Living kidney donation

Bailey, Pippa; Edwards, Adrienne L.; Courtney, Aisling E.

doi:10.1136/bmj.i4746

Cited by 25 publications

(18 citation statements)

References 73 publications

(49 reference statements)

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“…Comprehensive risk information can be confronting or irrelevant to donors. A "cooling-off" period and requiring donors to drive the evaluation ensure that donors make a considered decision (12,31). These practices can exacerbate stress for donors and prolong lifestyle intrusion.…”

Section: Discussionmentioning

confidence: 99%

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The Lived Experience of “Being Evaluated” for Organ Donation

Hanson

Ralph

Manera

et al. 2017

CJASN

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Previous donors described an emotional investment in donating and determination to protect their eligibility, despite having concerns for their health, financial and lifestyle disruption, and opposition from their family or community. Our findings suggest the need to prepare donors for surgery and recovery, minimize anxiety and lifestyle burdens, ensure that donors feel comfortable expressing their fears and concerns, reduce unnecessary delays, and make explicit the responsibilities of donors in their assessment process.

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Section: Discussionmentioning

confidence: 99%

“…Donors undergo rigorous assessment of their mental and physical health, relationship with the recipient, motivations, expectations, lifestyle, finances, social support, and understanding of risks (11,12). Difficulty navigating an unfamiliar health care system can cause considerable stress (6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

The Lived Experience of “Being Evaluated” for Organ Donation

Hanson

Ralph

Manera

et al. 2017

CJASN

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“…Understanding of the medical risks to living kidney donors is evolving, with the progressive publication of more robust long-term data (7)(8)(9). Recent evidence of small absolute increases in the risk of ESKD, hypertension, hypertension in pregnancy, and allcause mortality in donors in the three decades after donation, compared with the general or healthy population (4,7,8,(10)(11)(12)(13), reinforces the need for ongoing research and follow-up of living kidney donors.…”

Section: Introductionmentioning

confidence: 99%

Identifying Outcomes that Are Important to Living Kidney Donors

Hanson

Chapman

Gill

et al. 2018

CJASN

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Background and objectives Living kidney donor candidates accept a range of risks and benefits when they decide to proceed with nephrectomy. Informed consent around this decision assumes they receive reliable data about outcomes they regard as critical to their decision making. We identified the outcomes most important to living kidney donors and described the reasons for their choices.Design, setting, participants, & measurements Previous donors were purposively sampled from three transplant units in Australia (Sydney and Melbourne) and Canada (Vancouver). In focus groups using the nominal group technique, participants identified outcomes of donation, ranked them in order of importance, and discussed the reasons for their preferences. An importance score was calculated for each outcome. Qualitative data were analyzed thematically.Results Across 14 groups, 123 donors aged 27-78 years identified 35 outcomes. Across all participants, the ten highest ranked outcomes were kidney function (importance=0.40, scale 0-1), time to recovery (0.27), surgical complications (0.24), effect on family (0.22), donor-recipient relationship (0.21), life satisfaction (0.18), lifestyle restrictions (0.18), kidney failure (0.14), mortality (0.13), and acute pain/discomfort (0.12). Kidney function and kidney failure were more important to Canadian participants, compared with Australian donors. The themes identified included worthwhile sacrifice, insignificance of risks and harms, confidence and empowerment, unfulfilled expectations, and heightened susceptibility.Conclusions Living kidney donors prioritized a range of outcomes, with the most important being kidney health and the surgical, lifestyle, functional, and psychosocial effects of donation. Donors also valued improvements to their family life and donor-recipient relationship. There were clear regional differences in the rankings.Clin J Am Soc Nephrol 13: 916-926, 2018.

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“…Living kidney donors may have an increased risk of hypertension and proteinuria after donation. 2 For early identification of these modifiable risk factors for progressive loss of kidney function, annual monitoring of blood pressure, serum creatinine level and urine albumin:creatinine ratio is suggested after donation. 2 PRACTICE | FIVE THINGS TO KNOW ABOUT ...…”

Section: Annual Follow-up Is Recommended After Kidney Donationmentioning

confidence: 99%