Psychological and Socioeconomic Outcomes Among Directed and Non-directed Living Kidney Donors

Abstract

Non-directed living kidney donors (NDDs) are unique from the traditional directed living donors in terms of the circumstances that led NDDs to undergo a donation. The purpose of this study was to synthesize and discuss key similarities, differences, and existing gaps in the literature comparing their kidney donation process experiences and post-donation outcomes among directed and non-directed donors. A total of eight recent studies were reviewed as part of this study. These studies provided insights into the socioeconomic, physical, and mental health outcomes experienced by NDDs and directed donors throughout the various stages of the evaluation and donation process. Among the studies, NDDs were generally not found to demonstrate having substantial differences as compared to the traditional directed donor within the realms of physical and psychosocial health outcomes post-donation. However, NDDs did have fewer financial burdens as compared to directed donors, which may be related to the differences in demographic characteristics and the limited study sample sizes. Recent evidence on outcomes among non-directed living donors as compared with directed donors should inform efforts to enhance the evaluation and post-donation experiences for this special population. While future studies remain warranted, the current literature signals that further improvements can be made by revisiting the current evaluation screening protocols for living kidney donation as well as the donation system’s infrastructure to help yield enhanced outcomes and experiences among both directed and non-directed donors.