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  • Title: Understanding risk in living donor nephrectomy.
    Author: Maple NH, Hadjianastassiou V, Jones R, Mamode N.
    Journal: J Med Ethics; 2010 Mar; 36(3):142-7. PubMed ID: 20211992.
    Abstract:
    OBJECTIVES: To investigate risk perception relating to living kidney donation, to compare the risk donors would accept with current practice and identify influential factors. DESIGN: An observational study consisting of questionnaires completed by previous living donors and the general public. Participants selected the risk they would accept from a list of options, in various scenarios. Risk communication was investigated by randomly dividing the sample and presenting risk differently. SETTING: Primary care (two centres) and secondary care (one centre), London. PARTICIPANTS: 175 questionnaires were sent to patients who had previously undergone living-donor nephrectomy and to members of the public consulting a general practitioner. The living-donor sample comprised 77 consecutive donors at Guy's Hospital from May 2003 to January 2005. The general-public sample was recruited from two London healthcare centres. Of the eventual 151 participants, 61 were living donors and 90 were from the general public. MAIN OUTCOME MEASURE: The amount of risk a participant would accept to donate a kidney. RESULTS: 74% of participants were willing to accept a risk of death higher than 1/3000. The most commonly accepted risk was 1/2 (29%). Those presented with a 'chance of survival' accepted higher risks than those presented with a 'risk of death' (p<0.01). Greater risks were accepted when the recipient was closely related and, for some, when the recipient's prognosis was worse. No difference was observed between the living-donor and general-public groups. CONCLUSIONS: Kidney donors will accept a higher risk of death than is currently quoted, especially if risks are presented in terms of chance of survival.
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