The living donor study: the concepts and frames of living kidney donors

Abstract

This thesis explores the concepts and frames of living kidney donors through the use of recorded and transcribed conversations between living kidney donor patients and their transplant team. It offers insight into the expectations of living kidney donors as they prepare themselves to gift a kidney to someone they know.Living kidney donor frames are represented as particularly resilient and well-defined, shielding them from messages delivered by their transplant team. Those frames incorporate their acceptance as living kidney donors, the risk to themselves and their own personal definitions of autonomy and choice.With the intention of using phenomenological discourse analysis to examine the recorded and transcribed data, ten potential living kidney donors and their recipients were invited to take part in a PhD project entitled the Living Donor Study at the Princess Alexandra Hospital, in Queensland Australia. Transcriptions were analysed using line-by-line and axial coding and living donor transcripts were repeatedly compared with one another in order to reach an appropriate level of saturation and provide evidence of re-emerging concepts and frames.Data for the Living Donor Study were obtained during the living kidney donor's initial transplant assessment clinic visit. The purpose of this project was to examine prospective accounts of the living donation experience using conversations with their transplant team as opposed to using retrospective questionnaires and interviewing methods. By eliminating much of the subjectivity that is common in ex post facto interviews, I was able to identify many of the concepts that assist living kidney donors in framing their experience and how those frames impact upon their expectations of the transplant assessment clinic and their upcoming donation.

The Lived Experience of “Being Evaluated” for Organ Donation

“…The need to protect their eligibility left some donors unwilling to disclose their concerns. Other studies have also found that directed and nondirected donors feel anxious about undergoing psychosocial assessment due to their determination to donate and attempt to manage how they are perceived, and some conceal experiences that might exclude them (16,22,25). We found that some donors who were men were overcome with anxiety before their operation, which supports findings from a study that used self-administered anxiety scales (26).…”

“…Some donors recalled ignoring information that contradicted their decision to donate. This reflects an analysis of the dialogue between potential donors and transplant professionals, which found that donors express disinterest in risk information, because their decision is "entrenched" (22). This accords with cognitive dissonance theory, the tendency to minimize inconsistency between our thoughts and actions (23).…”

Organ Donation and Transplantation in Mongolia

“…1,9 Data provided by the First Central Hospital (December 2020) documented 1-and 3-y patient survival rates of 93.1% and 89.7 % after liver transplantation and 100% and 95.9% after kidney transplantation, respectively. 1,7 The Mongolian Pancreas Transplant Team completed their special training program at Asan Medical University in Korea in 2019. The team has thus far retrieved 3 deceased donor pancreata and plans for their first clinical pancreas transplant in 2021.…”