title: Remaining experiences of living kidney donors more than 3 yr after early recipient graft loss.
abstract: Living kidney donor programs, based on willingness among family members and close relatives to donate, have made it possible to perform a satisfactory number of kidney transplantations. Early graft loss in the recipient may occur and it is not known if such an event will result mainly in acute, rather transient, emotional reactions or if long-lasting reactions may be evoked in the living kidney donor. The aim of the present study was to assess and describe the remaining experiences of donors (n = 10) more than 3 yr after early recipient graft loss or death of the recipient. A phenomenographic, interview-based research approach was used. Five different fields or domains were identified: (i) the decision to donate; (ii) the information provided; (iii) care received at the time of donation; (iv) responses at graft failure; and (v) concerns remaining at the time of the interview. All donors expressed that they had volunteered to donate and that no stress had been put on them. The information given prior to and in connection with the donation procedure was deemed insufficient but all donors were satisfied with the medical care provided in connection with the nephrectomy and in the immediate post-operative period. Graft failure was immediately accepted on the intellectual level by nine of 10 donors but still evoked emotional reactions and responses included a wish that continuing contact with the transplant staff had been provided. The present interview-based study shows that it is of importance that the donor is thoroughly informed about all donor as well as recipient-related factors including the potential risk of recipient graft failure. In case of graft failure, or the death of the recipient, the transplant unit staff members should offer contact for discussions of medical matters as well as for psychosocial support. In individual cases it may be necessary to maintain such a supportive contact channel for a prolonged period of time.
authors.affiliation: Department of Transplantation and Liver Surgery, Sahlgrenska University Hospital, Göteborg, Sweden. Ulla.Haljamae@vgregion.se
authors.forename: Ulla
authors.initials: U
authors.lastname: Haljamäe
authors.forename: Gudrun
authors.initials: G
authors.lastname: Nyberg
authors.forename: Björn
authors.initials: B
authors.lastname: Sjöström
mesh_terms: D000328:Adult; D000368:Aged; D001290:Attitude; D001294:Attitude to Health; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality; D019520:Living Donors / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011787:Quality of Health Care; D013315:Stress, Psychological / Q000453:epidemiology*; D013997:Time Factors; D014342:Truth Disclosure