The Meaning of Being a Living Kidney, Liver or Stem Cell Donor - A Meta-Ethnography

ABSTRACTBackgroundStudies on living donors from the donors' perspective show that the donation process involves both positive and negative feelings involving vulnerability. Qualitative studies of living kidney, liver, and allogeneic hematopoietic stem cell donors have not previously been merged in the same analysis. Therefore, our aim was to synthesize current knowledge of these donors' experiences in order to deepen understanding of the meaning of being a living donor for the purpose of saving or extending someone's life.MethodsThe meta-ethnography steps presented by Noblit & Hare in 1988 were used.ResultsForty-one qualitative studies from 1968 to 2016 that fulfilled the inclusion criteria were analyzed. The studies comprised experiences of over 670 donors. The time since donation varied from 2 days to 29 years. A majority of the studies, 25 out of 41, were on living kidney donors. The synthesis revealed that the essential meaning of being a donor is doing what one feels one has to do, involving 6 themes; A sense of responsibility, Loneliness and abandonment, Suffering, Pride and gratitude, A sense of togetherness, and A life changing event.ConclusionThe main issue is that one donates irrespective of what one donates. The relationship to the recipient determines the motives for donation. The deeper insight into the donors' experiences provides implications for their psychological care. Background Studies on living donors from the donors' perspective show that the donation process involves both positive and negative feelings involving vulnerability. Qualitative studies of living kidney, liver, and allogeneic hematopoietic stem cell donors have not previously been merged in the same analysis. Therefore, our aim was to synthesize current knowledge of these donors' experiences in order to deepen understanding of the meaning of being a living donor for the purpose of saving or extending someone's life. Methods The meta-ethnography steps presented by Noblit & Hare in 1988 were used. Results Forty-one qualitative studies from 1968 to 2016 that fulfilled the inclusion criteria were analyzed. The studies comprised experiences of over 670 donors. The time since donation varied from 2 days to 29 years. A majority of the studies, 25 out of 41, were on living kidney donors. The synthesis revealed that the essential meaning of being a donor is doing what one feels one has to do, involving 6 themes; A sense of responsibility, Loneliness and abandonment, Suffering, Pride and gratitude, A sense of togetherness, and A life changing event. Conclusion The main issue is that one donates irrespective of what one donates. The relationship to the recipient determines the motives for donation. The deeper insight into the donors' experiences provides implications for their psychological care. Corresponding author: Annika M Kisch, Department of Haematology, Skåne University Hospital, S-221 85 Lund, Sweden, annika.m.kisch@skane.se AUTHORSHIP PAGE - Authorship statement Annika M Kisch, Anna Forsberg, Isabell Fridh, and Annette Lennerling were responsible for the research design. Annika M Kisch, Anna Forsberg, Isabell Fridh, and Annette Lennerling wrote the paper. Matilda Almgren, Martina Lundmark, Charlotte Lovén, Anne Flodén, Madeleine Nilsson, and Veronika Karlsson contributed with comments to the draft manuscript. All authors: Annika M Kisch, Anna Forsberg, Isabell Fridh, Matilda Almgren, Martina Lundmark, Charlotte Lovén, Anne Flodén, Madeleine Nilsson, Veronika Karlsson, and Annette Lennerling participated in conducting the research and data analysis. Annika M Kisch, Anna Forsberg, Isabell Fridh, and Annette Lennerling were primarily responsible for the synthesis. The authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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