Introduction: The moral and ethical justification for living donation is provided by an assumed psychological benefit to the donor after donation. However, there are no studies that categorically prove this to be the case. The aims of this study were to determine whether living kidney donors benefited from donation and if so, how they do so. We hypothesised an improvement in wellbeing, life satisfaction, self-esteem, social comparison, distress, depression, stress and anxiety scores. We also hypothesised that levels of social support and optimism would remain the same after donation.

Methods: 100 living kidney donors completed 11 validated psychological questionnaires at 3 time points: pre-operatively and 3 and 12 months after donation.

Results: 55 men and 45 women participated. The average age was 45yrs (s.d. 12.98; range 18-70yrs). There was no clinical, nor statistically significant difference in scores for wellbeing (29.5 vs. 29.5 vs. 29.5; p=0.81), distress (10.2 vs. 9.4 vs. 10.7; p=0.09), mood (0 vs. 0 vs. 0; p=0.15), stress (4.5 vs. 4.5 vs. 5.2; p=0.074), life satisfaction (27.5 vs. 27 .0 vs. 26.0; p=0.92), self-esteem (22.7 vs. 21.8 vs. 21.8; p=0.37), anxiety (10.0 vs. 10.0 vs. 11.0; p=0.36), optimism (21.2 vs. 20.7 vs. 20.2; p=0.72) and social comparison (68.6 vs. 66.8 vs. 66.7; p=0.89). Social support was the only measure that demonstrated a statistically significant change across the 3 time points. Levels of perceived social support were found to have decreased over the first year after donation (72.0 vs. 71.0 vs. 67.5; X² (2, 70) = 10.29, p=0.006).

Discussion: This study has failed to demonstrate psychological benefit from living kidney donation within the first year. This is across a range of psychosocial factors and through the use of validated measures. This calls into question whether donors really do experience a psychological benefit after donation and in turn raises questions about the moral and ethical justifiability of living donation. Donors experience lower social support after donation and this is likely to either represent an assumption by their social network that less support is needed following transplantation or an artificial elevation in social support in the lead up to donation.

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