A qualitative systematic review of anonymous/unspecified living kidney and liver donors’ perspectives

Abstract

Objectives & background Anonymous live organ donors or unspecified donors are individuals willing to be organ donors for any transplant recipient with whom they have no biological or antecedent emotional relationship. Despite excellent recipient outcomes and the potential to help address organ scarcity, controversy surrounds the unconditional act of gifting one’s organs to an unrelated recipient. This qualitative systematic review provides insights into the first-hand experiences, motivations, and challenges that unspecified donors face. Methods A systematic search was conducted on Medline, Embase, CINAHL, PsycINFO, and Web of Science database for qualitative literature regarding unspecified living donors’ motivations and experiences in liver and kidney transplantation. An inductive thematic analysis was conducted to generate themes and supportive subthemes. Results 12 studies were included. The four major themes were (i) motivations, (ii) perception of risks, (iii) donor support, and (iv) benefits of donation. Unspecified donors demonstrated a deep sense of social responsibility but tended to underestimate health risks in favour of benefits for recipients. Despite the lack of emotional support from family and friends, the decision to donate was a resolute personal decision for donors. Majority benefitted emotionally and did not express regret. Conclusion This qualitative review bridges the gap in literature on unspecified living donor psychology and provides a comprehensive understanding of the decision-making matrix and experiences of donors.

Exploring Staff Attitudes Towards Unspecified Kidney Donors in the United Kingdom: Results From the BOUnD Study

“…Previous research demonstrates that UKDrs have positive outcomes [ 34 ] and equivalent psychological outcomes to SKDrs [ 9 , 35 ]. Motives are honourable, however the evidence to date for the personal benefit of UKD is mixed [ 36 ], and studies reporting benefits are mainly retrospective [ 37 ]. The BOUnD study will hopefully help to fill this gap in the literature [ 8 ].…”

The incidence of adverse outcome in donors after living donor liver transplantation: A meta-analysis of 60,829 donors

“…LDLT remains a significant form of organ donation, particularly in Asian countries where cultural and religious factors have resulted in a lack of deceased donors. [22][23][24] However, the ethical concerns associated with LDLT are multifaceted and require careful consideration. In particular, the principle of double equipoise is essential in ensuring a fair and justifiable decisionmaking process, particularly with regard to balancing the interests and welfare of both the donor and recipient.…”

“…LDLT remains a significant form of organ donation, particularly in Asian countries where cultural and religious factors have resulted in a lack of deceased donors 22–24 . However, the ethical concerns associated with LDLT are multifaceted and require careful consideration.…”

“…Eighty-seven articles involving 60,829 living liver donors were included. The overall pooled incidence of complications in LDLT donors was 24.7% (CI: 21.6%-28.1%). The incidence of minor complications was 17.3% (CI: 14.7%-20.3%), while the incidence of major complications was lower at 5.5% (CI: 4.5%-6.7%).…”