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Canadian transplant nephrologists’ perspectives on the decision‐making process for accepting or refusing a kidney from a deceased organ donor
Author(s) -
Cardinal Héloïse,
Ballesteros Gallego Fabian,
Affdal Aliya,
Fortin MarieChantal
Publication year - 2020
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13793
Subject(s) - medicine , thematic analysis , clinical decision making , decision making , medical decision making , transplantation , kidney transplantation , intensive care medicine , kidney , decision process , family medicine , qualitative research , surgery , operations management , management science , social science , purchasing , sociology , economics
Background Kidney transplantation is the best treatment for patients with end‐stage renal disease. The decision to accept a kidney from a deceased donor can be a difficult one, especially when organs from high KDPI (>85%) donors are offered. This study aims to capture the perspectives of transplant nephrologists (TNs) on the decision‐making process when an organ is offered. Methods Fifteen Canadian TNs took part in semi‐structured interviews between December 2017 and April 2018. The interviews were digitally recorded, transcribed, and analyzed using the thematic analysis method. Results The decision to accept a deceased‐donor kidney offer is a medical one for the participants. However, transplant candidates could be involved when the offered kidney is from a donor with a KDPI >85% or increased infectious risk donor. The TNs’ past experience, comprehensive data on the donor, and education of the transplant candidate could facilitate the decision‐making process. A decision aid could also facilitate the decision‐making process, but different concerns should be addressed. Conclusion Although accepting a deceased‐donor organ offer is often viewed as an opportunity for shared decision‐making, participants in this study viewed the decision to accept or refuse an offer as a medical decision with little room for patient participation.