recipients’ STAI-T score and donors’ STAI-S (r=.466, P=.033), STAI-T (r=.520, P=.016) score is also positively correlated. Besides, recipients’ CES-D and donors’ STAI-S (r=.529, P=.014) and STAI-T (r=.560, P=.008) score show a positive correlation. Conclusions : The study indicated that transplantation recipients suffered from a higher level of depression and anxiety compared to the donors before transplantation. The findings suggest that recipients are more depressive and anxious than donors, and psychological problems like depression and anxiety can be shared in living kidney transplantation donors and recipients, especially in biologically unrelated but emotionally related groups.