title: Practices for Supporting and Confirming Decision-Making Involved in Kidney and Liver Donation by Related Living Donors in Japan: A Nationwide Survey.
abstract: This nationwide survey investigated the actual practices for supporting and confirming the decision-making involved in related living-organ donations in Japan, focusing on organ type and program size differences. Answers to a questionnaire survey were collected from 89 of the 126 (71%) kidney and 30 of the 35 (86%) liver transplantation programs in Japan that were involved in living-donor transplantations in 2013. In 70% of the kidney and 90% of the liver transplantation programs, all donors underwent "third-party" interviews to confirm their voluntariness. The most common third parties were psychiatrists (90% and 83%, respectively). Many programs engaged in practices to support decision-making by donor candidates, including guaranteeing the right to withdraw consent to donate (70% and 100%, respectively) and prescribing a set "cooling-off period" (88% and 100%, respectively). Most donors were offered care by mental health specialists (86% and 93%, respectively). Third parties were designated by more of the larger kidney transplant programs compared with the smaller programs. In conclusion, the actual practices supporting and confirming the decision to donate a living organ varied depending on the organ concerned and the number of patients in the program.
authors.affiliation: Department of Psychiatry, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Nishimura
authors.affiliation: Department of Psychiatry, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kobayashi
authors.affiliation: Department of Psychiatry, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Tsutsui
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kawasaki
authors.affiliation: Department of Psychiatry, Toho University Sakura Medical Center, Sakura, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Katsuragawa
authors.affiliation: Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Noma
authors.affiliation: Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kimura
authors.affiliation: Department of Surgery, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Egawa
authors.affiliation: Department of Transplantation Surgery, National Hospital Organization Mito Medical Center, Mito, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Yuzawa
authors.affiliation: Department of Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Umeshita
authors.affiliation: Department of Nephrology, Faculty of Medicine, Toho University, Tokyo, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Aikawa
authors.affiliation: Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Uemoto
authors.affiliation: Department of Advanced Technology for Transplantation, Osaka University, Osaka, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Takahara
authors.affiliation: Department of Psychiatry, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Ishigooka
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D003657:Decision Making; D005190:Family / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D016030:Kidney Transplantation / Q000523:psychology*; D016031:Liver Transplantation / Q000523:psychology*; D019520:Living Donors / Q000523:psychology*; D008297:Male; D009042:Motivation; D011379:Prognosis; D011795:Surveys and Questionnaires; D009927:Tissue and Organ Procurement / Q000379:methods* / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: donors and donation: donor evaluation; donors and donation: living; ethics; ethics and public policy; kidney transplantation: living donor; liver transplantation: living donor; organ transplantation in general