title: Kidney transplant candidates' understanding of increased risk donor kidneys: a qualitative study.
abstract: BACKGROUND
  The Organ Procurement and Transplantation Network (OPTN) requires specific informed consent when "increased risk" (IR) donor organs are utilized. Little is known about kidney transplant candidates' understanding of IR donor kidneys.
  
  
  METHODS
  We assessed kidney transplant candidates' perceptions, reasons for accepting or declining a future IR donor kidney offer, and information needs through semi-structured interviews.
  
  
  RESULTS
  One hundred and sixty-two (80%) patients participated. Patients perceived IR donors as having poor health (44%), advanced age (38%), and poor kidney quality (24%). Patients (31%) would accept IR donor kidneys to get off dialysis (n=18/50), to improve health by receiving a transplant quickly (n=13/50), and felt that the risk of infection was low (n=10/50). Patients (47%) would decline IR donor kidneys for fear of infection transmission (n=34/76), perceived poor-quality kidneys (n=32/76), and their health was good enough to wait for an average-risk kidney (n=23/76). Undecided patients (22%) needed information about the donation situation. Patients desired information about IR donors, their kidneys, and their impact on patients' health.
  
  
  CONCLUSIONS
  Patients confuse risk posed by OPTN-defined IR donors and other non-standard risk donors. Greater efforts are needed to educate kidney transplant candidates about IR donor kidneys and refine terminology used to describe risks to patients.
authors: Institute for Healthcare Studies Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611-3152, USA. e-gordon@northwestern.edu
authors: Elisa J
authors: EJ
authors: Gordon
authors: Elizabeth
authors: E
authors: Reddy
authors: Daniela P
authors: DP
authors: Ladner
authors: John
authors: J
authors: Friedewald
authors: Michael M
authors: MM
authors: Abecassis
authors: Michael G
authors: MG
authors: Ison
mesh_terms: D000328:Adult; D000368:Aged; D001290:Attitude; D032882:Comprehension; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D010361:Patients / Q000523:psychology*; D012307:Risk Factors; D012959:Socioeconomic Factors; D014019:Tissue Donors; D009927:Tissue and Organ Procurement; D014481:United States; D055815:Young Adult