Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
West Region, Institute of Mental Health, Singapore.
Gen Hosp Psychiatry. 2021 May-Jun;70:51-75. doi: 10.1016/j.genhosppsych.2021.03.002. Epub 2021 Mar 6.
With increasing demands for living organ donations, understanding the prevalence of depression and anxiety, which are the commonest psychiatric disorders in donors following organ transplantation, will serve to improve psychiatric care to safeguard donors' mental wellbeing. This descriptive systematic review examines all observational studies in English investigating prevalence of depression and anxiety in adult transplant donors using bibliographic databases. Sixty-two papers were included (kidney, n = 25; liver, n = 25; bone marrow, n = 7; uterus, n = 2; lung, n = 1; kidney and lung concurrently, n = 2). Post-transplantation depression and anxiety prevalence rates (Depression: 0-46.9%, Anxiety: 0-66.7%) did not differ significantly from pre-transplantation and were largely comparable to the general population. Other psychiatric disorders observed included bipolar disorder, conversion disorder, adjustment disorder and sleep disorder. Other psychological outcomes observed included lower quality of life, lower satisfaction of life and regret after donation. Pre-donation risk factors such as poor physical/psychological health status, and post-donation risk factors such as complicated post-surgical recovery and poor physical/psychological health in recipients were identified, predisposing donors to poor psychological outcomes. Individuals with risk factors should be monitored and provided with social support, psychoeducation, psychotherapy and long-term follow up. Future studies should adopt consistent methodological approaches to improve comparability between various studies. More research investigating poor psychological outcomes in other organ donors besides kidney and liver donors, donors who have past psychiatric history, unrelated and parent donors is warranted.
随着对活体器官捐赠需求的增加，了解抑郁和焦虑的患病率变得尤为重要，这两种疾病是器官移植后捐赠者中最常见的精神疾病，有助于改善精神保健，保障捐赠者的心理健康。本描述性系统综述调查了使用文献数据库的所有英文观察性研究，以评估成人器官移植捐赠者中抑郁和焦虑的患病率。共纳入 62 篇论文（肾脏，n=25；肝脏，n=25；骨髓，n=7；子宫，n=2；肺，n=1；同时进行肾脏和肺移植，n=2）。移植后抑郁和焦虑的患病率（抑郁：0-46.9%，焦虑：0-66.7%）与移植前无显著差异，与普通人群大致相当。观察到的其他精神疾病包括双相情感障碍、转换障碍、适应障碍和睡眠障碍。观察到的其他心理结果包括生活质量下降、生活满意度下降和捐赠后后悔。确定了捐赠前的风险因素，如身体/心理健康状况不佳，以及捐赠后的风险因素，如术后恢复复杂和受者身体/心理健康不佳，使捐赠者易出现不良心理后果。应监测有风险因素的个体并为其提供社会支持、心理教育、心理治疗和长期随访。未来的研究应采用一致的方法学方法，以提高各项研究之间的可比性。有必要对除肾脏和肝脏捐赠者以外的其他器官捐赠者、有既往精神病史的捐赠者、无关和亲属捐赠者的不良心理结果进行更多研究。
