Potential living kidney donors' health education use and comfort with donation

Abstract

Before evaluation, most potential donors are willing to donate because they think that it is important to improve the health of a loved one. Their knowledge of donation varies and they need clear information about medical testing and support coping with any negative donation outcomes.

Informed Consent for Living Donation: A Review of Key Empirical Studies, Ethical Challenges and Future Research

“…For example, LKDs report experiencing more painful surgery and recovery than expected (34%) (61). Consequently, LKDs (60) and LLDs report desiring more information to prepare for donation (53,61), and perceive the lack of information on certain aspects of the procedure as a major source of concern and anxiety (54,55). LLDs reported limited knowledge about the donation process and procedure, and did not know what questions to ask during evaluation (57,59).…”

“…In particular, survey questionnaires using the term "coercion" often fail to define it (23). Nonetheless, LKD and LLD candidates' reports of hesitancy, reluctance (76), anxiety (60,61), fear (77), and insecurity about the decision to donate (67) suggest that LDs may feel undue pressure. On the other hand, the fact that donors do withdraw from evaluation indicates that they are capable of expressing a voluntary, autonomous decision not to donate (78).…”

“…Evidence in support of this point was found in one study of LKDs whose decision to donate was based primarily on the desire to help the recipient rather than on the appreciation of risks/benefits of donation (52). Thus, the decision-making process for some can be construed as somewhat superficial (60,86) in the sense that it challenges ethical presumptions that LDs undergo moral deliberation of the risks and benefits to themselves of donating (25). Still, other LDs engage in lengthy deliberation about whether to donate (87).…”

Improving transplant education in the dialysis setting: the “explore transplant” initiative

“…[19][20][21] Many patients are also unaware that living donors report positive benefi ts from donating, including getting to help a loved one and having increased selfworth. 22,23 Multiple randomized controlled trials have shown that improved education about deceased and living donation can signifi cantly increase patients' knowledge and informed transplant decision-making. [24][25][26][27][28] However, with dialysis patients varying in their level of readiness regarding pursuing deceased or living-donor transplant, transplant education must be tailored by a patient's level of transplant readiness to support each individual in making an informed transplant choice.…”

The Impact of the Israeli Transplantation Law on the Socio-Demographic Profile of Living Kidney Donors

“…In the post-law period we found the unrelated donor population to be composed of more donors above 41 years of age, with higher education with better-paid occupations and whitecollar occupations. Furthermore, since higher education most probably enables easier access to medical and administrative information and reduces donation barriers (27), a higher education level and a higher income suggests the donors in our study cohort were more informed and less needy, hinting at emotional or altruistic motives for donation rather than financial. Another indication of a non-commercial motive comes from the lack of increase in the socio-demographic gap between recipients and donors (14,15).…”