Associations Between Recipients’ Feelings of Guilt for Donor and Depressive Symptoms Before Living Kidney Transplantation

•Recipients’ feelings of guilt for donors were associated with depressive symptoms.•Recipients with feelings of guilt showed the cognitive aspects of depression.•Findings may be helpful to prevent or reduce recipients’ depression before surgery. Recipient depression before kidney transplantation needs to be treated to reduce poor posttransplant outcomes. For recipients who receive living kidney transplantation, feelings of guilt for potential donors may be factors related to the presence of depressive symptoms. This study aimed to examine the association between recipients’ feelings of guilt for the donor and depressive symptoms before living kidney transplantation. Participants included 178 patients in Sapporo City General Hospital, Hokkaido, Japan, who completed a questionnaire before having living kidney transplantation from April 2009 to May 2016. Feelings of guilt for the donor, depressive symptoms using the Beck Depression Inventory-II (BDI-II), relationship to the donor, dialysis period, and socio-demographic characteristics were assessed via a questionnaire. Multivariate regression analyses were performed to examine the association between feelings of guilt for the donor and BDI-II score after multiple imputations. The results showed that feelings of guilt for donors were associated with depressive symptoms, especially cognitive factors. These findings indicate that medical staff needs to address recipients’ feelings of guilt for donors before living kidney transplantation.