Loss of imagined future; grieving the loss of a transplanted kidney

Abstract: Background: Kidney transplantation is the treatment of choice for most patients with end-stage renal disease. Kidney transplants are effective and efficient, but are not without complications. Approximately 7-12% of all kidney transplants fail within a year (UK Transplant 2007) and rates of graft failure increase over time. The impact of graft failure is profound, often inducing a grief like reaction, causing depression and, occasionally, suicidal feelings. However, despite these issues, the personal dimensions of graft failure have been poorly researched. Aims and Objectives: The purpose of this paper is to provide a comprehensive insight into the graft rejection experience from the participants’ perspective. Methods: 11 live kidney donors and their recipients were originally recruited into this study from a regional transplant centre in South-West England. Of this sample, one donor-recipient couple experienced an irreversible episode of graft rejection immediately post-transplant. A phenomenological case-study approach was therefore used to explore their experiences. Data were collected through a series of semi structured interviews, conducted pre-transplant and at three and ten months post transplant. Interviews were recorded, transcribed verbatim and analysed using a process of thematic content analysis. Analyses were also validated using a process of inter-rater reliability. Findings and conclusion: This paper discusses the impact of graft failure on the participants, focusing on the psychosocial trauma and feelings of grief, loss, depression and suicidal ideations. The paper also explores coping mechanisms, emotional readjustment and service provision issues relating to care, support and information provision. Recommendations for practice and research are also made. Recommended reading list: UK Transplant (2007) Transplant survival. http://www.uktransplant.org.uk/ukt/statistics/transplant_activity_report/transplant_activity_report.jsp Source of Funding: UK - Higher Education Institution Amount in Funding: 10,001 - 50,000