Peer-Reviewed
The attitudes of patients and donors towards living donor liver transplantation
L.M. McGregor
University of Stirling
V. Swanson
University of Stirling
P.C. Hayes
University of Stirling
R.E. O'Carroll
University of Stirling
Background
A Living Donor Liver Transplantation (LDLT) programme was introduced at the Scottish Liver Transplant Unit (SLTU) in April 2006. This was the first time adult LDLT had become available on the UK NHS. LDLT is routinely performed in select transplant units throughout the USA, Canada and Europe, with Toronto alone having performed over 175 procedures since their programme began in 2000. However, in Scotland, as of July 2007, no patients have pursued the option of LDLT. The aim of this project was to find out why, by assessing the attitudes of patients on the liver transplant waiting list, and their families, towards LDLT.
Methods
All 25 patients who have received a LDLT information pack from the SLTU were invited to participate. A total of 14 patients participated, 6 declined the invitation, 2 were too ill to participate, 2 are yet to be contacted and 1 died. Each participant was asked to provide the contact details of at least one potential donor. A total of 13 potential donors were invited to participate and 11 accepted. Participation involved a short interview semi-structured interview. All participants were given the option of either a face-to-face interview or a telephone interview with the researcher. Thematic analysis was performed on the interview transcripts.
Findings
The main deterrent to pursuing LDLT was the patients’ perceived risk to their healthy donor. Patients felt that they “couldn’t live with themselves” if anything adverse happened to the donor as a result of the operation. In contrast, many potential donors did not appear to consider the risk involved, as they were only focused on helping their loved one survive.
Discussion
LDLT is a highly emotive subject which may cause significant tension within the family unit. Other transplant units in the UK are currently developing LDLT programmes and could benefit from a deeper understanding of the attitudes, concerns and risk perceptions of patients and their families when faced with the option of LDLT.
