Decision-making and risk-assessment in living liver donation: how informed is the informed consent of donors? A qualitative study.
BACKGROUND
The practice of living donor liver transplantation (LDLT) has been increasing over the past 20 years. In LDLT, a healthy individual offers a substantial part of his or her liver (up to 60%) for the benefit of a terminally-ill recipient.


OBJECTIVE
The aim of the study was to identify decision-making and risk-assessment patterns of living liver donors and assess whether the principles of informed consent and decision autonomy are being met.


METHODS
The authors conducted semistructured clinical interviews with 28 donors before transplantation.


RESULTS
The authors found that a decision was being reached before a decision-making process could take place. Surgery risks were perceived and processed in different ways, including the factors of risk-awareness, denial, limited acceptance, and fatalism.


CONCLUSIONS
The authors assess concepts of informed consent and decision autonomy in LDLT, and offer suggestions for donor selection.
Papachristou
Christina
C
Medical Clinic for Psychosomatics, Charité - University Medicine Berlin, Luisenstr. 13a, 10117 Berlin, Germany. christina.papachristou@charite.de
Walter
Marc
M
Marc
Walter
W
Frommer
Joerg
J
Frommer
Jeorg
J
Klapp
Burghard F
BF
D000328:Adult; D000368:Aged; D003657:Decision Making; D004644:Emotions; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007258:Informed Consent / Q000523:psychology*; D007406:Interview, Psychological / Q000379:methods; D016031:Liver Transplantation / Q000523:psychology*; D019520:Living Donors / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment