Kidneys from marginal donors: views of patients on informed consent

Considering the fact that donor age is a major risk factor for graft survival, and taking into account the importance attached to the principle of autonomy in the Swedish Health Care Law, we decided that allocation of kidneys from marginal donors should be restricted to patients who have given their informed consent. Written information was given to the patients on the waiting list for kidney transplantation in the southern part of Sweden. Patients were asked to state whether they would accept either a single kidney or dual transplantation kidneys from marginal donors. The aim of this study was to investigate the views of patients on the information they received about kidneys from marginal donors and their reaction to being asked to make a decision on this issue.

A questionnaire was posted to 61 patients who had already replied to the question of whether or not they would accept kidneys from a marginal donor for themselves. The median age of the patients was 52 years (range 22-74 years). Answers were given anonymously.

Among the 53 respondents, 48 considered the information to be comprehensible. The extent of the information was considered sufficient by 43 patients. No patient thought that the information was too extensive. According to 41 patients, it is totally right to be asked to make a decision on this type of issue. Two patients thought it was totally wrong. Finally, 33 patients thought it was easy to make a decision on this issue.

This study indicates that patients on the waiting list for kidney transplantation accept information on donor-related risk factors and most patients want to be involved in the decision concerning transplantation with a kidney from a marginal donor.