Psychological Reactions to Giving a Kidney

Abstract

Kidney transplantation involves the unique resource of donated kidneys. Both living relatives and “newly dead cadavers” can provide this resource, with a living relative donating one of his kidneys to save the life of a family member and with cadavers able to donate both kidneys to persons on a waiting list. Because of immunological processes, the living related kidneys have tended to do better and survive longer;¹ in addition, patients with willing related donors are spared the long and uncertain time on a waiting list. However, there is a widespread skepticism about the ability of a relative to make the major sacrifice of a kidney willingly and without significant regret later on.² The perception is that family blackmail and pressure will be pervasive and will be the major factor motivating the potential donor. Posttransplant, the loss of a body part will engender long-term regret and depression. Thus, at many centers the policy of using related donors is regarded as a major ethical problem.^3,4*