Psychosocial assessment of living kidney donors: What implications have temperament and character for decision-making?

Objective: We compared the personality of kidney donor candidates to non-donor controls and analyzed the personality profile of candidates psychosocially at risk. Methods: 49 consecutive living kidney donor candidates underwent an extensive psychosocial evaluation. Psychosocial risk factors concerning knowledge of donation risks (1), donor recipient-relationship (2), and/or mental health (3) were rated on a 3-point rating scale (0 = high risk, 2 = no risk). Furthermore, candidates as well as 49 age- and gender-matched non-donor controls filled in questionnaires concerning psychological distress (Symptom Checklist 90-R) and personality (Temperament and Character Inventory). Results: There were no significant differences between candidates and controls concerning psychological distress or personality. Psychosocial assessment identified 13 candidates (26.5%) with increased psychosocial risk. This group displayed compared to candidates without psychosocial risk no difference concerning age, gender, formal education, donor recipient relationship and psychological distress. However, this group scored significantly higher on reward dependence compared to suitable donors and controls (p < 0.05). Reward dependence was associated with a lack of adequate knowledge on donation (r = -0.35, p < 0.05). Conclusion: Reward dependence has important implications for decision-making, because it is associated with an increased tendency to deny potential risks of donation. Careful identification and assessment of reward dependent donor candidates is needed to ensure a free-willed decision. (C) 2016 Elsevier Inc. All rights reserved.