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匿名/未指定活体肾和肝供体观点的定性系统评价

A qualitative systematic review of anonymous/unspecified living kidney and liver donors' perspectives.

机构信息

Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore.

出版信息

PLoS One. 2022 Dec 30;17(12):e0277792. doi: 10.1371/journal.pone.0277792. eCollection 2022.

Abstract

OBJECTIVES & BACKGROUND: Anonymous live organ donors or unspecified donors are individuals willing to be organ donors for any transplant recipient with whom they have no biological or antecedent emotional relationship. Despite excellent recipient outcomes and the potential to help address organ scarcity, controversy surrounds the unconditional act of gifting one's organs to an unrelated recipient. This qualitative systematic review provides insights into the first-hand experiences, motivations, and challenges that unspecified donors face.

METHODS

A systematic search was conducted on Medline, Embase, CINAHL, PsycINFO, and Web of Science database for qualitative literature regarding unspecified living donors' motivations and experiences in liver and kidney transplantation. An inductive thematic analysis was conducted to generate themes and supportive subthemes.

RESULTS

12 studies were included. The four major themes were (i) motivations, (ii) perception of risks, (iii) donor support, and (iv) benefits of donation. Unspecified donors demonstrated a deep sense of social responsibility but tended to underestimate health risks in favour of benefits for recipients. Despite the lack of emotional support from family and friends, the decision to donate was a resolute personal decision for donors. Majority benefitted emotionally and did not express regret.

CONCLUSION

This qualitative review bridges the gap in literature on unspecified living donor psychology and provides a comprehensive understanding of the decision-making matrix and experiences of donors.

摘要

目的和背景

匿名活体器官捐献者或未指定的捐献者是指愿意为任何与自己没有生物学或先前情感关系的移植受者捐献器官的人。尽管受者的结局良好,而且有可能有助于解决器官短缺问题,但将自己的器官无条件地捐献给一个非亲属受者的行为仍存在争议。本定性系统评价提供了对未指定捐献者所面临的第一手经验、动机和挑战的深入了解。

方法

在 Medline、Embase、CINAHL、PsycINFO 和 Web of Science 数据库中对有关未指定活体供者在肝和肾移植中动机和经验的定性文献进行了系统检索。采用归纳主题分析生成主题和支持性子主题。

结果

纳入了 12 项研究。四个主要主题是:(i)动机,(ii)对风险的认知,(iii)供者支持,以及(iv)捐赠的益处。未指定的供者表现出强烈的社会责任感,但往往低估健康风险,而更看重对受者的益处。尽管缺乏家人和朋友的情感支持,但做出捐献的决定是供者坚定的个人决定。大多数供者在情感上受益,并不表示后悔。

结论

本定性综述填补了未指定活体供者心理学文献的空白,全面了解了供者的决策矩阵和经验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a1c/9803135/e6ea09de8f29/pone.0277792.g001.jpg

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