Living kidney donor decision making: State of the science and directions for future research

Background-The Federal government and transplantation organizations have called for further study of living donation at a time when 3 new living donor protocols are being introduced throughout the United States that promise to significantly increase the donor pool and change the face of living donation. Donation to a once incompatible and sometimes unknown recipient may now occur through the use of plasmapheresis therapy or paired and nondirected living donor protocols. Objective-To describe the state of the science on living kidney donor decision making, and to provide recommendations for future research to guide donor education and care. Data Sources-Automated literature search using PubMed and CINAHL scientific literature databases. Study Data Extraction-Research papers on living donor decision making from 1997 to 2003. Studies available only as abstracts were excluded. Data Synthesis-Studies of living kidney donor decision making and outcomes have been limited in scope; with small sample sizes and inconsistent reports of racial and ethnic characteristics of the sample. The retrospective nature of the majority of living donor studies is a significant limitation. Conclusions-Future prospective studies that are diverse by sex, race, and ethnicity will contribute to our knowledge of factors that influence the decision to be a living kidney donor.