Khira Hennemann1, Maximilian Bauer-Hohmann1, Felix Klewitz1, Uwe Tegtbur2, Lars Pape3, Lena Schiffer4, Mario Schiffer5, Martina de Zwaan1, Mariel Nöhre6. 1. Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany; Project Kidney Transplantation 360° (NTx360°), Hannover Medical School, Hannover, Germany. 2. Department of Sports Medicine, Hannover Medical School, Hannover, Germany; Project Kidney Transplantation 360° (NTx360°), Hannover Medical School, Hannover, Germany. 3. Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany; Department of Pediatrics II, University Hospital Essen, Essen, Germany; Project Kidney Transplantation 360° (NTx360°), Hannover Medical School, Hannover, Germany. 4. Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany; Project Kidney Transplantation 360° (NTx360°), Hannover Medical School, Hannover, Germany. 5. Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany; Department of Nephrology and Hypertension, University Hospital Erlangen, Erlangen, Germany; Project Kidney Transplantation 360° (NTx360°), Hannover Medical School, Hannover, Germany. 6. Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany; Project Kidney Transplantation 360° (NTx360°), Hannover Medical School, Hannover, Germany. Electronic address: noehre.mariel@mh-hannover.de.
Abstract
OBJECTIVE: Organ transplantation is the treatment of choice for patients with end-stage organ disease. From early on, the psychological perspective on integrating the organ has been of interest. As quantitative studies on organ integration are scarce, we aimed at evaluating this aspect in a large sample of kidney transplant (KTx) recipients. METHODS: For this cross-sectional study, 684 patients after KTx were recruited within the structured post-transplant care program KTx360°. To measure organ integration and donor relationship, a previously developed and published questionnaire (FOSP), generated explicitly for this purpose, was used. Associations with sociodemographic, medical, donation-specific, and psychological variables were investigated. RESULTS: Overall, more than 90% of the patients perceived the transplant as part of themselves; however, a small minority reported perceiving it as a foreign object. Frequent thoughts about the donor and the belief of having adopted some of the donor's traits were common (52% and 14%, respectively), specifically in living donor recipients. Higher anxiety and depression scores and reduced kidney functioning were associated with less ideal organ integration, while a more extended period since KTx and more perceived social support correlated with better organ integration. No association between organ integration and adherence, as well as organ integration and cognitive functioning, could be found. CONCLUSION: Organ integration and donor relationship were unproblematic in most KTx patients. However, offering psychosocial support to those struggling with organ integration and donor relationship is crucial from a clinical perspective.
OBJECTIVE: Organ transplantation is the treatment of choice for patients with end-stage organ disease. From early on, the psychological perspective on integrating the organ has been of interest. As quantitative studies on organ integration are scarce, we aimed at evaluating this aspect in a large sample of kidney transplant (KTx) recipients. METHODS: For this cross-sectional study, 684 patients after KTx were recruited within the structured post-transplant care program KTx360°. To measure organ integration and donor relationship, a previously developed and published questionnaire (FOSP), generated explicitly for this purpose, was used. Associations with sociodemographic, medical, donation-specific, and psychological variables were investigated. RESULTS: Overall, more than 90% of the patients perceived the transplant as part of themselves; however, a small minority reported perceiving it as a foreign object. Frequent thoughts about the donor and the belief of having adopted some of the donor's traits were common (52% and 14%, respectively), specifically in living donor recipients. Higher anxiety and depression scores and reduced kidney functioning were associated with less ideal organ integration, while a more extended period since KTx and more perceived social support correlated with better organ integration. No association between organ integration and adherence, as well as organ integration and cognitive functioning, could be found. CONCLUSION: Organ integration and donor relationship were unproblematic in most KTx patients. However, offering psychosocial support to those struggling with organ integration and donor relationship is crucial from a clinical perspective.