F. A. Muthny, D. Breuker, J. Brockmann, N. Senninger, B. Suwelack, S. Wiedebusch

Abstract

According to the German transplantation law of 1997 the ethical and psychopathological investigation of potential donors before a living donation is a major basis of the decision of the expert commission at the General Medical Council. But the concrete practice in the different transplantation regions is somehow varying with respect to micro goals, proceeding, efforts and formalia of the expertise. In the ‘Muenster Model’ this practice has been proven since 1998 with three sessions, one together with donor and recipient (conducted by two experienced psychosocial experts), and one each only with donor or recipient. The interdisciplinary communication with surgeons and physicians seems important for an early identification of problems and therefore chances of problem-solving. Donations among spouses or from parents to child were the most common constellations; 70% of the donors were women. Although in the great majority of the cases no severe problems or even donation obstacles occurred, in some cases psychopathology and/or family conflicts were found, which confirmed the need for a psychosocial screening (and counseling). Problems of the procedure have also been identified, e.g. the conflict between marked empathy and the voluntariness demanded but also problems with respect to the limited predictability of relationship dynamics and the coping ressources for future crises. For this reason it seems important to combine the assessment with an offer for counseling and psychosocial care for donor and recipient after the tranplantation.

Key words: living donation, End stage renal disease (ESRD), psychosocial counseling, kidney transplantation

Prof. Dr. Dr. Fritz A. Muthny

Institut für Medizinische Psychologie

Universitätsklinikum Münster (UKM)

Von-Esmarch-Str. 52

48149 Münster

E-Mail: muthny@bitte-keinen-spamuni-muenster.de