Recently, two KDOC Study investigators (Jim Rodrigue, Paul Morrissey) published findings from a study examining the psychosocial and functional outcomes of adult living donors with no pre-existing emotional relationship to the transplant recipient. This so-called “anonymous donation to a stranger” has increased over the last several years and now accounts for about 3% of all living kidney donation in the United States. Most of these living donors respond to a plea for help – whether it be in the newspaper, a church bulletin, on a website, or through an organization – and may never have direct contact with the intended recipient. Many transplant centers do not consider these types of living donors, but Beth Israel Deaconess Medical Center and Rhode Island Hospital are two programs that routinely evaluate such donors in the New England region.
Rodrigue and Morrissey compared the psychosocial and functional outcomes of 39 altruistic donors to a stranger with those of 52 traditional donors, or living donors with a longstanding relationship with the recipient such as a sibling, relative, or close friend. The two groups of donors were similar on age, sex, and year of donation. They found that the motives of altruistic donors to a stranger did not differ significantly from more traditional living donors. Both types of donors were motivated by a desire to help, the benefits to the recipient outweighing the risks to the donor, a sense of moral duty, and imagining oneself in the position of the recipient. Also, they did not differ significantly on quality of life and psychological outcomes. Most donors reported meaningful personal growth and interpersonal benefits from living donation.
Importantly, although we found highly favorable outcomes for the majority of donors, Rodrigue and Morrissey also identified some areas of concern. For instance, six donors reported problems getting life insurance and two donors had difficulty getting health insurance due to their donation status. Despite the overall high quality of life found in the study, 7% of donors reported new-onset hypertension and several others reported health problems that they attributed to living donation, including exercise intolerance and positional injury requiring rehabilitation. Also, three altruistic donors to a stranger and one traditional donor regretted their decision to donate.
Overall, study findings are similar to those reported recently by researchers in The Netherlands, who similarly found that altruistic donors to a stranger have favorable psychological outcomes and few regrets. Collectively, these data suggest that carefully screened altruistic donors to a stranger should not be systematically excluded from the opportunity to donate.
Rodrigue JR, Schutzer ME, Paek M, Morrissey P. Altruistic kidney donation to a stranger: psychosocial and functional outcomes at two US transplant centers. Transplant. 2011; 91:772-8. [Abstract]
Altruistic Kidney Donation (9/2011)