The Federal government and transplantation organizations have called for further study of living donation at a time when 3 new living donor protocols are being introduced throughout the United States that promise to significantly increase the donor pool and change the face of living donation. Donation to a once incompatible and sometimes unknown recipient may now occur through the use of plasmapheresis therapy or paired and nondirected living donor protocols.
Objective
To describe the state of the science on living kidney donor decision making, and to provide recommendations for future research to guide donor education and care.
Data Sources
Automated literature search using PubMed and CINAHL scientific literature databases.
Study Data Extraction
Research papers on living donor decision making from 1997 to 2003. Studies available only as abstracts were excluded.
Data Synthesis
Studies of living kidney donor decision making and outcomes have been limited in scope, with small sample sizes and inconsistent reports of racial and ethnic characteristics of the sample. The retrospective nature of the majority of living donor studies is a significant limitation.
Conclusions
Future prospective studies that are diverse by sex, race, and ethnicity will contribute to our knowledge of factors that influence the decision to be a living kidney donor.
Get full access to this article
View all access options for this article.
References
1.
WarrenJ. ACOT recommends set of live organ donor standards: Spotlight now on HHS Secretary Thompson's response. Transplant News.2002;12:1–3.
2.
AdamsPLCohenDJDanovitchGM. The nondirected live-kidney donor: Ethical considerations and practice guidelines: A national conference report. Transplantation.2002;74:582–589.
3.
De OrtuzarMGSoraattiCVelezI. Bioethics and organ transplantation. Transplant Proc.1997;29:3627–3630.
4.
GlannonWRossLF. Do genetic relationships create moral obligations in organ transplantation?Camb Q Healthc Ethics.2002;11:153–159.
5.
MarcusAD. New hope for people waiting for a kidney. The Wall Street Journal.2003;D1.
6.
MontgomeryRAZacharyARacusenL. Plasmapheresis and intravenous immuno globulin provides effective rescue therapy for refractory humoral rejection and allows kidneys to be successfully transplanted into cross-match-positive recipients. Transplantation.2000;70:887–895.
7.
BoulwareLERatnerLECooperLASosaJALaViestTAPoweNR. Understanding disparities in donor behavior. Med Care. February 2002;40:85–95.
8.
OlsonWDBogetti-DumlaoA. Living donors' perception of their quality of health after donation. Prog Transplant.2001;11:108–115.
9.
JacobsCJohnsonEAndersonKGillinghamKMatasA. Kidney transplants from living donors: How donation affects family dynamics. Adv Ren Replace Ther. April 1998;5:89–97.
10.
CorleyMCElswickRKSargeantCCScottS. Attitude, self-image, and quality of life of living kidney donors. Nephrol Nurs J. February 2000;27:43–52.
11.
LouisSaint C. Family scars: Three people in desperate need of kidneys and the siblings who provided them. New York Times Magazine.2002:52–55.
12.
LockM. Cultural aspects of organ donation and transplantation. Transplant Proc.1999;31:1345–1346.
13.
YiM. Decision-making process for living kidney donors. J Nurs Scholarsh.2003;35(1):61–66.
14.
ZimmermanDDonnellySMillerJStewartDAlbertSE. Gender disparity in living renal transplant donation. Am J Kidney Dis.2000;36:534–540.
15.
BroelschCETestaGAlexandrouAMalagoM. Living related liver transplantation: Medical and social aspects of a controversial therapy. Gut.2002;50:143–145.
16.
Biller-AndornoNAgichGJDoepkensKSchauenburgH. Who shall be allowed to give? Living organ donors and the concept of autonomy. Theor Med.2001;22:351–368.
17.
GilliganC. In a Different Voice: Psychological Theory and Women's Development.Cambridge, Mass: Harvard University Press; 1982.
18.
JacobsC. Expanding living donor options. Minn Med. December 2001;84:46–48.
19.
