Risk Taking and Decision Making in Kidney Paired Donation: A Qualitative Study by Semistructured Interviews.

Abstract:

INTRODUCTION:Despite excellent outcomes of kidney paired donation (KPD), little is known about how a patient's frame (apply cognitive bias) or weight (attribute value) and concerns relating to risk, justice, and equity affect his or her decision-making process. MATERIALS AND METHODS:A pilot study consisting of 3 KPD transplant recipients and 3 KPD kidney donors in the last year was conducted to identify and explore themes in decision making and risk taking. The pilot study was followed by the main study comprised of 20 recipients who had already undergone KPD transplantation and 20 donors who had undergone donor nephrectomy. We conducted semistructured interviews in this cohort and analyzed the data thematically. Each donor-recipient pair was interviewed together to facilitate dyadic conversation and provide deeper insight into the decision-making process leading to transplant and donation. RESULTS:Common themes to both recipient and donor decision making included quality of life; characteristics of the unknown donor and post-transplant expectations. Recipient-specific themes included failure to reach life span milestones, experiences of fellow patients, and altruistic desire to expand the donor pool. Donor-specific themes included balancing existing life commitments with the recipient's need for a kidney, equity and mental accounting in kidney exchange (comparable quality of the kidney received versus the kidney donated), and logistical justice for the recipient. DISCUSSION:Donors and recipients frame and weight the concepts of risk, justice, and equity differently. This may have direct implications to facilitating patient-centered communication and engagement in KPD pairs.

journal_name

Transplant Proc

authors

Baines LS,Dulku H,Jindal RM,Papalois V

doi

10.1016/j.transproceed.2018.02.079

subject

Has Abstract

pub_date

2018-06-01 00:00:00

pages

1227-1235

issue

5

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(18)30243-4

journal_volume

50

pub_type

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