NDT Advance Access originally published online on May 25, 2007
Nephrology Dialysis Transplantation 2007 22(10):3040-3045; doi:10.1093/ndt/gfm305
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Transplant professionals vary in the long-term medical risks they communicate to potential living kidney donors: an international survey
1Division of Nephrology, University of Western Ontario, London, Canada, 2Department of Epidemiology and Biostatistics, University of Western Ontario, London, Canada, 3Department of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia, 4School of Medicine and Pharmacology, University of Western Australia, Perth, Australia, 5Section of Nephrology, Yale University, West Haven, Connecticut, USA, 6Division of Nephrology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates, 7Department of Nuclear Medicine, University of Western Ontario, London, Canada and 8Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
Correspondence and offprint requests to: Amit Garg, London Kidney Clinical Research Unit, Room ELL-101, Westminster Tower, London Health Sciences Centre, 800 Commissioners Road East, London, Ontario, Canada N6A 4G5. Email: Amit.Garg{at}lhsc.on.ca
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Abstract |
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Background. Discussing long-term medical risks with potential living donors is a vital aspect of informed consent. We considered whether there are global practice variations in the information communicated to potential living kidney donors.
Methods. Transplant professionals participated in a survey to determine which long-term risks are communicated to potential living kidney donors. Self-administered questionnaires were distributed in person and by electronic mail.
Results. We surveyed 203 practitioners from 119 cities in 35 different countries. Sixty-three percent of participants were nephrologists, and 27% were surgeons. Risks of hypertension, proteinuria or kidney failure requiring dialysis were frequently discussed (usually over 80% of practitioners discussed each medical condition). However, many practitioners do not believe these risks are increased after donation, with surgeons being less convinced of long-term sequelae compared with nephrologists (P < 0.01). About 30% of practitioners discuss long-term risks of premature cardiovascular disease or death with potential donors.
Conclusions. Transplant professionals vary in the long-term risks they communicate to potential donors. Improving consensus will enhance decision-making, and emphasize best practices which maintain good, long-term donor health.
Keywords: consent; donor nephrectomy; living kidney donation; long-term complications; risk communication; survey
Donor Nephrectomy Outcome Research (DONOR) Network Investigators: Neil Boudville, Laurence Chan, Mona Doshi, Amit Garg, Colin Geddes, Eric Gibney, John Gill, Martin Karpinski, Scott Klarenbach, Greg Knoll, Charmaine Lok, Mauricio Monroy-Cuadros, Norman Muirhead, Chirag Parikh, Emilio Poggio, G. V. Ramesh Prasad, Leroy Storsley, Sudha Tata and Darin Treleavan, Robert Yang Author contributions: Housawi, Thiessen-Philbrook, and Garg had full access to all of the data in the study and take responsibility for the accuracy of the data analysis. Study concept and design: Housawi, Boudville, Muirhead, Garg; Questionnaire development: Housawi, Boudville, Muirhead, Rehman, Garg; Acquisition of data: Housawi, Young, Boudville, Thiessen-Philbrook, Al-Obaidli, El-Triki, Garg; Analysis and interpretation of data: Housawi, Thiessen-Philbrook, Garg; Drafting of the manuscript: Housawi, Boudville, Rehman, Parikh, Garg; Critical revision of the manuscript for important intellectual content: Housawi, Young, Thiessen-Philbrook, Muirhead, Rehman, Parikh, Al-Obaidli, El-Triki, Garg; Statistical analysis: Thiessen-Philbrook, Garg; Obtained funding: Boudville, Muirhead, Garg; Administrative, technical, or material support: Garg; Study supervision: Garg.
Received for publication: 10.10.06
Accepted in revised form: 20. 4.07
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