Organ integration in kidney transplant patients – results of a KTx360° substudy

Objective: Organ transplantation is the treatment of choice for patients with end-stage organ disease. Since the beginning of transplant medicine, the psychological perspective on integrating the transplanted organ has been of interest. However, quantitative studies on organ integration are scarce. Therefore, we aimed at evaluating this aspect in a large sample of kidney transplant (KTx) recipients. Methods: For this cross-sectional study, 684 patients after KTx were recruited within the structured post-transplant care program KTx360°. A previously developed and published questionnaire (FOSP), generated explicitly for this purpose, was used to measure organ integration and donor relationship. Associations with sociodemographic, medical, donation-specific, and psychological variables were evaluated. Results: Overall, more than 90% of the patients perceived the transplant as part of themselves. Yet, a small minority reported to perceive it as a foreign object Recurring thoughts about the donor and the belief of having adopted some of the donor's traits were common (52% and 14%, respectively), in particular in living donor recipients. Higher anxiety and depression scores, as well as reduced kidney functioning were associated with less ideal organ integration, while a longer period since KTx and more perceived social support correlated with better organ integration. Conclusion: Organ integration and donor relationship were unproblematic in most KTx patients. However, offering psychosocial support to those struggling with organ integration and donor relationship is crucial from a clinical perspective.