Beyond the gift: exploring mental health and quality of life after kidney donation in a resource limited country.

Background: Kidney transplant is a life changing treatment. It improves the quality of life and ideally restores the kidney function of recipients. However, it also poses challenges, especially for the donors. Pakistan is a resource-limited country and donors have to face some specific social and cultural challenges. Knowledge about the donor's mental health and quality of life after donation is limited. This study aims to explore the mental health and quality of life after kidney donation.

Methods: The study was retrospective and cross-sectional, carried out between August and December 2023. One hundred donors from a single center were selected through convenience sampling. Two questionnaires, namely the Beck Depression Inventory and Satisfaction with life scale were employed during an interview with donors. Data were analyzed using SPSS- 27.

Results: Overall, 70 females and 30 males participated. Only 9 donors (9%), reported significant disturbance in their mental health, amongst which 2 were males and 7 were females. Of note, two recipients of their donation passed away, while another experienced graft failure. Insomnia and tiredness were significant contributors to the donors' inability to work, with a reported percentage of 25%. In addition, dissatisfaction with life was reported by 8 donors only. There was no significant association between depression and satisfaction with life and age, marital and education status and time since transplant. Only status of the graft in the recipient was associated with an impact on the donor's mental health. Thirteen donors exhibited depression post-nephrectomy, with 4% experiencing mild disturbance and 9% showing major mood disturbances including borderline clinical depression and moderate depression. Notably, none of the donors had test scores indicating extreme depression.

Conclusion: Kidney donation has no severe impact in terms of mental health and quality of life in donors. Apart from the status of the graft, none of the demographic characteristics had a significant impact on the mental health of donors.