TY - JOUR
T1 - Satisfaction with life and depressive symptoms in living organ donors and non-donors
T2 - New insights from the National Living Donor Assistance Center
AU - Mathur, Amit K.
AU - Hong, Barry A.
AU - Goodrich, Nathan P.
AU - Xing, Jiawei
AU - Warren, Patricia H.
AU - Gifford, Kimberly A.
AU - Merion, Robert M.
AU - Ojo, Akinlolu O.
N1 - Funding Information:
Return on investment for financial assistance for living kidney donors in the United States
Funding Information:
U13 HS07689-09-01. The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. This publication/presentation was supported by Grant No. U13HS030586 from the US Department of Health and Human Services, Health Resources and Services Administration's Division of Transplantation (HRSA/DoT). The contents of this publication/presentation are solely the responsibility of the author(s) and do not necessarily represent the views of HRSA/DoT. The authors would like to acknowledge Shauna Leighton of Arbor Research for editorial assistance.
Publisher Copyright:
© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
PY - 2020/5/1
Y1 - 2020/5/1
N2 - Background: Previous studies indicate there may be psychological consequences of being unable to serve as a living donor, but these have not been explored in a large national cohort of low-income individuals who initiated living donor evaluation in US transplant centers. Methods: Using data from 6574 National Living Donor Assistance Center (NLDAC) participants (November 1, 2007-December 31, 2018), we utilized a cross-sectional study design to evaluate short-term depressive symptoms and satisfaction with life in living donors and non-donors (those who were declined or withdrew from evaluation) using the Satisfaction with Life Scale (SWLS) and the PHQ-8, with and without risk adjustment using linear regression. Results: National Living Donor Assistance Center participants originated from 207 US transplant centers. 52% of NLDAC participants responded to the survey (n = 3423; donors = 2848 (58.6% of all donors), non-donors = 575 (33.5% of all non-donors); ncenters = 201)). Respondents were significantly older, more likely to be female, white, non-Hispanic, married, more educated, more full-time employed, and more likely to be unrelated to the recipient vs non-respondents (all, P <.001). Among survey respondents, donors were significantly younger, more likely to be non-Hispanic, employed, and related to the recipient compared to non-donors (all, P <.05). Higher PHQ-8 scores were correlated with lower SWL scores (r = −.32, P <.001). Both groups displayed high SWLS (donors vs non-donors: 27.1 vs 26.3, P =.002). Both groups had low levels of depressive symptoms overall, but donors had more symptoms than non-donors (3.5 vs 2.4, P <.001). After risk adjustment, non-donors had significantly less depressive symptoms by PHQ-8 (28% lower, P <.001), but had lower life satisfaction (1.2 points lower, P <.001). Conclusions: Donors and non-donors have high global levels of overall life satisfaction and low levels of depressive symptoms at 8 weeks after donation or denial. While small effect sizes were observed between groups in these outcomes, being a non-donor was an independent risk factor for lower life satisfaction, which warrants further evaluation.
AB - Background: Previous studies indicate there may be psychological consequences of being unable to serve as a living donor, but these have not been explored in a large national cohort of low-income individuals who initiated living donor evaluation in US transplant centers. Methods: Using data from 6574 National Living Donor Assistance Center (NLDAC) participants (November 1, 2007-December 31, 2018), we utilized a cross-sectional study design to evaluate short-term depressive symptoms and satisfaction with life in living donors and non-donors (those who were declined or withdrew from evaluation) using the Satisfaction with Life Scale (SWLS) and the PHQ-8, with and without risk adjustment using linear regression. Results: National Living Donor Assistance Center participants originated from 207 US transplant centers. 52% of NLDAC participants responded to the survey (n = 3423; donors = 2848 (58.6% of all donors), non-donors = 575 (33.5% of all non-donors); ncenters = 201)). Respondents were significantly older, more likely to be female, white, non-Hispanic, married, more educated, more full-time employed, and more likely to be unrelated to the recipient vs non-respondents (all, P <.001). Among survey respondents, donors were significantly younger, more likely to be non-Hispanic, employed, and related to the recipient compared to non-donors (all, P <.05). Higher PHQ-8 scores were correlated with lower SWL scores (r = −.32, P <.001). Both groups displayed high SWLS (donors vs non-donors: 27.1 vs 26.3, P =.002). Both groups had low levels of depressive symptoms overall, but donors had more symptoms than non-donors (3.5 vs 2.4, P <.001). After risk adjustment, non-donors had significantly less depressive symptoms by PHQ-8 (28% lower, P <.001), but had lower life satisfaction (1.2 points lower, P <.001). Conclusions: Donors and non-donors have high global levels of overall life satisfaction and low levels of depressive symptoms at 8 weeks after donation or denial. While small effect sizes were observed between groups in these outcomes, being a non-donor was an independent risk factor for lower life satisfaction, which warrants further evaluation.
KW - depression
KW - living organ donation
KW - satisfaction with life
KW - transplantation
UR - https://www.scopus.com/pages/publications/85081726366
U2 - 10.1111/ctr.13838
DO - 10.1111/ctr.13838
M3 - Article
C2 - 32073689
AN - SCOPUS:85081726366
SN - 0902-0063
VL - 34
JO - Clinical Transplantation
JF - Clinical Transplantation
IS - 5
M1 - e13838
ER -