TY - JOUR
T1 - Donor and Recipient Views on Their Relationship in Living Kidney Donation
T2 - Thematic Synthesis of Qualitative Studies
AU - Ralph, Angelique F.
AU - Butow, Phyllis
AU - Hanson, Camilla S.
AU - Chadban, Steve J.
AU - Chapman, Jeremy R
AU - Craig, Jonathan C
AU - Kanellis, John
AU - Luxton, Grant
AU - Tong, Allison
PY - 2017/5/1
Y1 - 2017/5/1
N2 - Background Many donors and recipients report an improved relationship after transplantation; however, tension, neglect, guilt, and proprietorial concern over the recipient can impede donor and recipient well-being and outcomes. We aimed to describe donor and recipient expectations and experiences of their relationship in the context of living kidney donation. Study Design Thematic synthesis of qualitative studies. Setting & Population Living kidney donors and recipients. Search Strategy & Sources Electronic databases were searched to October 2015. Analytical Approach Thematic synthesis. Results From 40 studies involving 1,440 participants (889 donors and 551 recipients) from 13 countries, we identified 6 themes. “Burden of obligation” described the recipient's perpetual sense of duty to demonstrate gratitude to the donor. “Earning acceptance” was the expectation that donation would restore relationships. “Developing a unique connection” reflected the inexplicable bond that donor-recipient dyads developed postdonation. “Desiring attention” was expressed by donors who wanted recognition for the act of donation and were envious and resentful of the attention the recipient received. “Retaining kidney ownership” reflected the donor's inclination to ensure that the recipient protected “their” kidney. “Enhancing social participation” encompassed relieving both the caregiver from the constraints of dialysis and the recipient from increased involvement and contribution in family life. Limitations Non-English articles were excluded. Conclusions Living kidney donation can strengthen donor-recipient relationships but may trigger or exacerbate unresolved angst, tension, jealousy, and resentment. Facilitating access to pre- and posttransplantation psychological support that addresses potential relationship changes may help donors and recipients better adjust to changes in the relationship dynamics, which in turn may contribute to improved psychosocial and transplantation outcomes following living kidney donation.
AB - Background Many donors and recipients report an improved relationship after transplantation; however, tension, neglect, guilt, and proprietorial concern over the recipient can impede donor and recipient well-being and outcomes. We aimed to describe donor and recipient expectations and experiences of their relationship in the context of living kidney donation. Study Design Thematic synthesis of qualitative studies. Setting & Population Living kidney donors and recipients. Search Strategy & Sources Electronic databases were searched to October 2015. Analytical Approach Thematic synthesis. Results From 40 studies involving 1,440 participants (889 donors and 551 recipients) from 13 countries, we identified 6 themes. “Burden of obligation” described the recipient's perpetual sense of duty to demonstrate gratitude to the donor. “Earning acceptance” was the expectation that donation would restore relationships. “Developing a unique connection” reflected the inexplicable bond that donor-recipient dyads developed postdonation. “Desiring attention” was expressed by donors who wanted recognition for the act of donation and were envious and resentful of the attention the recipient received. “Retaining kidney ownership” reflected the donor's inclination to ensure that the recipient protected “their” kidney. “Enhancing social participation” encompassed relieving both the caregiver from the constraints of dialysis and the recipient from increased involvement and contribution in family life. Limitations Non-English articles were excluded. Conclusions Living kidney donation can strengthen donor-recipient relationships but may trigger or exacerbate unresolved angst, tension, jealousy, and resentment. Facilitating access to pre- and posttransplantation psychological support that addresses potential relationship changes may help donors and recipients better adjust to changes in the relationship dynamics, which in turn may contribute to improved psychosocial and transplantation outcomes following living kidney donation.
KW - donor-recipient relationship
KW - emotional outcomes
KW - interpersonal relationships
KW - kidney donor
KW - kidney transplant recipient
KW - Living kidney donation
KW - psychosocial issues
KW - qualitative research
KW - relationship processes
KW - thematic synthesis
UR - http://www.scopus.com/inward/record.url?scp=85007209998&partnerID=8YFLogxK
U2 - 10.1053/j.ajkd.2016.09.017
DO - 10.1053/j.ajkd.2016.09.017
M3 - Article
AN - SCOPUS:85007209998
SN - 0272-6386
VL - 69
SP - 602
EP - 616
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 5
ER -