Introduction: Individuals considering live kidney donation should have a thorough understanding of the risks and benefits. Regulations focus exclusively on donation risks. However, no data are available to counsel potential donors about outcomes if they are turned down for donation. Being turned down for donation may affect some individuals' quality of life, financial security, and/or mental health.

Methods: We conducted a retrospective study of 32 individuals turned down for kidney donation and 105 kidney donors at a single center during the years 2010 to 2013. All turned down donors underwent an evaluation by a transplant professional. Study participants completed the SF-12 quality of life scale, the Patient Health Questionnaire-9 to measure depression, a financial security instrument, a scale to measure provider empathy, and a digitally recorded semi-structured interview. Investigators performed detailed thematic reviews of the interviews.

Results: Quality of life in both groups was better than population norms. Quality of life (p=0.98 for physical component score, p=0.67 for mental component score), depression (p=0.50), financial security (p=0.08), and assessment of provider empathy (p=0.29) scores were similar between groups (Table 1). The majority of turned down donors expressed regret that they missed an opportunity to help another person. Among turned down donors whose intended recipients had not received transplants (n=15), 67% disagreed with the statement, "My life is better than it would have been if I had donated a kidney", and cited emotional and practical aspects of their lives that would have been improved if they had been accepted for donation.

Conclusion: Despite concerns about the risks of kidney donation on quality of life, finances, and depression, these outcomes are nearly identical between donors and individuals who were turned down for donation. For some turned down donors, the inability to donate a kidney is viewed as a missed opportunity.

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