title: Living kidney donation: considerations and decision-making.
abstract: BACKGROUND
  When possible, renal transplantation is the treatment of choice for patients with end-stage kidney disease. Technological developments in immunology have made it possible to perform kidney transplants between donors and recipients despite antibodies against the donor organ. This allows for a wider range of relationships between recipient and donor. We investigated experiences of, and reflections on, kidney donation among genetic and non-genetic living donors before first consultation at the transplant centre.
  
  
  OBJECTIVE
  The aim was to investigate early experiences in the process of becoming a living kidney donor (LKD).
  
  
  METHODS
  The study was conducted within a phenomenological-hermeneutic theoretical framework. Data were generated through semi-structured interviews with 18 potential donors. Data were interpreted and discussed in accordance with the Ricoeur's text interpretation theory on the three levels of naïve reading, structural analysis and critical interpretation and discussion.
  
  
  RESULTS
  Two themes emerged: the decision-making process and dilemmas in decision-making. The study identifies that the decision about donation was made in relation to one's own life, family situation and in relation to the recipient-considerations that demonstrate that a range of dilemmas can occur during the decision-making process. The desire to help was prominent and was of significance in decision-making.
  
  
  CONCLUSIONS
  The study provides insight and knowledge for the health care professionals to meet and involve donors' narratives in reflections about and modifications to clinical nursing practice. It is essential that health care professionals have an understanding and appreciation of the experiences and concerns among LKDs, and this can help in planning and providing individual nursing care and support to donors.
authors.affiliation: Research Unit of Nursing, University of Southern Denmark, Denmark; Department of Nephrology, Odense University Hospital, Denmark.
authors.forename: Hanne
authors.initials: H
authors.lastname: Agerskov
authors.forename: Claus
authors.initials: C
authors.lastname: Bistrup
authors.forename: Mette Spliid
authors.initials: MS
authors.lastname: Ludvigsen
authors.forename: Birthe D
authors.initials: BD
authors.lastname: Pedersen
mesh_terms: D000328:Adult; D064591:Allografts; D000533:Altruism; D003718:Denmark; D005260:Female; D006304:Health Status; D006801:Humans; D007406:Interview, Psychological; D064596:Isografts; D007676:Kidney Failure, Chronic / Q000451:nursing* / Q000601:surgery; D016030:Kidney Transplantation / Q000451:nursing* / Q000523:psychology*; D019520:Living Donors / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009042:Motivation
keywords: Decision-making; Living kidney donation; Phenomenology