Living donors in kidney transplantation: five-year follow-up

Melchor, J.L; Gracida, C; Lopez, A.

doi:10.1016/s0041-1345(98)00847-1

Cited by 7 publications

(4 citation statements)

References 2 publications

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“…For example, donors (1) may be harmed by the two-to three-hour-long operation, (2) tend to have longer recovery periods than do recipients, and (3) are out of work for about six weeks following the surgery, thus presenting a financial challenge to those donors who are employed. 4 Perioperative mortality for living donor nephrectomy is very low; reports estimate a risk of 0.03 percent or less (Melchor et al 1998;Najarian et al 1992). These risks are necessarily minimal because of the medical profession's ethical duty to avoid harming patients when there is no therapeutic gain to those patients (Sofaeretal.…”

Section: Decision-making Theorymentioning

confidence: 99%

“They Don't Have to Suffer for Me”: Why Dialysis Patients Refuse Offers of Living Donor Kidneys

Gordon

2001

Med Anthropol Q

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In the present climate of organ shortage, high demand for kidney transplants, and better clinical outcomes from living donors, health care professionals expect and encourage patients to accept offers of living related donor (LRD) kidneys. When patients decide not to adhere to this course of treatment, scholars and policy makers may question why, given that it delays their chances of receiving a transplant. This article reports on patients' decisions to refuse LRD kidney offers. An 18-month study was conducted of treatment decisions by hemodialysis patients (N = 79). Fewer than half of those offered an LRD kidney (N = 64) were willing to accept it, suggesting that sociocultural factors inform decisions. Patients expressed concerns about the potential donors' well-being over their own and about compromising their relationships with the donors. This article concludes that social relations, emotions, and ethnomedical beliefs play an important role in patients' treatment decisions and thus contributes to the anthropology of decision making.

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Section: Decision-making Theorymentioning

confidence: 99%

“They Don't Have to Suffer for Me”: Why Dialysis Patients Refuse Offers of Living Donor Kidneys

Gordon

2001

Med Anthropol Q

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“…Whether this accurately represents the discussion they had with their transplant team is unknown, although one must remember that until very recently, most data were single-center studies that were underpowered to show long-term risks. [21-25] However, even among these small studies, a few authors suggested that there may be some risk to donation and encouraged the establishment of donor registries. [26-28] That said, it has only been in the past five years that large studies over longer observation periods have had the power to show an increased risk of ESRD[3,4] and pregnancy complications in former living kidney donors.…”

Section: Discussionmentioning

confidence: 99%

Living Kidney Donors Who Develop Kidney Failure: Excerpts of Their Thoughts

et al. 2016

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Background: Psychosocial data about living kidney donors have been collected for almost 5 decades now. To date, however, no study has provided any psychosocial follow-up of donors who developed a serious health problem such as end-stage renal disease (ESRD). Methods: Donors who developed ESRD were invited to participate in a qualitative interview if they met one or both of the inclusion criteria: (1) developed ESRD within 10 years of donating and/or (2) lacked health insurance at the time of donation. We contacted 38 individuals who met these criteria, and 22 participated (58%). Two were subsequently excluded from analysis. Results: Twenty qualitative interviews were analyzed. Five findings are described: (1) donors describe the decision-making process as spontaneous and fast; (2) donors describe lack of appreciation for the need for post-donation self-care; (3) donors do not regret donating despite the adverse outcome; (4) donors advise future donors to have in place emotional and physical support post donation; and (5) donors appreciate the opportunity to tell their story from being a living donor to living with ESRD, which virtually all perceive as 2 separate unrelated events. Conclusions: Most donors are positive about their donation decision and experience and would donate again, despite developing ESRD themselves. They propose some important changes to the decision-making and informed-consent processes. Our data are reassuring regarding lack of donor regret, but highlight the need for living donor transplant programs to ensure that living donors understand their long-term risks and receive appropriate life-long follow-up care to minimize these risks.

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“…22 Since grafts from living related donors were first used, there has been concern about the risks to the donor, including perioperative morbidity and death and the long-term risk of living with one kidney. The perioperative rate of morbidity ranges from 1 percent 27 to 1.3 percent, 28 with a perioperative mortality rate of 0 percent 29 to about 0.03 percent, 30 if donors are selected carefully.…”

Section: Expanding the Supply Of Kidneys From Living Related And Unrementioning

confidence: 99%