生体腎移植ドナー候補の提供意思における問題

—自発的意思の確認のための“第三者面接”を通して—

抄録

In Japan, more than 80% of kidney transplant donors are living donors. It is stipulated that a living donor must be an immediate family member, or be a relative of the organ recipient. Moreover, the donor must have the voluntary intention to donate, as well as decision-making ability. According to the ethical guideline of the Japan Society for Transplantation, the voluntary intent of the donor candidates should be confirmed by a third party outside the patient's family. Over one year, we conducted interviews with 156 candidate donors to confirm their intention to donate a kidney. The interviewers included a psychiatrist and a clinical psychologist. Candidates that were judged to be in conflict about their intention to donate a kidney were selected after the interview. A total of 14 (9%) out of 156 interviewees had a conflict in their intention to donate. The problems described by the donor candidates included the ability to express their intention, psychological pressure from others, agreement in the family for the donation and the ability to understand medical information, such as the risks of donation. The results of this study suggest that careful psychosocial assessment of living kidney donor candidates is necessary to confirm their decision.