Abstract
This paper is part of an ongoing study of the psychiatric aspects of renal transplantation at Notre-Dame Hospital in Montreal, and deals specifically with the clinical significance of the patient's fantasies concerning the acquisition of a kidney.
Fantasy material concerning the issues of life and death, the fantasies linking the acquired organ to libidinal drives and those concerning the impact of transplantation upon body image are examined.
Patients defend against anxieties concerning living and dying by denial. Fantasies are described which suggest that transplantation is experienced on the genital level as a rephallicisation of doubtful outcome, following the castrative effect of the illness and hemodialysis. It was confirmed also that the archaic mental representation of the kidney was far more encompassing than that of a mere excretory organ, and thus the vicissitudes of the process of acceptance of the grafted body part appear as very complex phenomena which can have a bearing on clinical outcome.