Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States; Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.
Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.
J Hepatol. 2015 Oct;63(4):838-47. doi: 10.1016/j.jhep.2015.05.003. Epub 2015 May 20.
BACKGROUND & AIMS: Adult-to-adult live donor liver transplantation (LDLT) poses serious health risks and no direct health benefits to donors. Ensuring live donors' autonomy through informed consent is critical. We assessed live liver donors' (LD) comprehension, information needs, risk perceptions, and demographics.
Semi-structured interviews were prospectively conducted with LDs after completing donor evaluation and informed consent at our transplant center. Likert scales measured informed consent domains. Open-ended responses underwent thematic analysis.
Thirty LDs participated (100% participation rate). Although 90% of LDs reported being informed about donation 'a great deal', only 66% reported understanding information about donation 'a great deal.' Many (40%) reported difficulty understanding medical terminology. Information LDs most desired to feel comfortable with their decision included: incidence and type of donor complications (67%), description of donation procedure (57%), and the process of donor preparation (43%). Most (83%) LDs rated risks to themselves as 'not at all' to 'somewhat' risky, and minimized these risks.
Although LDs perceived that they were adequately informed, their actual comprehension about donation was inadequate. Findings suggest the value of informed consent for preparation for the procedure and potential periprocedural risks rather than for decision-making. More comprehensible information disclosure may optimize informed consent.
成人对成人活体肝移植(LDLT)对供体造成严重的健康风险,且没有给供体带来直接的健康益处。通过知情同意来确保活体供者的自主权至关重要。我们评估了活体肝供者(LD)的理解能力、信息需求、风险感知和人口统计学特征。
在我们的移植中心完成供者评估和知情同意后,前瞻性地对 LD 进行半结构式访谈。李克特量表测量知情同意的各个领域。对开放性回答进行主题分析。
30 名 LD 参与了研究(100%的参与率)。尽管 90%的 LD 报告说他们对捐赠“非常了解”,但只有 66%的 LD 报告说他们对捐赠信息“非常了解”。许多(40%)LD 表示理解医学术语有困难。LD 们最希望了解的能让他们对自己的决定感到放心的信息包括:供体并发症的发生率和类型(67%)、捐赠程序的描述(57%)和供体准备过程(43%)。大多数(83%)LD 认为对自己的风险是“一点也不”到“有些”风险,并将这些风险最小化。
尽管 LD 们认为他们得到了充分的告知,但他们对捐赠的实际理解是不足的。研究结果表明,知情同意对于准备手术和潜在的围手术期风险很有价值,而不是用于决策。更易于理解的信息披露可能会优化知情同意。