Decision making around living and deceased donor kidney transplantation: a qualitative study exploring the importance of expected relationship changes
1 Department of Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands
2 Department of Medical Humanities, EMGO institute, VU Medical Center, Amsterdam, The Netherlands
3 Department of Medical Psychology, Leiden University Medical Center, Leiden, The Netherlands
4 Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands
5 Department of Transplantation Surgery, Leiden University Medical Center, Leiden, The Netherlands
BMC Nephrology 2012, 13:103 doi:10.1186/1471-2369-13-103Published: 7 September 2012
Limited data exist on the impact of living kidney donation on the donor-recipient relationship. Purpose of this study was to explore motivations to donate or accept a (living donor) kidney, whether expected relationship changes influence decision making and whether relationship changes are actually experienced.
We conducted 6 focus groups in 47 of 114 invited individuals (41%), asking retrospectively about motivations and decision making around transplantation. We used qualitative and quantitative methods to analyze the focus group transcripts.
Most deceased donor kidney recipients had a potential living donor available which they refused or did not want. They mostly waited for a deceased donor because of concern for the donor’s health (75%). They more often expected negative relationship changes than living donor kidney recipients (75% vs. 27%, p = 0.01) who also expected positive changes. Living donor kidney recipients mostly accepted the kidney to improve their own quality of life (47%). Donors mostly donated a kidney because transplantation would make the recipient less dependent (25%). After transplantation both positive and negative relationship changes are experienced.
Expected relationship changes and concerns about the donor’s health lead some kidney patients to wait for a deceased donor, despite having a potential living donor available. Further research is needed to assess whether this concerns a selected group.