Background: Although many living organ donors experience no adverse psychosocial consequences of donation, others develop enduring somatic symptoms, psychological distress, and interpersonal difficulties. There are no evidence-based interventions to prevent such outcomes. We conducted a single-site randomized controlled trial to examine the feasibility and impact of a new preventive intervention. The intervention utilized motivational interviewing (MI) to target a major risk factor for poor psychosocial outcomes, residual ambivalence about donating (i.e., lingering hesitation and uncertainty that coexist with the intention to donate).

Methods: Of 184 prospective kidney or liver donors, 131 screened positive for residual ambivalence; 113 were randomized to (a) the 2-session telephone-based MI intervention, (b) an active comparison condition (2 telephone education sessions on healthy lifestyle habits), or (c) standard care only before donation. Ambivalence was reassessed post-intervention (before any donation surgery). Psychosocial outcomes in somatic, psychological, and familial interpersonal relationship domains were assessed at 6 weeks and 3 months postdonation.

Results: In terms of feasibility, all interventions were able to be completed before any donation surgery. Postdonation, there was no attrition in any study group; subjects successfully completed all assessments. In terms of outcomes, MI subjects showed the greatest decline in ambivalence about donation from pre- to post-intervention (p=.050). By the 3 months postdonation assessment, in the somatic outcomes domain MI subjects reported fewer physical symptoms related to donation (p=.038), lower rates of fatigue (p=.021) and pain (p=.016), shorter recovery times (p=.041), and fewer unexpected medical problems (p=.023). Among psychological and interpersonal outcomes, MI subjects had a lower rate of anxiety symptoms (p=.046) and fewer unexpected family-related problems (p=.045). MI subjects did not differ from other subjects on depression, feelings about donation, or family relationship quality.

Conclusions: The MI intervention is feasible to offer to prospective donors, and appears to reduce residual ambivalence and prevent poor postdonation outcomes. The findings suggest that the intervention merits testing in a larger, multisite trial.

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