Identifying outcomes that are important to living kidney donors : A nominal group technique study

Journal article

Hanson, Camilla S., Chapman, Jeremy R., Gill, John S., Kanellis, John, Wong, Germaine, Craig, Jonathon C., Teixeira-Pinto, Armando, Chadban, Steve J., Garg, Amit X., Ralph, Angelique F., Pinter, Jule, Lewis, Joshua R. and Tong, Allison. (2018). Identifying outcomes that are important to living kidney donors : A nominal group technique study. Clinical Journal of the American Society of Nephrology. 13(6), pp. 916-926. https://doi.org/10.2215/CJN.13441217

Publication dates
Authors	Hanson, Camilla S., Chapman, Jeremy R., Gill, John S., Kanellis, John, Wong, Germaine, Craig, Jonathon C., Teixeira-Pinto, Armando, Chadban, Steve J., Garg, Amit X., Ralph, Angelique F., Pinter, Jule, Lewis, Joshua R. and Tong, Allison
Abstract	Background and objectives Living kidney donor candidates accept a range of risks and benefits when they decide to proceed with nephrectomy. Informed consent around this decision assumes they receive reliable data about outcomes they regard as critical to their decision making. We identified the outcomes most important to living kidney donors and described the reasons for their choices. Design, setting, participants, & measurements Previous donors were purposively sampled from three transplant units in Australia (Sydney and Melbourne) and Canada (Vancouver). In focus groups using the nominal group technique, participants identified outcomes of donation, ranked them in order of importance, and discussed the reasons for their preferences. An importance score was calculated for each outcome. Qualitative data were analyzed thematically. Results Across 14 groups, 123 donors aged 27–78 years identified 35 outcomes. Across all participants, the ten highest ranked outcomes were kidney function (importance=0.40, scale 0–1), time to recovery (0.27), surgical complications (0.24), effect on family (0.22), donor-recipient relationship (0.21), life satisfaction (0.18), lifestyle restrictions (0.18), kidney failure (0.14), mortality (0.13), and acute pain/discomfort (0.12). Kidney function and kidney failure were more important to Canadian participants, compared with Australian donors. The themes identified included worthwhile sacrifice, insignificance of risks and harms, confidence and empowerment, unfulfilled expectations, and heightened susceptibility. Conclusions Living kidney donors prioritized a range of outcomes, with the most important being kidney health and the surgical, lifestyle, functional, and psychosocial effects of donation. Donors also valued improvements to their family life and donor-recipient relationship. There were clear regional differences in the rankings.
Year	2018
Journal	Clinical Journal of the American Society of Nephrology
Journal citation	13 (6), pp. 916-926
Publisher	American Society of Nephrology
ISSN	1555-9041
Digital Object Identifier (DOI)	https://doi.org/10.2215/CJN.13441217
PubMed ID	29853616
Scopus EID	2-s2.0-85048270123
PubMed Central ID	PMC5989678
Open access	Open access
Page range	916-926
Funder	National Health and Medical Research Council (NHMRC)
	Canadian Institutes of Health Research (CIHR)
	Australian Research Council (ARC)
Publisher's version	License All rights reserved File Access Level Controlled
Output status	Published
Online	Jun 2018
Publication process dates
Accepted	14 Mar 2018
Deposited	21 May 2025
ARC Funded Research	This output has been funded, wholly or partially, under the Australian Research Council Act 2001
Grant ID	GNT1092741
	1106716
	1107474
	DE120101710
Additional information	Bronze open access.
	Copyright © 2018 by the American Society of Nephrology.

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