“Everything starts now”: Psychosocial transformations among Greek living-donor kidney recipients

While quality of life often improves following kidney transplantation, recipients frequently face psychosocial challenges. Those receiving kidneys from living compared with deceased donors may face complex challenges, particularly in navigating their relationship with the donor. In Greece, where living donor transplants account for a significant proportion of procedures, exploring these experiences is especially relevant. This study aimed to understand how living donor kidney recipients experience the disease trajectory -from diagnosis through post-transplantation- and to identify sociocultural factors influencing that experience and patient needs. Twelve recipients of living donor kidney transplants participated in individual semi-structured interviews. Data were analysed using reflexive thematic analysis. Three primary themes emerged, organised around the overarching concept of “Transformation”, reflecting changes in recipients’ psychological and social experiences throughout the transplantation journey: “Managing Expectations,” “Dynamics of Family Ties,” and “Reaching Out for Help.” The findings highlight the complexity of transplantation as a biopsychosocial process, requiring sensitive management of expectations and donor-related guilt, sensitivity to patients’ personal experiences and interpretations, and a culturally informed understanding of family syste.ms. Specific issues relating to youth and adherence, gendered experiences, and the emotional implications of kidney paired donation were also identified. The study underscores the need for greater public awareness of CKD and transplantation. A whole-family approach, alongside increased state support to strengthen the healthcare system, may enhance patient well-being and transplant outcomes.