Posttraumatic growth in kidney and liver donors and recipients: a systematic review

Background Posttraumatic growth (PTG) describes positive psychological changes following highly stressful events, including organ transplantation. Kidney and liver transplantation improve survival but pose significant psychosocial challenges for recipients and living donors. Understanding PTG and its correlates is important for strengthening psychosocial care. Objective To synthesise quantitative evidence on post-traumatic growth (PTG) among adult kidney and liver transplant recipients and living donors. Methods Following PRISMA 2020 guidelines, five databases (CINAHL, PubMed, Web of Science, ScienceDirect, and Scopus) were searched between 18 March and 11 May 2025 for peer-reviewed, English-language quantitative observational studies (2015–2025) involving adult (≥ 18 years) kidney or liver transplant recipients or living donors assessed with validated PTG measures (e.g., PTGI). Data on study characteristics, PTG levels, and associated factors were narratively synthesized. Methodological quality was appraised using Joanna Briggs Institute checklists. Results Out of 276 records screened, 19 studies from eight countries were included (13 recipient-only studies, four donor-only studies, one study including both recipients and donors, and one study including recipients and family members/caregivers. PTG was generally reported at moderate-to-high levels, with higher scores commonly observed in domains related to relating to others, appreciation of life, and personal strength (as reported across studies). Study-reported positive associations with PTG included female sex, marital status, socioeconomic status, living donor graft type, time since transplantation, better perceived health, resilience, social support, adaptive coping, and spirituality. Negative associations were reported for depressive symptoms, alexithymia, and avoidant coping. Across the limited longitudinal evidence, PTG appeared higher in earlier post-transplant periods and tended to decrease over time. Methodological quality was appraised using JBI checklists; most studies had low-to-some concerns, with key limitations in confounding control and attrition reporting. Conclusion PTG is commonly reported among transplant recipients and donors. The findings highlight potentially modifiable psychosocial correlates (e.g., resilience, coping, and social support) that may inform supportive care strategies across the transplant trajectory. PROSPERO registration ID CRD420251020904.