Transformational experiences in adult-to-adult living-donor liver transplant recipients

Authors

  • Akemi Watanabe,

    1. Akemi Watanabe PhD RN Lecturer Department of Critical and Invasive-Palliated Care Nursing, Graduate School of Health Sciences, Tokyo Medical and Dental University, Japan
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  • Tomoko Inoue

    1. Tomoko Inoue PhD RN Professor Department of Critical and Invasive-Palliated Care Nursing, Graduate School of Health Sciences, Tokyo Medical and Dental University, Japan
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A. Watanabe: e-mail: tinoue.cc@tmd.ac.jp

Abstract

watanabe a. & inoue t. (2010) Transformational experiences in adult-to-adult living-donor liver transplant recipients. Journal of Advanced Nursing66(1), 69–81.

Abstract

Title.  Transformational experiences in adult-to-adult living-donor liver transplant recipients.

Aim.  This paper is a report of a study conducted to explore the transformational experiences of adult-to-adult living-donor liver transplant recipients.

Background.  Living-donor liver transplant was developed to overcome the shortage of cadaveric livers available for transplantation. However, living-donor liver transplant generates multifaceted psychosocial problems for recipients.

Method.  Data were collected from 2002 to 2004 through in-depth interviews and participant observations. We adopted a phenomenological approach that examined the experience of 30 recipients.

Findings.  We classified the experiences into three types: common, innate and unrealized. Analysis of the transcripts revealed four themes, all with associated sub-themes. The first theme, guilt and concrete issues, includes anguish when thinking about survival by hurting a potential donor and problems associated with donor and cost. The second theme, let it happen includes leave it to fate; ambivalence; and worry about the donor candidate and whether he/she will change their mind. The third theme, pain, includes extreme physical and mental pain for me and the donor; and worry about cost. The fourth theme, balancing gains and losses, includes grateful for and hoping to enjoy my new life; burden of new body; difficulty in adapting to modified life plan; and changes in family relationships.

Conclusion.  Nursing practice should be developed to (1) give support to patients and their families during decision-making; (2) give support for the dramatic life change; (3) help recipients accept the reality of the transplant; and (4) help achieve the essential balance between feelings of attainment and loss.

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