Decision-making and risk-assessment in living liver donation: how informed is the informed consent of donors? A qualitative study.

摘要

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.