Relieved or disappointed - experiences of accepted and rejected living kidney donors: a prospective qualitative study

Aim and objectives. To investigate the perceived experiences and considerations among potential kidney transplantation donors in relation to acceptance or rejection as donors. Background. Kidney transplantations are successfully performed in all Western countries, but the prevalence of patients waiting for organs from deceased donors far exceeds the number of organs available. This shortfall has promoted donation by living donors, who enter the donation process with feelings of hope, concern and patience to be accepted or rejected for donation. Design. A phenomenological-hermeneutic approach was applied in the study. Methods. Semi-structured interviews were conducted with 16 participants. Data were interpreted and discussed in accordance with Ricoeur's theory of interpretation involving: naive reading, structural analysis, critical interpretation and discussion. Results. Accepted donors experienced relief and delight. Reflections were made on being prepared for donation and on the risks involved. Relationships between donors and recipients became closer. Rejected donors experienced frustration and disappointment, including anxiety about the recipient's prospects. Rejected donors reflected on the reason for rejection, and this could include considerations about changes to their own lifestyle. Reactions from relatives had an impact on donors. Conclusions. The study concluded that both the accepted and rejected donors were vulnerable and in need of attention, engagement, support and care. The study draws attention to the need for healthcare professionals to be open and sensitive to the donors' descriptions of their unique experiences of being accepted or rejected for kidney donation. Relevance to clinical practice. Nurses should be aware that dialogue with donors, including reflections on experiences, is important to reduce and alleviate vulnerability and to give the best possible support and attention, including the opportunity to promote optimal postdonation outcomes.