Patients' attitudes about living donor transplantation and living donor nephrectomy

Pradel, Françoise G.; Limcangco, M.Rhona; Mullins, C. Daniel; Bartlett, Stephen T.

doi:10.1016/s0272-6386(03)00033-7

Cited by 84 publications

(63 citation statements)

References 24 publications

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“…According to participants, the reasons most frequently raised by patients to delay preemptive transplantation were their reluctance to talk with family or friends about donating a kidney, their concerns about the health consequences of a kidney removal on their donor, and their concerns about financial costs related to transplantation and kidney removal. These barriers are similar to the barriers reported by hemodialysis patients when considering live donor kidney transplantation (22,26). Needing time to adjust to the idea of preemptive transplantation and still feeling healthy, although not as widely reported, might need further attention.…”

Section: Discussionsupporting

confidence: 55%

“…Patients might encounter psychologic and attitudinal barriers when seeking a donor, similar to those experienced by patients on dialysis. Patients may be reluctant to ask relatives for a kidney and express concerns about the long-term consequences of donating a kidney (22)(23)(24)(25)(26). Patients with CKD who feel relatively well and are not burdened with dialysis may have less sense of urgency to pursue transplantation than those who are already established on dialysis (27).…”

mentioning

confidence: 99%

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A Survey of Nephrologists’ Views on Preemptive Transplantation

Pradel

Jain

Mullins

et al. 2008

Clinical Journal of the American Society of Nephrology

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Background and objectives: Despite emerging evidence that preemptive transplantation is the best treatment modality for patients reaching end-stage renal disease (ESRD), it is underutilized. Nephrologists' views on preemptive transplantation are explored herein.Design, setting, participants, & measurements: A web-based survey elicited barriers to preemptive transplantation as perceived by nephrologists as well as demographic and practice variables associated with a favorable attitude toward preemptive transplantation.Results: Four hundred seventy-six of 5,901 eligible nephrologists responded (8% participation rate). Seventy-one percent of respondents agreed that preemptive transplantation is the best treatment modality for eligible chronic kidney disease (CKD) patients reaching ESRD, 69% reported that late referrals did not allow enough time for patients to be evaluated for preemptive transplantation, and 50% stated that there was too much delay between a patient's referral and the time the patient was seen at the transplant center. Nephrologists agreed to a lesser extent that they should be held accountable for CKD patients' education (26%) and preemptive transplant referrals (23%). The most important patient factors considered when deciding not to discuss preemptive transplant were poor health status (70%), lack of compliance (69%), other medical problems (51%), being too old (40%), lack of prescription coverage (37%), and lack of health insurance to cover the costs of the procedure (36%).Conclusions: Surveyed nephrologists consider preemptive transplantation as the optimal treatment modality for eligible patients. Late referral, patient health and insurance status, and delayed transplant center evaluation are perceived as major barriers to preemptive transplantation.

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Section: Discussionsupporting

confidence: 55%

mentioning

confidence: 99%

A Survey of Nephrologists’ Views on Preemptive Transplantation

Pradel

Jain

Mullins

et al. 2008

Clinical Journal of the American Society of Nephrology

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“…Minimal published literature exists on how transplant candidates interact with donors. Although some transplant candidates seek altruistic donors through the media, the majority of donors are recruited through the personal relationships that comprise a candidate's social support network (14,17,34,35). Because these interactions are usually private, transplant professionals interested in donor recruitment need to rely on the self-report of candidates and donors to identify possible methods to increase live donation overall.…”

Section: Discussionmentioning

confidence: 99%

“…On the basis of published literature and our clinical experience with transplant candidates, we identified a series of domains that were plausibly related to live donor kidney recruitment (14,19,20). Twenty semistructured interviews with transplant candidates were performed to understand the barriers to finding live donors that transplant candidates identify (Figure 1).…”

Section: Instrument Developmentmentioning

confidence: 99%

“…The creation of successful programs that maximize live donor transplantation would require a more detailed understanding of the barriers confronted by individual candidates when attempting to find donors. Proposed barriers include limited knowledge of the benefits of live donor transplantation, concern about donor harm, cultural, or religious beliefs, poor ability to cope with chronic kidney disease, and lack of social support (9,(13)(14)(15)(16)(17)(18) Attempted donor recruitment is an important step toward live donor transplantation and a plausible surrogate endpoint in understanding factors that limit overall access to live donor transplantation. The purpose of this cross-sectional study was to identify characteristics of transplant candidates that are associated with attempts to recruit potential live kidney donors.…”

mentioning

confidence: 99%

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Recruitment of Live Donors by Candidates for Kidney Transplantation

Reese

Shea²,

Berns³

et al. 2008

Clinical Journal of the American Society of Nephrology

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Background: Little is known about efforts that renal transplant candidates make to recruit live donors. It was hypothesized that preference for live donor kidney transplantation and greater knowledge about live donor transplantation are associated with candidates' initiating conversations about donation with potential donors.Design, setting, participants, & measurements: A cross-sectional study of renal transplant candidates was performed at initial transplant evaluation. Candidates completed a questionnaire that specified whether they had initiated conversations about donation with any potential donors. The questionnaire also measured preference for live donor transplantation, knowledge about transplantation, concern about donor harm, willingness to ask for help in coping with kidney disease, and social support.Results: Ninety-six candidates participated. Forty-nine (51%) reported initiating a conversation with at least one potential donor. In multivariable logistic regression, domains associated with initiating a conversation included: preference for live donor transplantation, willingness to ask for help, and female gender. Older age was associated with a lower odds of initiating a conversation. Knowledge, concern about donor harm, social support, and ethnicity were not associated with initiating a conversation with a donor.Conclusions: Attempts at donor recruitment by kidney transplant candidates are common. These findings suggest that interventions that influence preferences about transplantation and willingness to ask others for help are logical targets to enhance access to live donor transplantation.

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Ethically and Effectively Advancing Living Donation

Waterman¹,

Rodrigue

2009

Understanding Organ Donation

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Patients' attitudes about living donor transplantation and living donor nephrectomy

Cited by 84 publications

References 24 publications

A Survey of Nephrologists’ Views on Preemptive Transplantation

A Survey of Nephrologists’ Views on Preemptive Transplantation

Recruitment of Live Donors by Candidates for Kidney Transplantation

Ethically and Effectively Advancing Living Donation

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