Original Investigation: transplantation
Patients' attitudes about living donor transplantation and living donor nephrectomy

https://doi.org/10.1016/S0272-6386(03)00033-7Get rights and content

Abstract

Background: The growing shortage of organs available for transplantation has resulted in an increased use of living donors for kidney transplantation. The laparoscopic nephrectomy is a new procedure used to remove kidneys from donors. The study objective was to explore the attitudes of recipients and donors toward living donor kidney transplantation and the impact of the laparoscopic donor nephrectomy on donors' and recipients' acceptance of living donor kidney transplantation. Methods: Tailored self-administered questionnaires were mailed to kidney donors, potential donors, recipients and potential recipients who visited the University of Maryland School of Medicine Division of Transplantation between January 1998 and May 2001. Results: The laparoscopic donor nephrectomy helped recipients and potential recipients with their decision to accept a kidney from a living donor (recipients: 53% strongly agreed, 36% agreed; potential recipients: 42% strongly agreed, 46% agreed). To a lesser extent, the laparoscopic donor nephrectomy assisted donors and potential donors with their decision to donate (donors: 19% strongly agreed, 20% agreed; potential donors: 20% strongly agreed, 20% agreed). Potential recipients and recipients identified 2 barriers to accepting living donor kidney transplantation: they were unwilling to accept a kidney if it meant this would financially burden their donors, and they worried that their donors might succumb to a future kidney problem. Conclusion: Overall, the study found a positive attitude toward living donor kidney transplantation and laparoscopic donor nephrectomy. This new surgical procedure seemed to positively influence recipients and potential recipients to accept a kidney. In contrast, it had less impact on donors' and potential donors' willingness to give their kidney.

Section snippets

Participants

We mailed a survey to groups of patients and potential patients who visited the University of Maryland School of Medicine Division of Transplantation between January 1998 and June 2001. The first group consisted of individuals who were considering kidney donation (potential donors). The second group included those individuals who had donated a kidney (donors). The third group comprised patients who needed a transplant and were considering a live donor (potential recipients). The last group

Response rate

Of 665 patients to whom we mailed a survey, 461 (33 potential donors, 40 potential recipients, 184 donors, and 204 recipients) returned the survey, resulting in a response rate of 51%, 51%, 75%, and 74%, respectively.

Demographics

Fifty-four percent of respondents were women, 24% were African-American, and the mean age was 47 years (range, 21 to 86). Nonrespondents were more likely to be African-American (P < 0.01) with a mean age of 44 (range, 19 to 81). Table 1 presents the demographic characteristics of

Discussion

Unlike previous mail surveys on kidney transplantation,30, 31, 32 this study focused on 4 different transplant populations: recipients, potential recipients, donors, and potential donors. High response rates, ranging from 51% to 75%, were obtained with each of these groups. In part, this could be attributed to careful questionnaire preparation and pilot testing as well as the follow-up with nonrespondents. The response rates for potential recipients and potential donors were lower than the

Conclusion

Overall, our results suggest a positive attitude toward living donor kidney transplantation and the laparoscopic donor nephrectomy. With respect to their willingness to accept/donate a kidney, the laparoscopic donor nephrectomy seems to affect recipients and potential recipients more than donors and potential donors. These results suggest that educational interventions regarding the laparoscopic donor nephrectomy should target potential recipients.

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    Supported by a grant from Roche Laboratories Inc.

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