Renal transplantation and the living donor. Decision and consequences

Renal transplantation in end-stage renal disease is now an accepted medical procedure but the source and origin of the grafted organ (living donor vs. cadaveric kidney) remain controversial and it appears that each transplant team has to work out its own guidelines. We present the results of questionnaires and interviews of a large number of donors, many of them looking back on their experience with the knowledge that unfortunately, and in the long run, their sacrifice proved to be in vain. All our subjects evaluated their participation as donors in the transplant program in a very positive way. There was general agreement that none of them was significantly harmed by his action and that, in the realms of self-knowledge and feelings of self-worth and self-respect, the act of donorship turned out to be a very positive and very highly valued experience. These donors' opinions and attitudes, their relatively unconflicted conduct, are in sharp contrast with the agonizing appraisal of many a transplant team. It remains the task of the team doctors to weigh and balance risks and advantages of such an intervention and to be the advocate of both the donor and the recipient. It is to them that we offer our findings in the hope that it may help them in that difficult decision-making process.