Living kidney donor decision making: state of the science and directions for future research.

BACKGROUND: The Federal government and transplantation organizations have called for further study of living donation at a time when 3 new living donor protocols are being introduced throughout the United States that promise to significantly increase the donor pool and change the face of living donation. Donation to a once incompatible and sometimes unknown recipient may now occur through the use of plasmapheresis therapy or paired and nondirected living donor protocols.

OBJECTIVE: To describe the state of the science on living kidney donor decision making, and to provide recommendations for future research to guide donor education and care.

DATA SOURCES: Automated literature search using PubMed and CINAHL scientific literature databases. STUDY DATA EXTRACTION: Research papers on living donor decision making from 1997 to 2003. Studies available only as abstracts were excluded.

DATA SYNTHESIS: Studies of living kidney donor decision making and outcomes have been limited in scope, with small sample sizes and inconsistent reports of racial and ethnic characteristics of the sample. The retrospective nature of the majority of living donor studies is a significant limitation.

CONCLUSIONS: Future prospective studies that are diverse by sex, race, and ethnicity will contribute to our knowledge of factors that influence the decision to be a living kidney donor.