Practices for Supporting and Confirming Decision-Making Involved in Kidney and L

[Clark]

http://onlinelibrary.wiley.com/doi/10.1111/ajt.13515/abstract

Practices for Supporting and Confirming Decision-Making Involved in Kidney and Liver Donation by Related Living Donors in Japan: A Nationwide Survey
K. Nishimura^1,*, S. Kobayashi¹, J. Tsutsui¹, H. Kawasaki², S. Katsuragawa³, S. Noma⁴, H. Kimura⁵, H. Egawa⁶, K. Yuzawa⁷, K. Umes***a⁸, A. Aikawa⁹, S. Uemoto¹⁰, S. Takahara¹¹ andJ. Ishigooka¹
DOI: 10.1111/ajt.13515
American Journal of Transplantation
Early View (Online Version of Record published before inclusion in an issue)

Abstract
This nationwide survey investigated the actual practices for supporting and confirming the decision-making involved in related living-organ donations in Japan, focusing on organ type and program size differences. Answers to a questionnaire survey were collected from 89 of the 126 (71%) kidney and 30 of the 35 (86%) liver transplantation programs in Japan that were involved in living-donor transplantations in 2013. In 70% of the kidney and 90% of the liver transplantation programs, all donors underwent “third-party” interviews to confirm their voluntariness. The most common third parties were psychiatrists (90% and 83%, respectively). Many programs engaged in practices to support decision-making by donor candidates, including guaranteeing the right to withdraw consent to donate (70% and 100%, respectively) and prescribing a set “cooling-off period” (88% and 100%, respectively). Most donors were offered care by mental health specialists (86% and 93%, respectively). Third parties were designated by more of the larger kidney transplant programs compared with the smaller programs. In conclusion, the actual practices supporting and confirming the decision to donate a living organ varied depending on the organ concerned and the number of patients in the program.