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Living Donor Anxiety and Stress Some anxiety and stress during the living donor evaluation and surgical process is normal and to be expected. In addition to the following, worries can include the possibility of being excluded (or approved) as a living donor, loved ones' reactions to the decision to donate, the long-term effects of one-kidney life including possible kidney failure, and physiological changes. According to one study, 39% of living donors claimed the "overall experience was at least somewhat stressful" (10). Furthermore, 8% were concerned about medical costs and 14% were worried about loss of income (10). In other studies, more than a third of donors reported feeling anxious about their own health, work, health insurance and recipient health after donation (23). Across other studies, 50% of living donors worried about the complications of nephrectomy (21)
Some living donors are unprepared for the reality of the actual surgery and physical recovery, especially if they've never been admitted to the hospital or experienced major surgery. 6-22% found the surgery and recovery stressful (12,13,14,15) and several found it unsettling (16). The physical postoperative state was stressful for 34% and 49% of donors (4,5) and 53% experienced at least some physical distress at work (17). When donors who underwent laparoscopic nephrectomy were compared to those who underwent open nephrectomy, stress scores were not significantly different (11).
It is not uncommon for prospective living donors to blind themselves to the possible negative repercussions of their choice in the weeks/months leading up to the surgery. According to Fellner's landmark study, "It appeared that not one of the donors weighed alternatives and decided rationally. 2/3 of the donors stated that they made their decision immediately when the subject of the kidney transplant was first mentioned over the telephone "in a split-second," "instantaneously," or "right away.", and "that once the decision had been made by the prospective donor, he carefully refrained from considering further data and engaged in several maneuvers which permitted him never to vary in his decision or even to question it." (82) Consequently, for a number of living donors, 'reality sets in' during the recovery period.** Living Donors were more anxious about death 1 and 6 months after donation (9).
Having one kidney caused worry for 3 to 36%
(4,5,15,18,19,8) and 31% of donors in two studies worried about
their remaining kidney failing (20,21). Of the donors 15% believed that donation impacted their health negatively, 34% worried at least once in a while about having only 1 kidney and 2% worried fairly often.(4)
**Very Important: This is not to say the living donor is to blame for her/his lack of preparedness. Transplant centers are often not completely candid about the long-term risks of living donation, or about the lack of comprehensive data on living donors' long-term health and well-being. The decision-making process of becoming a living donor is a very emotional one, and everyone's first priority is helping the sick recipient. The need for a truly Independent Living Donor Advocate is paramount and so far, unrealized.
Emotional/Mood Symptoms
Physical Symptoms
Click here for a more expansive list. Anxiety and stress-related symptoms can be linked to depression. According to the Anxiety Disorders Association of America (AADA), nearly one-half of people diagnosed with depression are also diagnosed with anxiety disorder. Treatments for Anxiety
Anxiety can also be a symptom of Post-Traumatic Stress Disorder. PTSD is not relegated to veterans, but affects anyone who has experienced a life-changing and traumatic event.
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