I.C. Frade, I. Fonseca, L. Dias, A.C. Henriques, L.S. Martins, J. Santos, M. Sarmento, A. Lopes

背景：活体肾移植对移植物的存活和受体的生活质量（QoL）会产生积极影响。我们评估了捐赠行为对捐赠者本人社会心理方面的影响。

方法：32名活体肾移植捐赠者（平均41岁）在术前和术后都进行了Zung氏焦虑自评测试和抑郁自评测试、SF-36以及一份对器官捐赠看法的问卷调查。

结果：活体肾移植的捐赠者有兄弟姐妹（62.5%）、父母（34.4%）、或女儿（3.1%）。此项研究中，有两例移植手术不成功：一例受体死亡，另一例则是移植肾功能衰竭。在捐赠后，除SF-36社交能力明显得到改善外，捐赠者的QoL并没有发生明显的变化（P = .038）；捐赠后抑郁综合症的发病频率也有所下降（从术前的65.6%下降到术后46.9%）。在考虑到会成功进行移植手术时（P = .021），捐赠者的抑郁指数也出现了显著的下降（P = .077）。捐赠者的焦虑指数没有出现明显的变化。移植后的时间长短与捐赠者的整体焦虑程度（r = .443, P = .011）和躯体焦虑指数（r = .357, P = .045）呈反比。对大部分捐赠者而言，决定进行器官捐赠是容易的，也是自愿的。几乎所有的捐赠者都愿意再次捐赠，同时他们也会积极鼓励其他人进行器官捐赠。

结论：在进行活体肾移植捐赠之后，除社交能力有所改善之外，捐赠者的QoL并没有出现明显的变化。捐赠后，抑郁指数有所下降，但是焦虑指数仍然保持稳定。大部分捐赠者与受体之间为兄弟姐妹的关系，这些捐赠者对器官捐赠持积极态度，没有人为此决定而后悔；相反，他们在捐赠之后还积极鼓励更多的人加入到器官捐赠的行列中。

Impact Assessment in Living Kidney Donation: Psychosocial Aspects in the Donor

Background: Living donor kidney transplantation has a positive influence on graft survival and recipient quality of life (QoL). We assessed the psychosocial impact of donation to the donor.

Methods: Before and after the procedure 32 living kidney donors (mean age 41 years) completed the Zung Self-Rating Anxiety and Depression Scales; a Sociodemographic, Short-Form 36 Health Survey (SF-36), and a Donation Perceptions Questionnaire.

Results: Living kidney donors were siblings (62.5%), parents (34.4%), or a daughter (3.1%). Transplantation was not successful in two cases: one recipient death and one graft failure. No significant changes were observed in donor QoL except for the SF-36 social functioning subscale that showed significant improvement after donation (P = .038). A reduction in depression symptom frequency was verified after donation (from 65.6% to 46.9%). There was an almost significant decrease in depression scores (P = .077), which was in fact was significant when one considered only successful transplants (P = .021). There was no significant variation in anxiety scores among donors. Time since transplantation was inversely correlated with overall anxiety (r = .443, P = .011), and with somatic anxiety subscales (r = .357, P = .045). For most donors, the decision to donate was easy and spontaneous. Nearly all donors would donate again and strongly encourage others to donate.

Conclusions: Except for the social functioning scale that improved, no significant changes were observed in QoL of living kidney donors after the procedure. Depression scores significantly decreased after donation, but anxiety scores remained stable. Donors, who were mostly siblings, showed positive perceptions about donation, did not regret their decision, and strongly recommend it to others.

Volume 40, Issue 3, Pages 677-681 (April 2008)

[责任编辑:刘 聪]