Finding a living kidney donor: experiences of New Zealand renal patients
Paula Martin
+ Author Affiliations
- Author Affiliations
Health Services Research Centre, School of Government, Victoria University of Wellington, PO Box 600, Wellington 6011, New Zealand. Email: paula.martin@vuw.ac.nz
Australian Health Review 37(1) 48-53 https://doi.org/10.1071/AH12159
Submitted: 15 March 2012 Accepted: 19 July 2012 Published: 14 December 2012
Abstract
A living donor kidney transplant (LDKT) is the preferred treatment for many people with end stage renal failure but there is a significant and growing gap between the number of people who might benefit from a transplant and those who receive one in New Zealand. International research suggests a range of barriers for patients in the journey to LDKT. One hundred and ninety-three patients on the New Zealand waiting list for a kidney transplant responded to a postal survey about live transplantation. While many patients are willing to discuss LDKT with family and friends, most are reluctant to go on to ask others directly to consider live donation. Patients who have not discussed LDKT with others are significantly less likely to have received even one offer from a potential donor. Pākehā and Māori are more likely to have received an offer to donate and to have had someone go on to be tested for compatibility than either Pacific or Other ethnic groups. Information gaps, ineffective donor recruitment strategies, donor incompatibility and donor medical unsuitability appear to be major barriers to LDKT. Many barriers are amenable to intervention and the implications for policy and practice are discussed.
What is known about the topic? International studies suggest donor recruitment is difficult for patients and is a major barrier to LDKT. Incompatibility and medical unsuitability are barriers for many willing potential donors. There is no previous patient-centred NZ research on the barriers to living donor kidney transplantation (LDKT).
What does this paper add? The paper provides evidence about patterns of donor recruitment activity amongst NZ patients, and suggests a strong relationship between discussing LDKT with family and friends, and receiving offers from potential donors. Asking potential donors directly to consider donation, as opposed to just discussing LDKT in general, does not seem to be associated with receiving more offers. Differences among ethnic groups can be seen.
What are the implications for practitioners? Many of the barriers to LDKT are amenable to intervention, and possible options, such as support for donor recruitment and boosting NZ’s paired exchange scheme, are identified.
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