Satisfaction with life and depressive symptoms in living organ donors and non-donors: New insights from the National Living Donor Assistance Center.

Abstract

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. 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. 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). Donors and non-donors have high global levels of overall life satisfaction and low levels of depressive symptoms at 8weeks 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.