A model of donors' decision-making in adult-to-adult living donor liver transplantation in Japan: Having no choice

Authors

  • Misao Fujita,

    1. Department of Biomedical Ethics, School of Public Health, Kyoto University Graduate School of Medicine, Kyoto, Japan
    2. Department of Biomedical Ethics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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  • Akira Akabayashi,

    Corresponding author
    1. Department of Biomedical Ethics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
    • Professor, Department of Biomedical Ethics, School of Health Science and Nursing, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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    • Telephone: 81-35841-3509; FAX: 81-35841-3319

  • Brian Taylor Slingsby,

    1. Department of Biomedical Ethics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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  • Shinji Kosugi,

    1. Department of Biomedical Ethics, School of Public Health, Kyoto University Graduate School of Medicine, Kyoto, Japan
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  • Yasuhiro Fujimoto,

    1. Department of Transplantation Surgery, Nagoya University Hospital, Nagoya, Japan
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  • Koichi Tanaka

    1. Department of Transplantation and Immunology, Kyoto University Hospital, Kyoto, Japan
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Abstract

This study examined the decision-making processes of donors in adult-to-adult living donor liver transplantation. Twenty-two donors were interviewed using a semi-structured format. Interview contents were transcribed verbatim and analyzed qualitatively using grounded theory. A decision-making model was developed consisting of 5 stages: (1) recognition, (2) digestion, (3) decision-making, (4) reinforcement, and (5) resolution. The second and the third stages described donors' experiences of “reaching a decision”; the fourth and fifth stages described those of “facing transplantation.” The central theme of this model was “having no choice,” which consisted of 4 codes: (1) priority of life, (2) only LDLT, (3) for family, and (4) only me. In conclusion, this model can help health care professionals to understand the donor experience and, based on that understanding, to provide sufficient support to the donor. Liver Transpl 12:768–774, 2006. © 2006 AASLD.

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