title: The general public's concerns about clinical risk in live kidney donation.
abstract: Difficulty in attracting live kidney donors may be related to fears regarding both the surgical procedure for kidney harvesting and future failure of the remaining kidney. We conducted a cross-sectional study of households in Maryland to identify public disincentives to living related kidney donation. In multivariate analyses, we assessed the independent effects of several factors on willingness to donate a kidney to a sibling. We also assessed thresholds for factors above which persons would not donate a kidney. Of 385 participants, 66% were extremely willing to donate to a sibling. After adjustment, those who considered the length of a hospital stay, out-of-pocket expenses, size and appearance of a scar, the time it takes to get to the transplant center, and the donor risk of developing kidney failure very important had 50-60% less odds of being extremely willing to donate. Median acceptable levels for risk of complications, hospital stay, compensated and uncompensated time from work, time requiring pain medications, and out-of-pocket expenses were greater than levels from clinical evidence regarding both laparoscopic and open nephrectomy. Unrealistic concerns among the general public regarding live donation may serve as potential disincentives to donation. Efforts to educate the public regarding live donation might help assuage fears and attract those who may not otherwise donate.
authors.affiliation: Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: L Ebony
authors.initials: LE
authors.lastname: Boulware
authors.forename: Lloyd E
authors.initials: LE
authors.lastname: Ratner
authors.forename: Julie Ann
authors.initials: JA
authors.lastname: Sosa
authors.forename: Alexander H
authors.initials: AH
authors.lastname: Tu
authors.forename: Satish
authors.initials: S
authors.lastname: Nagula
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Simpkins
authors.forename: Raegan W
authors.initials: RW
authors.lastname: Durant
authors.forename: Neil R
authors.initials: NR
authors.lastname: Powe
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D015142:Baltimore; D003430:Cross-Sectional Studies; D004651:Employment; D005260:Female; D006801:Humans; D007182:Income; D016030:Kidney Transplantation; D007902:Length of Stay; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects* / Q000191:economics; D010465:Perception; D011183:Postoperative Complications / Q000453:epidemiology*; D044469:Racial Groups; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D020858:Tissue and Organ Harvesting / Q000009:adverse effects* / Q000191:economics