Purpose: The quality of life of Iranian kidney vendors was clarified.
Materials and methods: A questionnaire was completed by 300 kidney vendors 6 to 132 months postoperatively (median 61). Interviews and living conditions were videotaped. In addition, the 300 vendors and 100 controls that underwent nephrectomy for benign disease completed the RAND 36-Item Health Survey (SF-36).
Results: Poverty prevented 79% of vendors from attending followup visits, and vending caused negative effects on employment in 65%. Of the families 68% strongly disagreed with vending, which caused rejection of 43% and increased marital conflicts in 73% of vendors, including 21% who divorced. There were 70% of vendors isolated from society, and 71% had severe de novo postoperative depression and 60% anxiety. Vending caused somewhat (20%) to very (66%) negative financial effects. It also had negative effects on the physical abilities in 60% of vendors who were mainly unskilled laborers, and 80% were dissatisfied with postoperative physical stamina, which was decreased mostly by depression. Of the vendors 37% concealed the truth of kidney sale from anyone, 14% disclosed it only to spouses, 43% to first generation relatives and 94% were unwilling to be known as donors. The mental preoccupation with kidney loss was usually (30%) to always (57%) present and interfered negatively with vendor life, and 62% reported negative effects on sense of being useful. Effects on general health were somewhat (22%) to very (58%) negative. When thinking about vending, the majority cited negative feelings. They responded that if they had another chance 85% would definitely not vend again, and 76% strongly discouraged potential vendors from "repeating their error." Half the vendors were ready to lose greater than 10 years of life and 76% to 100% of properties to regain kidneys. Compared to controls, vendors had significantly lower scores on all SF-36 scales (p <0.001).
Conclusions: Our sample is a good representative of Iranian kidney vendors, with the majority having psychosocial complications. Globally, the medical community should focus more attention on motivations, quality of life, health and opinions of kidney vendors.