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Kidney transplant candidates’ understanding of increased risk donor kidneys: a qualitative study

Authors

  • Elisa J. Gordon,

    1. Institute for Healthcare Studies
    2. Comprehensive Transplant Center, Department of Surgery, Division of Organ Transplantation, Feinberg School of Medicine, Northwestern University, Chicago, IL
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  • Elizabeth Reddy,

    1. Department of Anthropology, University of California, Irvine, CA
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  • Daniela P. Ladner,

    1. Institute for Healthcare Studies
    2. Comprehensive Transplant Center, Department of Surgery, Division of Organ Transplantation, Feinberg School of Medicine, Northwestern University, Chicago, IL
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  • John Friedewald,

    1. Comprehensive Transplant Center, Department of Surgery, Division of Organ Transplantation, Feinberg School of Medicine, Northwestern University, Chicago, IL
    2. Department of Medicine, Division of Nephrology & Hypertension
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  • Michael M. Abecassis,

    1. Comprehensive Transplant Center, Department of Surgery, Division of Organ Transplantation, Feinberg School of Medicine, Northwestern University, Chicago, IL
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  • Michael G. Ison

    1. Comprehensive Transplant Center, Department of Surgery, Division of Organ Transplantation, Feinberg School of Medicine, Northwestern University, Chicago, IL
    2. Department of Medicine, Division of Infectious Diseases, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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  • Conflict of interest: The results presented in this study have not been published previously in whole or part, except in abstract format.

Corresponding author: Elisa J. Gordon, PhD, MPH, Research Associate Professor, Institute for Healthcare Studies, Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL 60611-3152, USA.
Tel.: 312 503 5563; fax: 312 503 2777; e-mail: e-gordon@northwestern.edu

Abstract

Gordon EJ, Reddy E, Ladner DP, Friedewald J, Abecassis MM, Ison MG. Kidney transplant candidates’ understanding of increased risk donor kidneys: a qualitative study.
Clin Transplant 2011 DOI: 10.1111/j.1399-0012.2011.01536.x.
© 2011 John Wiley & Sons A/S.

Abstract:  Background:  The Organ Procurement and Transplantation Network (OPTN) requires specific informed consent when “increased risk” (IR) donor organs are utilized. Little is known about kidney transplant candidates’ understanding of IR donor kidneys.

Methods:  We assessed kidney transplant candidates’ perceptions, reasons for accepting or declining a future IR donor kidney offer, and information needs through semi-structured interviews.

Results:  One hundred and sixty-two (80%) patients participated. Patients perceived IR donors as having poor health (44%), advanced age (38%), and poor kidney quality (24%). Patients (31%) would accept IR donor kidneys to get off dialysis (n = 18/50), to improve health by receiving a transplant quickly (n = 13/50), and felt that the risk of infection was low (n = 10/50). Patients (47%) would decline IR donor kidneys for fear of infection transmission (n = 34/76), perceived poor-quality kidneys (n = 32/76), and their health was good enough to wait for an average-risk kidney (n = 23/76). Undecided patients (22%) needed information about the donation situation. Patients desired information about IR donors, their kidneys, and their impact on patients’ health.

Conclusions:  Patients confuse risk posed by OPTN-defined IR donors and other non-standard risk donors. Greater efforts are needed to educate kidney transplant candidates about IR donor kidneys and refine terminology used to describe risks to patients.

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