Title

Identifying outcomes that are important to living kidney donors: A nominal group technique study

Document Type

Journal Article

Publication Title

Clinical Journal of American Society of Nephrology

ISSN

1555-905X

Volume

13

Issue

6

First Page

916

Last Page

926

PubMed ID

29853616

Publisher

American Society of Nephrology

School

School of Medical and Health Sciences

RAS ID

27235

Grant Number

NHMRC Number : 1107474

Comments

Originally published as: Hanson, C. S., Chapman, J. R., Gill, J. S., Kanellis, J., Wong, G., Craig, J. C., ... Tong, A. (2018). Identifying outcomes that are important to living kidney donors: a nominal group technique study. Clinical Journal of the American Society of Nephrology, 13(6), 916-926. Original publication available here

Abstract

BACKGROUND AND OBJECTIVES: Living kidney donor candidates accept a range of risks and benefits when they decide to proceed with nephrectomy. Informed consent around this decision assumes they receive reliable data about outcomes they regard as critical to their decision making. We identified the outcomes most important to living kidney donors and described the reasons for their choices.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Previous donors were purposively sampled from three transplant units in Australia (Sydney and Melbourne) and Canada (Vancouver). In focus groups using the nominal group technique, participants identified outcomes of donation, ranked them in order of importance, and discussed the reasons for their preferences. An importance score was calculated for each outcome. Qualitative data were analyzed thematically.

RESULTS: Across 14 groups, 123 donors aged 27-78 years identified 35 outcomes. Across all participants, the ten highest ranked outcomes were kidney function (importance=0.40, scale 0-1), time to recovery (0.27), surgical complications (0.24), effect on family (0.22), donor-recipient relationship (0.21), life satisfaction (0.18), lifestyle restrictions (0.18), kidney failure (0.14), mortality (0.13), and acute pain/discomfort (0.12). Kidney function and kidney failure were more important to Canadian participants, compared with Australian donors. The themes identified included worthwhile sacrifice, insignificance of risks and harms, confidence and empowerment, unfulfilled expectations, and heightened susceptibility.

CONCLUSIONS: Living kidney donors prioritized a range of outcomes, with the most important being kidney health and the surgical, lifestyle, functional, and psychosocial effects of donation. Donors also valued improvements to their family life and donor-recipient relationship. There were clear regional differences in the rankings.

DOI

10.2215/CJN.13441217

Access Rights

free_to_read

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