Psychological consequences for the recipient following a kidney transplantation

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Even before beginning the living donation process, recipients often wonder about how to broach the subject with the people in their lives. The discussion might come naturally to you, or perhaps you prefer to wait until someone else brings it up so that you don’t have to, because you are afraid of putting pressure on people. Recipients have different approaches, including handing out a leaflet discussing the possibilities offered by living donation or writing a letter. What matters most here is finding an approach you are comfortable with.

On the flipside of that same coin, recipients sometimes feel ambivalent or hesitant about accepting someone’s offer to make a living donation, because they are afraid of harming their loved one’s health. Communicating with the donor, searching for relevant information and taking the time to reflect are vital, as they will enable you to decide what is best for you. It is important that neither the recipient nor the donor feels obligated and that they can talk about it together. The context and the strength of the donor-recipient relationship are extremely important. Consequently, these issues may be discussed during your assessment process, when you meet with a member of the transplantation team, a health professional who specializes in evaluating and supporting those wishing to receive a kidney from a living donor.

Following a living donation, most recipients report a number of positive aspects of their experience and describe, in a general way, the major improvements in several areas of their life. They also noted strong feelings of recognition and gratitude toward their donor, though some people have a hard time fully expressing it.

Even if the donor has no expectation of getting anything back from the recipient following a living donation, recipients sometimes feel they owe or are responsible for their donor, or are under additional pressure to make the grafted kidney work because it came from a living donor. These feelings can have an impact on the relationship, so discussing these issues from the very outset often improves outcomes for both the donor and the recipient.
Note that even among recipients who do well medically after a transplant, a small proportion may develop psychological problems.

The issues include:

  • Fear of graft rejection;
  • Unmet expectations;
  • Psychological acceptance of the grafted kidney;
  • The shift from being a dialysis patient to being a transplant recipient, which causes a loss of bearings and of the social network built up through dialysis;
  • Returning to work;
  • Adapting to life after the transplant.

These issues can sometimes constitute major challenges that put a great strain on a person’s ability to adapt, regardless of the origin of the grafted kidney (deceased or living donor). Following the transplant, you might feel the need to seek help in order to discuss these issues further. If such a need arises, feel free to ask for help. It is one thing to know that you are receiving a graft. However, it is quite another thing, which will contribute greatly to your adaptation, to know that you will become a person who lives with a grafted kidney, that you will need to learn to live with an organ from someone else inside you, and that this could have repercussions on your life.