title: Gift exchange and organ donation: donor and recipient experiences of live related kidney transplantation.
abstract: BACKGROUND
  Live transplantation presents many stressors for donors and recipients, yet a holistic understanding of the process, from both perspectives, is limited. Gift exchange is a theory governed by the principles of giving, receiving and reciprocating and has many similarities with the process of organ transplantation. It may therefore provide a framework for understanding donor and recipient experiences of live kidney transplantation. However, the relevance of this theory to live kidney transplantation has not previously been properly explored.
  
  
  OBJECTIVE
  To gain a theoretical understanding of the live transplantation experience from the perspectives of donors and recipients.
  
  
  METHODS
  A phenomenological, longitudinal study.
  
  
  METHODS
  All donors and their recipients undergoing live kidney transplantation in a regional renal transplant centre in South-West England (between July 2003 and February 2004) were invited to participate in this study. Of this cohort, 11 families (n=55%) volunteered to participate.
  
  
  METHODS
  Data were collected through a series of 3 recorded, semi-structured interviews with donors and recipients. Interviews were conducted pre transplant and at 3 and 10 months post transplant. Data were analysed using a process of thematic content analysis. Findings were also considered within a theoretical framework of gift exchange.
  
  
  RESULTS
  All donors initially made an instantaneous, voluntary decision to donate and found the decision relatively easy to make. In contrast, recipients found accepting the donors' offer arduous, because of concern for their wellbeing. They were only able to accept the transplant after discussing the matter with their donor and establishing that it was something that they wanted to do. Recipients' lives were transformed by a successful transplant and they were subsequently very grateful to the donors for donating. Donors derived immense personal satisfaction from this outcome and it helped to confirm to them that what they had done had been worthwhile. The transplant did not have a detrimental effect on donor-recipient relationships.
  
  
  CONCLUSIONS
  The concept of gift exchange provides a logical explanation of donor and recipients experiences in this study, particularly in relation to factors that influence giving, receiving and reciprocating. This understanding should help health professionals assist donors, recipients and their families throughout this process.
authors.affiliation: Faculty of Health, Sport and Science, University of Glamorgan, Pontypridd CF37 1DL, UK. pwgill@glam.ac.uk
authors.forename: Paul
authors.initials: P
authors.lastname: Gill
authors.forename: Lesley
authors.initials: L
authors.lastname: Lowes
mesh_terms: D000328:Adult; D000533:Altruism; D001294:Attitude to Health; D003657:Decision Making; D004739:England; D005190:Family / Q000523:psychology*; D005260:Female; D037921:Gift Giving; D006801:Humans; D007398:Interpersonal Relations; D016030:Kidney Transplantation / Q000523:psychology* / Q000706:statistics & numerical data; D019520:Living Donors / Q000523:psychology* / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009392:Nephrectomy / Q000523:psychology*; D015404:Nursing Methodology Research; D010549:Personal Satisfaction; D011582:Psychological Theory; D036301:Qualitative Research; D011795:Surveys and Questionnaires