Impact of Perioperative Complications on Living Kidney Donor Health-Related Quality of Life and Mental Health: Results From a Prospective Cohort Study.

Abstract

Background:Although living kidney donation is safe, some donors experience perioperative complications.Objective:This study explored how perioperative complications affected donor-reported health-related quality of life, depression, and anxiety.Design:This research was a conducted as a prospective cohort study.Setting:Twelve transplant centers across Canada.Patients:A total of 912 living kidney donors were included in this study.Measurements:Short Form 36 health survey, Beck Depression Inventory and Beck Anxiety Inventory.Methods:Living kidney donors were prospectively enrolled predonation between 2009 to 2014. Donor perioperative complications were graded using the Clavien-Dindo classification system. Mental and physical health-related quality of life was assessed with the 3 measurements; measurements were taken predonation and at 3- and 12-months postdonation.Results:Seventy-four donors (8%) experienced a perioperative complication; most were minor (n = 67 [91%]), and all minor complications resolved before hospital discharge. The presence (versus absence) of a perioperative complication was associated with lower mental health-related quality of life and higher depression symptoms 3-month postdonation; neither of these differences persisted at 12-month. Perioperative complications were not associated with any changes in physical health-related quality of life or anxiety 3-month postdonation.Limitations:Minor complications may have been missed and information on complications postdischarge were not collected. No minimal clinically significant change has been defined for kidney donors across the 3 measurements.Conclusions:These findings highlight a potential opportunity to better support the psychosocial needs of donors who experience perioperative complications in the months following donation.Trial registration:NCT00319579 and NCT00936078.