Kidney Donation From Live Donors

¶ … Kidney Donation from Live Donors and Ethical Considerations in Legal Organ Sales Briefly discuss which experimental design you have chosen for your nursing research proposal and why.

The proposed study will use a qualitative, phenomenological approach and a purposeful sampling design following the semi-structured interview procedures used by Brown, Karley, Boudville, Builas, Garg and Muirhead (2008) in their study of living kidney donors to gain new insights about the decision-making processes that living kidney donors use and the psychosocial issues that these experience to inform transplant programs concerning the needs of living donors and improve quality assurance practices.

In this regard, Brown and his colleagues report that living kidney transplants are accounting for an increasing percentage of all transplanted kidneys. In response to these trends, there has been a concomitant increase in interest concerning the long-term psychosocial implications of paid- and nonpaid living kidney donations (Brown et al., 2008).

The studies to date have indicated that kidney donors may enjoy quality of life levels and self-esteem that are higher than those of the general population, but some researchers have suggested that there are some downsides to kidney donation, including anxiety, depression, and suicidal ideation (Brown et al., 2008). In addition, kidney donation has been shown to have positive as well as negative effects on marital, family, and sibling relationships (Brown et al., 2008).

Although most clinicians agree that the kidney donation process is safe for living donors, there remains a lack of substantive medical guidelines that should be followed in counseling living donors. For instance, Ross, Siegler and Thistlethwaite (2007) report that, "On September 19, 2007, the board of the United Network for Organ Sharing deferred a decision to adopt uniform medical guidelines to protect the safety of living kidney donors. There is disagreement about what the guidelines should say, primarily because there is a lack of definitive data about living organ donors" (p. 37).

Therefore, the proposed study can help illuminate both the decision-making process that living kidney donors undergo to reach a positive decision as well as what pre- and post-operative counseling can help minimize any adverse clinical outcomes that may result in order to improve legal organ donation rates, including the model used in Iran, the only country in the world where organ sales are legal (Hippen, 2008; Unique model, 2007).

Explain your choice of subjects for your research (the sample) The purposeful sample of subjects will consist of both paid and non-paid Iranian living kidney donors who agree to participate in the study. Any donor-recipient relationship will be noted and other variables such as gender, age, and geographic location will be captured.

These subjects will form the basis for the semi-structured interviews that will be based on a comprehensive review of the literature and conducted pre- and post-surgery to identify effective approaches to increasing kidney donation rates from live donors and the corresponding ethical considerations involved in legal organ sales in Iran today. Identify how you will recruit the participants for your research proposal.

Recruitment for subjects to participate in the study will be accomplished by contacting medical centers and healthcare clinics that specialize in organ transplant procedures with a request for referral to the researcher for inclusion in the study population. Although no compensation will be offered in return for participation in the study, all subjects will be assured of anonymity, the absolute right to withdraw from the study at any time without any repercussions and all subjects will be offered a copy of the study results following its completion.

Annotated Bibliography Brown, J.B., Karley, M.L., Boudville, N., Bullas, N., Garg, A.M. & Muirhead, N. (2008). The experience of living kidney donors. Health and Social Work, 33(2), 93-94. Authors provide an overview of recent trends in kidney donations in general and in Canada in particular. This goal of this qualitative study was to provide new insights concerning the decision-making processes and psychosocial issues that living kidney donors experience to identify ways to improve transplant programs by highlighting the special needs of living donors and to guide quality improvement.

To this end, the researchers used a purposeful sampling of 12 living kidney donors (m=8; f=4) and a semi-structured interview format. Authors determined that there was a profound need for pre- and post-operative counseling as well as emotional support to help donors cope with the sense of loss involved. Hippen, B. (2008). Organ sales in Iran: Is it worth a look? ReachMD. [Online]. Available: http://www.reachmd.com/xmsegment.aspx?sid=3037. In this online radio program, Dr.

Hippen reports that Iran is the only country in the world where the practice of organ sales, including kidneys, is legal and notes that there is no shortage of organs needed for transplantation in this country. In fact, people in need of organs from other parts of the Middle East frequently travel to Iran to have the transplantation procedures conducted and suggests that legalizing organ sales in other countries bear closer scrutiny. Ross, L.F., Siegler, M. & Thistlethwaite, J.R., Jr. (2007). We need a registry of living kidney donors.

The Hastings Center Report, 37(6), 37. Authors report that during the period 1993 to 2005, about 0.2% (~100) of the 63,000 living kidney donors in the United States went on to develop kidney failure and were subsequently included on.