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Review
. 2022 Aug 1;3(9):1590-1598.
doi: 10.34067/KID.0008152021. eCollection 2022 Sep 29.

Post-Traumatic Stress Disorder and Post-Traumatic Growth following Kidney Transplantation

Rebekah P Nash  1 , Marci M Loiselle  2 , Jessica L Stahl  3 , Jamie L Conklin  4 , Terra L Rose  5 , Alissa Hutto  1 , Donna M Evon  6 , Jennifer E Flythe  7   8 , Eileen J Burker  9
Affiliations
Review

Post-Traumatic Stress Disorder and Post-Traumatic Growth following Kidney Transplantation

Rebekah P Nash et al. Kidney360. .

Abstract

Background: Kidney transplantation (KT) is a life-saving therapy for kidney failure. However, KT recipients can suffer from debilitating depression, post-traumatic stress disorder (PTSD), and suicide. In contrast to PTSD, post-traumatic growth (PTG) is a positive psychologic change in response to a challenging situation. PTG has been studied in other chronic diseases, but less is known about its role in the setting of KT. We sought to elucidate the prevalence, predictors, and the effect of PTSD and PTG on post-KT outcomes. We also considered the roles of benefit finding and resilience.

Methods: In a literature review, we identified publications that examined PTSD, PTG, benefit finding, and/or resilience in KT recipients. We excluded case reports and first-person narratives. Publications meeting the specified criteria after full text review underwent data abstraction and descriptive analysis.

Results: Of the 1013 unique citations identified, 39 publications met our criteria. PTSD was the most common construct evaluated (16 publications). Resilience was studied in 11 publications, PTG in nine, and benefit finding in five. Up to 21% of adult and 42% of pediatric KT recipients may experience PTSD, which is associated with lower quality of life (QOL), impaired sleep, and other psychiatric comorbidity. PTG was associated with improved QOL, kidney function, and reduced risk of organ rejection. Although benefit finding tended to increase post KT, resilience remained stable post KT. Like PTG, resilience was associated with lower psychologic distress and increased treatment adherence and confidence in the health care team.

Conclusions: PTG, resilience, and benefit finding appear to reduce the risk of PTSD, promote well-being, and reduce risk of graft failure in KT recipients. Future research to understand these relationships better will allow clinicians and researchers to develop interventions to promote PTG, resilience, and benefit finding, and potentially improve post-transplant outcomes such as adherence and reducing risk of organ rejection.

Keywords: benefit finding; kidney transplantation; post-traumatic growth; post-traumatic stress disorder; resilience; transplantation.

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Conflict of interest statement

J.E. Flythe reports consultancy for Astra Zeneca and NxStage Medical Advisory Board; research funding from the NIH/NHLBI, NIH/NIDDK, PCORI, Renal Research Institute (subsidiary of Fresenius Medical Care—North America), and the Robert Wood Johnson Foundation; honoraria from American Renal Associates, American Society of Nephrology, Baxter, Dialysis Clinic, Inc., Fresenius Medical Care—North America, National Kidney Foundation, Renal Ventures, and numerous universities; and an advisory or leadership role for the American Journal of Kidney Diseases editorial board (2017–), CJASN editorial board (2017–), Hemodialysis theme editor (2018–), the KDIGO Executive Committee (2020–), KHI Board of Directors (2019–), KHI Patient Preferences Project Chairperson (2019–), Kidney Medicine editorial board (2019–), Kidney360 associate editor (2019–), and Nephrology Dialysis and Transplantation editorial board. All remaining authors have nothing to disclose.

Figures

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Graphical abstract
Figure 1.
Figure 1.
Identification of studies via systematic literature review.
See this image and copyright information in PMC

References

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