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2005 Fiscal Year Final Research Report Summary

Research on Psychosocial and Ethical Aspects of Living Donor Liver Transplantation

Research Project

Project/Area Number 15590456
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field Medical sociology
Research InstitutionThe University of Tokyo

Principal Investigator

AKABAYASHI Akira  The University of Tokyo, Graduate School of Medicine, Professor, 大学院・医学系研究科, 教授 (70221710)

Co-Investigator(Kenkyū-buntansha) KODAMA Satoshi  The University of Tokyo, Graduate School of Medicine, Research Associate, 大学院・医学系研究科, 助手 (80372366)
Project Period (FY) 2003 – 2005
Keywordsorgan transplantation / living donor liver transplantation / psychosocial aspects / qualitative study / professional ethics / biomedical ethics / informed consent
Research Abstract

Shortage of organs and advance of transplantation techniques have drawn international attention to living donor liver transplantation (LDLT), especially adult-to-adult right lobe hepatectomy. This study aims to construct a decision-making model of the psychological process leading up to donation in adult LDLT for a donor.
Twenty-two donors (15 males and 7 females, an average age of 37.9±10.1 (SD)) were interviewed using a semi-structured format. Questions included how participants felt when they first learned of the need for transplantation, circumstances of conversation (s) with family about who should be the donor, and so forth. Interviews were conducted after the operation (mean 12.6±5.2 days), lasted 48 minutes on average and ranged in duration from 20 to 77 minutes. All interviews were tape-recorded, transcribed verbatim, and analyzed based on grounded theory.
A decision-making model was developed consisting of five-stages : (1) recognition, (2) digestion, (3) decision-making, (4) reinforcement, and (5) resolution. The second and the third stages described donors' experiences of "reaching a decision;" the latter two described that of "facing transplantation." The central theme of this model was "having no choice," which consisted of four codes : (1) priority of life, (2) only LDLT, (3) for family, and (4) only me. Although the reality of having no choice existed as a psychological burden, it concurrently motivated each participant to donate throughout the process.
The model of "having no choice" describes the psychological process of donors' decision-making in LDLT. This study's framework serves as an essential tool for healthcare professionals to understand a donor's experience and, based on that understanding, to provide sufficient support to the donor.

  • Research Products

    (12 results)

All 2006 2005 2004 2003

All Journal Article (12 results)

  • [Journal Article] A model of donors' decision-making in adult-to-adult living donor liver transplantation in Japan : having no choice2006

    • Author(s)
      Fujita, M, Akabayashi A, Slingsby, BT, Kosugi, S, Fujimoto, Y, Tanaka,K.
    • Journal Title

      Liver Transplantation 12

      Pages: 768-774

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] A model of donors' decision-making in adult-to-adult living donor liver transplantation in Japan : having no choice2006

    • Author(s)
      Fujita, M, Akabayashi, A, Slingsby, BT, Kosugi, S, Fujimoto, Y, Tanaka, K.
    • Journal Title

      Liver Transplantation 12

      Pages: 768-774

    • Description
      「研究成果報告書概要(欧文)」より
  • [Journal Article] Live organ-donation for islet transplantation2005

    • Author(s)
      Slingsby, BT, Akabayashi A.
    • Journal Title

      Lancet 366(9479)

      Pages: 26-27

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] Conflict of interest : a Japanese perspective2005

    • Author(s)
      Akabayashi, A. et al.
    • Journal Title

      Cambridge Quarterly of Healthcare Ethics 14(3)

      Pages: 277-280

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] Live organ-donation for islet transplantation2005

    • Author(s)
      Slingsby, BT, Akabayashi, A. et al.
    • Journal Title

      Lancet 366(9479)

      Pages: 26-27

    • Description
      「研究成果報告書概要(欧文)」より
  • [Journal Article] The first donor death after living-related liver transplantation in Japan2004

    • Author(s)
      Akabayashi, A. et al.
    • Journal Title

      Transplantation 77(4)

      Pages: 634-634

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] Three patterns of voluntary consent in the case of adult to adult living related liver transplantation in Japan2004

    • Author(s)
      Fujita, M, Slingsby, BT, Akabayashi, A.
    • Journal Title

      Transplantation Proceedings 36(5)

      Pages: 1425-1428

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] Administrative legislation in Japan : guidelines on scientific and ethical standards2004

    • Author(s)
      Slingsby, BT, Nagao, N, Akabayashi, A.
    • Journal Title

      Cambridge Quarterly of Healthcare Ethics 13(3)

      Pages: 245-253

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] Administrative legislation in Japan : guidelines on scientific and ethical standards2004

    • Author(s)
      Slingsby, BT, Nagao, Akabayashi, A. et al.
    • Journal Title

      Cambridge Quarterly of Healthcare Ethics 13(3)

      Pages: 245-253

    • Description
      「研究成果報告書概要(欧文)」より
  • [Journal Article] Three patterns of voluntary consent in the case of adult to adult living related liver transplantation in Japan2004

    • Author(s)
      Fujita, M, Slingsby, BT, Akabayashi, A. et al.
    • Journal Title

      Transplantation Proceedings 36(5)

      Pages: 1425-1428

    • Description
      「研究成果報告書概要(欧文)」より
  • [Journal Article] Biomedical ethics in Japan : the second stage2003

    • Author(s)
      Akabayashi, A. et al.
    • Journal Title

      Cambridge Quarterly of Healthcare Ethics 12(3)

      Pages: 261-264

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] Living related liver transplantation2003

    • Author(s)
      Akabayashi, A. et al.
    • Journal Title

      Gut 52(1)

      Pages: 152-152

    • Description
      「研究成果報告書概要(和文)」より

URL: 

Published: 2007-12-13  

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