Stressors and coping mechanisms in live related renal transplantation

Abstract Aim: To explore donor and recipient experiences of stressors and coping mechanisms associated with live-related renal transplantation. Background: Live-related renal transplantation is an effective and efficient treatment for end stage kidney disease, but is also associated with a variety of stressors. Design: Longitudinal, phenomenological study. Methods: 11 live kidney donors and their recipients (n=22) were recruited from a regional renal transplant centre in South West England. Data were collected through three recorded, semi-structured interviews, conducted pre-transplant and at 3 and 10 months post-transplant. Interviews were transcribed verbatim, analysed using a process of thematic analysis and validated through a constructive process of inter-rater reliability. Findings: End stage kidney disease, dialysis and live transplantation produced a variety of stressors for donors and recipients. Common stressors included the live transplantation decision making process, the prospect of surgery and post-operative recovery, follow up care for donors and, in particular, concern for each other, especially amongst recipients. The main stressor, however, was fear of transplant failure. Participants used a variety of problem and emotion focused coping mechanisms to deal with these stressors and donors and recipients actively supported each other through the transplantation process. Conclusion: Renal transplantation remains the treatment of choice for most patients with end stage kidney disease but is a source of considerable stress for donors and especially recipients and subsequently requires a range of coping mechanisms, including social support.