Practices for Supporting and Confirming Decision-Making Involved in Kidney and Liver Donation by Related Living Donors in Japan: A Nationwide Survey

Am J Transplant. 2016 Mar;16(3):860-8. doi: 10.1111/ajt.13515. Epub 2015 Nov 10.

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.

Keywords: donors and donation: donor evaluation; donors and donation: living; ethics; ethics and public policy; kidney transplantation: living donor; liver transplantation: living donor; organ transplantation in general.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Attitude to Health
  • Decision Making*
  • Family / psychology*
  • Female
  • Follow-Up Studies
  • Humans
  • Japan
  • Kidney Transplantation / psychology*
  • Liver Transplantation / psychology*
  • Living Donors / psychology*
  • Male
  • Motivation
  • Prognosis
  • Surveys and Questionnaires
  • Tissue and Organ Procurement / methods*
  • Tissue and Organ Procurement / statistics & numerical data*
  • Young Adult