title: Relieved or disappointed--experiences of accepted and rejected living kidney donors: a prospective qualitative study.
abstract: OBJECTIVE
  To investigate the perceived experiences and considerations among potential kidney transplantation donors in relation to acceptance or rejection as donors.
  
  
  BACKGROUND
  Kidney transplantations are successfully performed in all Western countries, but the prevalence of patients waiting for organs from deceased donors far exceeds the number of organs available. This shortfall has promoted donation by living donors, who enter the donation process with feelings of hope, concern and patience to be accepted or rejected for donation.
  
  
  METHODS
  A phenomenological-hermeneutic approach was applied in the study.
  
  
  METHODS
  Semi-structured interviews were conducted with 16 participants. Data were interpreted and discussed in accordance with Ricoeur's theory of interpretation involving: naïve reading, structural analysis, critical interpretation and discussion.
  
  
  RESULTS
  Accepted donors experienced relief and delight. Reflections were made on being prepared for donation and on the risks involved. Relationships between donors and recipients became closer. Rejected donors experienced frustration and disappointment, including anxiety about the recipient's prospects. Rejected donors reflected on the reason for rejection, and this could include considerations about changes to their own lifestyle. Reactions from relatives had an impact on donors.
  
  
  CONCLUSIONS
  The study concluded that both the accepted and rejected donors were vulnerable and in need of attention, engagement, support and care. The study draws attention to the need for healthcare professionals to be open and sensitive to the donors' descriptions of their unique experiences of being accepted or rejected for kidney donation.
  
  
  CONCLUSIONS
  Nurses should be aware that dialogue with donors, including reflections on experiences, is important to reduce and alleviate vulnerability and to give the best possible support and attention, including the opportunity to promote optimal postdonation outcomes.
authors.affiliation: Research Unit of Nursing, University of Southern Denmark, Odense M, Denmark.|Department of Nephrology, Odense University Hospital, Odense C, Denmark.
authors.forename: Hanne
authors.initials: H
authors.lastname: Agerskov
authors.affiliation: Clinical Research Unit, Randers Regional Hospital, Randers, Denmark.
authors.forename: Mette Spliid
authors.identifier: http://orcid.org/0000-0001-9439-380X
authors.initials: MS
authors.lastname: Ludvigsen
authors.affiliation: Department of Nephrology, Odense University Hospital, Odense C, Denmark.
authors.forename: Claus
authors.initials: C
authors.lastname: Bistrup
authors.affiliation: Research Unit of Nursing, University of Southern Denmark, Odense, Denmark.
authors.forename: Birthe D
authors.initials: BD
authors.lastname: Pedersen
mesh_terms: D000328:Adult; D001364:Awareness; D046148:Donor Selection; D005260:Female; D006801:Humans; D007668:Kidney; D019520:Living Donors / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000523:psychology; D011446:Prospective Studies; D036301:Qualitative Research
keywords: accepted donors; care; genetic and nongenetic donors; living kidney donation; patient experiences; rejected donors; semi-structured interview