Renal Homotransplantation—Some Observations on Recipients and Donors

Abstract

The reports of the Registry of Human Kidney Transplantation show that the operation is being carried out with increasing frequency. Its medical, surgical and immunological problems are well documented, but attention needs also to be paid to the psychological difficulties of patients in chronic renal failure for whom this operation is recommended. Thus, Kemph (1966), in a study of seven cases has drawn attention to the unconscious hostility shown by some donors to recipients. The present paper is one of a series (Cramond, Court et al., 1967; Cramond, Knight et al., 1967; MacNamara, 1967) in which the psychiatric contribution to a renal unit and the criteria used in donor-selection have been discussed, as well as some of the psycho-social problems arising in connection with the work of the unit. It is now proposed to deal with some psychological, social and economic problems which recipients meet during rehabilitation, and the ambivalent dependency that may develop between recipient and donor. Although only a short series of cases has been studied so far, an awareness of this interaction will help to establish better criteria for future donor selection.