Psychological Aspects of Kidney Transplantation

The currently promoted holistic health care model assumes a close interaction between the somatic and mental aspects (Sheridan, Radmacher, 1998). The past few years have recorded a considerable progress in the study into the psychological determinants of somatic illnesses. The domains representing the so-called behavioural sciences show, at different levels, the relationships between the physical and mental health. Such approach, in practice, assumes that there is no illness which would be unconditioned by psychological factors (Salmon, 2002). The mental psychological factors can be the cause of the disease, they can maintain the occurrence of pathological symptoms or they can constitute the result of the pathological process. Interestingly, the psychological knowledge does not only account for the origin of the psychopathological symptoms found in somatic disorders but it also provides constantly improved and scientifically-verified methods of their treatment. Similarly the transplantation is a treatment method connected with numerous psychological implications for the patient and the family (Kidney Transplantation, 2000). The transplantation ward patients face psychological problems, e.g. concerning the autonomy and the responsibility for the health decisions, managing the chronic disease stress, operative procedure and the uncertainty after the transplantation. These problems often overlap with changes in behaviour, emotions and cognitive functions being a result of organic changes in the central nervous system (CNS) triggered by dialyses (Griva et al. 2002; Griva et al. 2003). For that reason the cooperation between transplant surgeons and clinical psychologists seems to be a natural consequence of the holistic understanding of the patient, taking into account the interactions between physical and mental health. The personnel of the transplantation clinics should form interdisciplinary teams of transplant surgeons, nephrologists, qualified nurse, transplant coordinator, dietician and the clinical psychologist. The present paper is an attempt at providing characteristics of the most essential psychological problems found in patients before and after the renal transplantation. Psychological aspects of the qualification process of potential living donors are also presented.