The inclusion of compatible pairs in kidney paired donation (KPD) may be a strategy to increase the chance of transplantation for incompatible pairs in KPD programs. In a prospective survey, we found that 77% of transplant candidates (TCs) and 61% of potential living donors (PLD) were willing to participate in KPD as compatible pairs. We conducted interviews with compatible TCs and PLDs to further understand their views on participation in KPD as a compatible pair.

Methods: 18 PLDs and 9 TCs, from 3 Canadian transplant centres took part in semi-directed interviews during their assessment for a compatible transplant. All interviews were conducted between May and October 2017, digitally recorded and transcribed. The content of interviews was analyzed using the qualitative data analysis method described by Miles and Huberman.

Results: Only 2 TCs and 2 PLDS were willing to participate in KPD, whereas 10 PLDs were unwilling and 6 TCs and 6 PLDs were ambivalent. One TC refused to answer citing that the decision to participate in KPD only belonged to his PLD. The main reason explaining ambivalence and unwillingness to participate in KPD was that PLDs wanted to donate to their intended recipient and TCs wanted to receive from their intended PLDs. The emotional relationships between PLDs and TCs was important. The TCs and PLDs who were willing to participate based their decision on an altruistic argument (to help more patients). Other concerns about participating in KPD included uncertainty about the outcomes of the transplantation with KPD, fear of chain breaks or donors backing out, delays in transplantation, travel, and the possibility of interacting with an unfamiliar medical team.

Discussion: The emotional consequences of not being able to directly donate to or receive a kidney from an emotionally related individual is a major barrier preventing compatible TC and PLD pairs from participating in KPD. Logistical concerns including delays in transplantation and concerns about outcomes and dealing with a new medical team are additional barriers to participate in KPD. Strategies are needed to address the emotional consequences of not being able to directly donate/recieve a kidney in order to increase participation of compatible pairs in KPD and to optimize the emotional experience for donors and recipients who participate in KPD. Ensuring optimal outcomes and minimizing delays and travel are also required.

CITATION INFORMATION: Fortin M., Gill J., Ballesteros F., Gill J. Compatible Donor and Recipient Pairs' Perspectives on Participation in Kidney Paired Donation Programs: The Emotional Implications of Indirect Donation and Transplantation Am J Transplant. 2017;17 (suppl 3).

« Back to 2018 American Transplant Congress