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Abstract
Live transplantation presents many stressors for donors and recipients, yet a holistic
understanding of the process, from both perspectives, is limited. Gift exchange is
a theory governed by the principles of giving, receiving and reciprocating and has
many similarities with the process of organ transplantation. It may therefore provide
a framework for understanding donor and recipient experiences of live kidney transplantation.
However, the relevance of this theory to live kidney transplantation has not previously
been properly explored.
To gain a theoretical understanding of the live transplantation experience from the
perspectives of donors and recipients.
A phenomenological, longitudinal study.
All donors and their recipients undergoing live kidney transplantation in a regional
renal transplant centre in South-West England (between July 2003 and February 2004)
were invited to participate in this study. Of this cohort, 11 families (n=55%) volunteered
to participate.
Data were collected through a series of 3 recorded, semi-structured interviews with
donors and recipients. Interviews were conducted pre transplant and at 3 and 10 months
post transplant. Data were analysed using a process of thematic content analysis.
Findings were also considered within a theoretical framework of gift exchange.
All donors initially made an instantaneous, voluntary decision to donate and found
the decision relatively easy to make. In contrast, recipients found accepting the
donors' offer arduous, because of concern for their wellbeing. They were only able
to accept the transplant after discussing the matter with their donor and establishing
that it was something that they wanted to do. Recipients' lives were transformed by
a successful transplant and they were subsequently very grateful to the donors for
donating. Donors derived immense personal satisfaction from this outcome and it helped
to confirm to them that what they had done had been worthwhile. The transplant did
not have a detrimental effect on donor-recipient relationships.
The concept of gift exchange provides a logical explanation of donor and recipients
experiences in this study, particularly in relation to factors that influence giving,
receiving and reciprocating. This understanding should help health professionals assist
donors, recipients and their families throughout this process.