The non‐directed living kidney donor: Why donate to strangers?

Abstract

Background: Kidney transplantation improves survival and quality of life for patients with end-stage kidney disease (ESKD). However, there is a shortage of donated organs, resulting in long wait times and the potential for death before a donor is found. Non-directed (also called altruistic) living kidney donation is a growing type of donation; however, few studies have examined the values and motivation of individuals evaluated to be a non-directed donor. Objectives: This qualitative study explores the motivations and values of individuals evaluated for non-directed donation. Design: Focus groups were conducted with individuals who had been evaluated for non-directed living kidney donation. Grounded theory method guided the data analysis. Participants: Participants (N ¼ 11) were individuals who completed the evaluation for a non-directed living kidney donation. Findings: Qualitative analyses revealed eight major themes participants considered in making their decision to donate to a non-related person: (i) motivation to donate; (ii) minimise perceived risk; (iii) ideal selected recipient; (iv) change in lifestyle;(v) source of donation knowledge; (vi) history of altruistic acts; (vii) donation chain and (viii) others' response. Conclusions: Results suggest that non-directed living kidney donors think deeply about their decision and have a resolve to help others that is aligned with their values. As organ availability remains at a critical shortage, unwillingness to consider non-directed living donors (NDD) due to beliefs of ill motivations appears unsupported. Future directions call for the need of standard practice of care in kidney donation evaluations across transplant centers.

Exploring the motives of Israeli Jews who were living kidney donors to strangers

“…This was also noted in other surveys conducted in the United Kingdom and USA 16,17 . Other international studies also report that the main motivation for donation was to help others 18,19,31 . Self‐esteem is high among these Jewish donors and was rarely enhanced by kidney donation.…”

“…We identified 20 donors (17,4%) who felt moments of fear and hesitance about donating. In a UK‐based study, donors also had concerns about lifestyle sacrifice, including reduced alcohol consumption, limited nonsteroidal use of anti‐inflammatory drugs, and other lifestyle changes 18 …”

“…In general, non‐directed donors are a population that is generally studied with small cohorts (overall there are few of these donors compared to living‐related donors) 16‐19 . Add in the contextual feature of Jews seemingly not supporting donation and the fears that some transplant hospitals have in allowing non‐directed donation 17 (eg, organ vending; donors seeking attention, reparation, or self‐harm via donation), the result is a unique situation for exploration.…”

Polish attitudes towards unspecified kidney donation: a cross-sectional study

“…Our study, amongst others [ 33 , 34 ] has shown that whilst altruism is a significant driver for UKLD, it is not enough to facilitate these donations. There is a need for actions aimed at increasing knowledge and awareness regarding donation and transplantation.…”

Uterine Transplantation Using Living Donation: A Cross-sectional Study Assessing Perceptions, Acceptability, and Suitability

“… 31 Qualitative interviews with nondirected kidney donors identified that donors want to offer someone else a chance at a normal life 32 and that the altruistic value gained from the gift of donation outweighs the fears and risks associated with the surgery. 33 …”