Abstract

Anonymous living donor kidney transplantation (LDKT) is performed in many countries and policies on anonymity differ. The UK is the only European country with a conditional policy, allowing pairs to break anonymity post-transplant. There is little evidence on how contact after anonymous LDKT is experienced. In this cross-sectional study participants who donated or received a kidney through non-directed altruistic kidney donation or within the UK living kidney sharing scheme completed a questionnaire on their experiences with and attitudes towards anonymity. Non-parametric statistics were used to analyse the data. 207 recipients and 354 donors participated. Anonymity was relinquished among 11% of recipients and 8% of donors. Non-anonymous participants were generally content with non-anonymity. They reported positive experiences with contact/meeting the other party. Participants who remained anonymous were content with anonymity, however, 38% would have liked to meet post-transplant. If the other party would like to meet, this number increased to 64%. Although participants agreed with anonymity before surgery, they believe that, if desired, a meeting should be allowed after surgery. UK donors and recipients were satisfied with conditional anonymity and experiences with breaking anonymity were positive. These results support the expansion of conditional anonymity to other countries that allow anonymous LDKT.

Highlights

  • Living donor kidney transplantation (LDKT) is the treatment of choice for patients with end-stage kidney disease

  • Changes to national legal frameworks and policies have enabled the growth of living donor programmes through both innovative approaches in clinical practice [e.g., kidney exchange programmes (KEPs) and antibody incompatible transplantation] and expansion of the donor pool—from genetically related donors, to inclusion of emotionally related donors

  • Donation of a kidney from a living person to a stranger is known as non-directed altruistic donation (NDAD), but it is described as unspecified kidney donation (UKD), anonymous or “Good Samaritan” donation [1]

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Summary

Introduction

Living donor kidney transplantation (LDKT) is the treatment of choice for patients with end-stage kidney disease. Donation of a kidney from a living person to a stranger (without knowing the identity or any characteristics of the recipient before transplantation) is known as non-directed altruistic donation (NDAD), but it is described as unspecified kidney donation (UKD), anonymous or “Good Samaritan” donation [1]. Non-directed altruistic donors (NDADs) often donate into KEPs to initiate chains of transplants that complete with a recipient on the national transplant list. This is allowed in many countries, such as Australia, Canada, Netherlands, United Kingdom and United States [2]. A detailed description of KEPs in Europe has been provided by Biro et al [6]

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