Differences in tolerance for health risk to the living donor among potential donors, recipients, and transplant professionals

Abstract

In organ donation, the donor, recipient, and transplant team must all accept potential health risks to the donor and any uncertainties. To gauge these risks, we surveyed general altruism and risk-taking behaviors in 112 potential donors, 111 potential recipients, and 51 transplant professionals. Next, participants indicated their risk thresholds for long-term donor hypertension, cardiovascular disease, and kidney failure that would stop them from pursuing living donation and their willingness to proceed when risks were uncertain. The three groups had similar general altruism and risk-taking behaviors. Potential donors were significantly more willing to accept greater long-term donor risks than potential recipients and transplant professionals. Moreover, these potential donors were significantly more likely to agree that living donation was acceptable when long-term donor risks were uncertain. Potential kidney donors readily accept high long-term risks, whereas potential recipients were the most averse to donor risk. Our study shows that transplant professionals facilitate the best decisions by appreciating the willingness of their patients to accept donor health risks along with their own risk tolerance.

Identifying Outcomes that Are Important to Living Kidney Donors

“…They suggest communicating absolute risks and disclosing uncertainty in long-term outcomes (6). However, donors' strong motivations and the confidence in their safety pose additional barriers to comprehending information before donation (38)(39)(40). Continued education about donor outcomes and emerging evidence is therefore critical after donation.…”

The dynamics of kidney donation: Viewpoints from the donor, the recipients, and the transplant team

“…The interaction between the three groups is complex: the donor's physician needs to protect the patient; the donor wishes to see his or her loved one healthy again but may be afraid of surgery; and the patient wishes to come co m m e nt a r y off dialysis but not to harm the donor in doing so. In a new report by Young et al 6 (this issue), a clearer picture of this complex interaction among potential donors, potential recipients, and the transplant professionals is displayed. The authors suggest that there is a tendency in medical teams to protect the donor's outcome, preferring cadaveric transplantation.…”

Live Donor Kidney Transplantation Pearls: A Practical Review

“…Patients in need of transplants need to be educated to understand the short-and long-term outcomes and the care available to living donors. Potential recipients should not feel guilty about living donation [76,77]. Other approaches such as advances in surgical techniques can encourage and improve living donation concept.…”