The literature on psychological reactions to renal transplantation in adult donors and recipients is reviewed. Although the psychiatric complications of kidney transplantation appear to be fewer than in renal dialysis, the operation represents a threat to the donor, recipient and extended family. Donors, despite altruistic motivations for offering their kidney, often harbor resentment toward the recipient and commonly experience depression in the early postoperative period. Recipients often unrealistically expect the homograft to be a panacea for their emotional stresses. Anxiety and depression are common reactions when a physical complication, particularly rejection, does occur. It has been proposed that psychological acceptance is related to a patient's psychological acceptance of the organ.
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