Decision-Making and Risk-Assessment in Living Liver Donation: How Informed Is the Informed Consent of Donors? A Qualitative Study

BackgroundThe 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.ObjectiveThe aim of the study was to identify decisionmaking and risk-assessment patterns of living liver donors and assess whether the principles of informed consent and decision autonomy are being met.MethodThe authors conducted semistructured clinical interviews with 28 donors before transplantation.ResultsThe 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.DiscussionThe authors assess concepts of informed consent and decision autonomy in LDLT, and offer suggestions for donor selection.