Fifty-one studies were included in the review, 10 of which were prospective studies. The included studies contained 5,139 donors, with sample sizes ranging from 12 to 536 donors.
Fourteen studies were insufficiently reported in terms of demographic information. The response rate could not be calculated for 9 studies. Where reported, the response rate averaged 71% (range: 33 to 95). Reasons for incomplete response were available for 20 studies, 11 studies collected information on nonresponders, and 5 studies compared responders with nonresponders.
Twenty-five studies assessed the quality of a donor’s relationship with their recipient, spouse, non-recipient children and family members after donation. Relationships were unchanged or improved with recipients (for 86 to 100% of donors; 15 studies); in marital relationships with spousal and non-spousal donors (for 82 to 98% of donors; 5 studies); in relationships between spousal or parental donors and their non-recipient children (for 95 to 100% of donors; 2 studies); and in terms of general family relationships (for 83 to 100% of donors; 4 studies).
Self-concept and body image.
Eighteen studies assessed self-concept, with six reporting that donors experienced an increase in self-esteem or self-worth after donating (no results were available). Ten studies assessed the donors’ perception of their physical appearance and their nephrectomy scar after donation; 4 studies reported that these did not present a problem with body image (results were available for 2 studies).
Thirty-six studies looked at the emotional well-being of donors after nephrectomy. In 5 studies, 77 to 95% of donors experienced no depression following donation (there was some discrepancy between the tabulated results and those reported in the text). Two studies found that 86 to 94% of donors did not suffer from anxiety following donation.
Quality of life.
Quality of life was considered in 29 studies, 22 of which used versions of the Short-Form health survey. In 17 of these studies donor scores were reported to be similar to, or better than, the general population (no results were available).
A small number of adverse effects were noted in the areas of body image, psychological well-being and quality of life (details were given in the paper). Further analyses on stress and other psychiatric symptoms were also reported.