To tell or not to tell: attitudes of transplant surgeons and transplant nephrologists regarding the disclosure of recipient information to living kidney donors.

Abstract

Organ Procurement and Transplantation Network policy regarding "Living Donation Informed Consent Requirements" only requires general disclosure of candidate health information to prospective living kidney donors. We examined attitudes of transplant surgeons and transplant nephrologists regarding greater disclosure. Web-based and mailed surveys to explore attitudes about disclosing potential recipient health information, health-associated behaviors, and lifestyle choices to living donors. Of 397 potential participants, 111 eligible participants (28%) fully or partially responded. Respondents were split between surgeons (42%) and nephrologists (58%). While 72% believed that general disclosure did not require explicit permission, 88% believed that disclosure of specific recipient information did. Many would disclose more information if legally permissible. Over 65% thought disclosure of recipient information should not depend on the donor-recipient relationship. Virtually all supported disclosing expected one- and five-yr graft survival and anticipated deceased donor wait-time. Sixty-six percent supported disclosing non-compliance or difficulty taking medications. Support was divided for disclosure of HIV (52%), hepatitis (49%), smoking (53%), illicit drugs (50%), alcohol (49%), and psychiatric history (44%). While virtually all respondents support disclosing recipient information directly relevant to graft and patient survival to prospective living donors, they are divided about sharing other recipient health, health behavior, and/or lifestyle information.