Family issues implicit in living donation

Abstract

Abstract Living renal donation is increasing and is an important source of kidneys for patients with end stage renal disease. Such donations have major quality of life implications for donors and recipients. The majority of studies in this field address physical health issues; live donation, however, also involves complex psychological, social, and cultural needs. It is important to have an understanding of this complexity to ensure that the quality of life of recipient and donor is not harmed. This paper reports the findings of an ethnographic study, which examined aspects of live donation from psychological, social, and cultural perspectives. Issues discussed include family relationships, complexities of seeking a donor from within the family, gift reciprocity, donor moral imperatives, and difficulties encountered within the donor decision-making process. The findings show: the degree and nature of the dependence and interdependence felt between donors and recipients; the difficulties encountered in both the decision to donate and the refusal to donate; the longer term obligations that may arise; and the impact on the family unit, demonstrating psychological, social, and cultural risks within the live donation process. These important findings should be recognised and addressed by relevant pre- and post-operative professional care, thus maintaining the integrity of the family unit and also, more importantly, the autonomy of both the donor and the recipient. Keywords: donorfamilylive donationliving donationrecipientkidney