From proposal to practice: participation of compatible donor-recipient pairs in the Dutch kidney exchange program
M. de Klerk, W. Zuidema, E.K. Massey, W. Weimar, J. van de Wetering
Chair(s): M.J.C. Wessels & J.M. Wierdsma
Thursday 9 march 2017
10:12 - 10:24h
at Willem Pijperzaal
Categories: Parallel - Verpleegkundig
Parallel session: Parallelsessie X – Verpleegkundig
Background:
Since 2004 incompatible donor-recipients pairs have participated in the Dutch living kidney exchange program. Between 2009 and 2012 5 compatible pairs decided to donate in the exchange program, which resulted in 14 instead of 5 transplants. Enrolment of compatible pairs could help increase the success rate in the kidney exchange program. However, how should we educate compatible donors and recipients about this participation. Here we discuss the implementation of a protocol for these pairs to participate in the exchange program and describe a study designed to evaluate the decision-making process.
Methods:
Our transplant team discussed the protocol to minimize undue influence, as well as the moment of education. A questionnaire was developed to evaluate the protocol and the decision-making process regarding participation.
Results:
In June 2016 we introduced the compatible pairs program. We developed a leaflet with neutral, objective information about the program. This information was also available on our website. Education about living donation programs was standardized. All new patients and donors who visit the outpatient clinic for the first time will be informed in the same way about these programs. The first consultation with the coordinator about the living donation/transplant programs take place at the time that donor-recipient pair do not know if they are compatible or not. The information leaflet about voluntary participation in the exchange program is handed out at this point. The second consultation with the coordinator takes place when the compatible pair visit the outpatient clinic for the immunological results. If the cross-match is negative and they are blood type and HLA compatible, we discuss the willingness to participate in the exchange program. When the pair has made a decision, we ask them to participate in a survey study on their decision-making process. The questionnaire can be filled in at home. Specific versions of the questionnaire were developed for participants and for non-participants, and for patients and donors respectively.
In conclusion:
Education takes place to raise awareness that a living donor can always give the kidney in a indirect way. This can be the case if it’s medical necessary or voluntary on an altruistic basis to help other pairs. With the questionnaire we aim to gain insights into patients and donors motivation to their decision. Acceptable and unacceptable conditions of the program will be evaluated.
