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Decision-making and risk-assessment in living liver donation: how informed is the informed consent of donors? A
Christina Papachristou1, Marc Walter, Walter Marc
1Medical Clinic for Psychosomatics, Charité - University Medicine Berlin, Luisenstr. 13a, 10117 Berlin, Germany. christina.papachristou@charite.de
Background:
The practice of living donor liver transplantation (LDLT) has been increasing over the past 20 years. In LDLT, a healthy individual offers a substantial part of his or her liver (up to 60%) for the benefit of a terminally-ill recipient.
Objective:
The aim of the study was to identify decision-making and risk-assessment patterns of living liver donors and assess whether the principles of informed consent and decision autonomy are being met.
Method:
The authors conducted semistructured clinical interviews with 28 donors before transplantation.
Results:
The authors found that a decision was being reached before a decision-making process could take place. Surgery risks were perceived and processed in different ways, including the factors of risk-awareness, denial, limited acceptance, and fatalism.
Discussion:
The authors assess concepts of informed consent and decision autonomy in LDLT, and offer suggestions for donor selection.
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