DobbinB. Stranger gives man ultimate gift—a kidney. Philadelphia Inquirer.2002;A-14.
20.
WardJ. It's something I'll never forget. The Washington Times.2002;A-1.
21.
DaarAS. Strangers, intimates, and altruism in organ donation. Transplantation.2002;74:424–425.
22.
McNamaraPGuadagnoliEEvaniskoMJ. Correlates of support for organ donation among three ethnic groups. Clin Transplant. February 1999;13(1 pt 1):45–50.
23.
SurmanOS. The ethics of partial-liver donation. N Engl J Med.2002;346:1038.
24.
CabrerCOppenhaimerFManyalichM. The living kidney donation process: The donor perspective. Transplant Proc.2003;35:1631–1632.
25.
DucheneDAJohnsonDBLiSRodenJSSagalowskyAICadedduJA. Laparoscopic donor nephrectomy at a low volume living donor transplant center: Successful outcomes can be expected. J Urol.2003;170:731–733.
26.
SandmannW. Living donor kidney transplantation: Pitfalls of the donor and recipient operation. Transplant Proc.2003;35:930.
27.
SmithGCTrauerTKerrPGChadbanSJ. Prospective psychosocial monitoring of living kidney donors using the SF-36 health survey. Transplantation.2003;76:807–809.
28.
LennerlingAForsbergANybergG. Becoming a living kidney donor. Transplantation.2003;76:1243–1247.
29.
FukunishiISugawaraYTakayamaTMakuuchiMKawarasakiHSurmanOS. Association between pretransplant psychological assessments and posttransplant psychiatric disorders in living-related transplantation. Psychomatics. January-February 2002;43:49–54.
30.
EllisonMDMcBrideMATarantoSEDelmonicoFLKauffmanHM. Living kidney donors in need of kidney transplants: A report from the organ procurement and transplantation network. Transplantation.2002;74:1349–1351.
31.
IsotaniSFujisawaMIchikawaI. Quality of life of living kidney donors: The short-form 36-item health questionnaire survey. Urology.2002;60:588–592.
32.
SpitalA. Public attitudes toward kidney donation by friends and altruistic strangers in the United States. Transplantation.2001;7:1061–1064.
33.
Fehrman-EkholmIDunerFBrinkBTydenGElinderCG. No evidence of accelerated loss of kidney function in living kidney donors: Results from a cross-sectional follow-up. Transplantation.2001;72:444–449.
34.
JohnsonEMAndersonJKJacobsC. Long-term follow-up of living kidney donors: Quality of life after donation. Transplantation.1999;67:717–721.
35.
KarrfeltHMEBergUBLindbladFIETydenGE. To be or not to be a living donor. Transplantation.1998;65:915–918.
36.
SchoverLRStreemSBBoparaiNDuriakKNovickAC. Psychosocial impact of donating a kidney: Long-term followup from a urology based center. J Urol.1997;157:1596–1600.
37.
IglesiasRACalderonSSantiago-DelpinEARive-MoraEGonzalez-CaraballoZMorales-OteroL. The health of living kidney donors 20 years after donation. Transplant Proc.2001;33:2041–2042.
38.
FisherRGouldDWainwrightSFallonM. Quality of life after renal transplantation. J Clin Nurs.1998;7:553–563.
39.
ToronyiEAlfoldyFJarayJ. Evaluation of the state of health of living related kidney transplantation donors. Transplant Int.1998;11:S57–S59.
CeckaJM. Kidney transplantation from living unrelated donors. Ann Rev Med.2000;51:393–406.
42.
BeaversKLSandlerRSFairJHJohnsonMWShresthaR. The living donor experience: Donor health assessment and outcomes after living donor liver transplantation. Liver Transplant.2001;7:943–947.
43.
KarliovaMMalagoMValentin-GamazoC. Living-related liver transplantation from the view of the donor: A 1-year follow-up survey. Transplantation.2002;73:1799–1804.
