Tarabeih Mahdi, Na'amnih Wasef
School of Nursing Sciences, The Academic College of Tel-Aviv-Yaffa, Tel Aviv 64044, Israel.
Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.
Nurs Rep. 2024 Aug 19;14(3):1998-2013. doi: 10.3390/nursrep14030149.
The rising frequency of live kidney donations is accompanied by growing ethical concerns as to donor autonomy, the comprehensiveness of disclosure, and donors' understanding of long-term consequences.
To explore donors' satisfaction with the ethical competence of multi-professional nephrology teams regarding disclosure of donation consequences to live kidney donors.
A cross-sectional study was performed among Israeli live kidney donors who had donated a kidney in two hospitals that belonged to the Ministry of Health's Transplantation Center one year after the donation, from December 2018 to December 2020. Data collection was conducted online and through face-to-face interviews with the donors in their native language (Hebrew or Arabic).
Overall, 91 live kidney donors aged 18-49 years were enrolled. Of those, 65.9% were males, and 54.9% were academic donors. Among the live kidney donors, 59.3% reported that the motivation behind the donation was a first-degree family member vs. 35.2% altruistic and 5.5% commercial. Only 13.2% reported that the provided disclosure adequately explained the possible consequences of living with a single kidney. Approximately 20% of the participants reported that the disclosure included information regarding their risk of developing ESRD, hypertension, and proteinuria. The donors reported a low mean of the index score that indicates a low follow-up by the physician after the donation (mean = 1.16, SD = 0.37). The mean GFR level was significantly lower in the post-donation period one year following a kidney donation (117.8 mL/min/1.73 m) compared with the pre-donation period (84.0 mL/min/1.73 m), < 0.001.
Our findings display that donors' satisfaction with the ethical competence of multi-professional nephrology teams regarding the disclosure of donation consequences to live kidney donors is low. This study indicates that donors are at an increased risk of worsening kidney functions (creatinine and GFR), and BMI. Our findings underscore the imperative to advise donors that their condition may worsen over time and can result in complications; thus, they should be monitored during short and long-term follow-up periods. This study was not registered.
活体肾捐赠频率的上升伴随着对捐赠者自主性、信息披露的全面性以及捐赠者对长期后果的理解等伦理问题的日益关注。
探讨捐赠者对多专业肾脏病团队向活体肾捐赠者披露捐赠后果的伦理能力的满意度。
对2018年12月至2020年12月期间在以色列两家隶属于卫生部移植中心的医院捐赠肾脏的活体肾捐赠者进行了一项横断面研究。在捐赠一年后，通过在线方式并以捐赠者的母语（希伯来语或阿拉伯语）进行面对面访谈来收集数据。
总共纳入了91名年龄在18至49岁之间的活体肾捐赠者。其中，65.9%为男性，54.9%为有学术背景的捐赠者。在活体肾捐赠者中，59.3%报告称捐赠背后的动机是一级家庭成员，35.2%是利他性的，5.5%是商业性的。只有13.2%报告称所提供的信息披露充分解释了单肾生活的可能后果。约20%的参与者报告称信息披露包括了关于他们患终末期肾病、高血压和蛋白尿风险的信息。捐赠者报告的指标得分均值较低，表明医生在捐赠后随访较少（均值 = 1.16，标准差 = 0.37）。与捐赠前阶段（84.0 mL/min/1.73 m²）相比，肾脏捐赠后一年的捐赠后阶段平均肾小球滤过率水平显著降低（117.8 mL/min/1.73 m²），P < 0.001。
我们的研究结果显示，捐赠者对多专业肾脏病团队向活体肾捐赠者披露捐赠后果的伦理能力的满意度较低。这项研究表明，捐赠者肾功能（肌酐和肾小球滤过率）及体重指数恶化的风险增加。我们的研究结果强调必须告知捐赠者，他们的状况可能会随着时间推移而恶化并可能导致并发症；因此，在短期和长期随访期间应对他们进行监测。本研究未注册。
