Purpose: Annually, Brazil performs less than half the estimated necessity of kidney transplants (KT), leaving nearly 33,000 patients on the waiting list at the end of 2023. Kidney paired donation (KPD) is a strategy to increase the number of living donor kidney transplants (LDKT), representing about 20% of such transplants in the United States. We are only aware of a single two-way kidney exchange performed in 2020 in Brazil. Since then, the topic has gained more attention in the medical community. Unfortunately, the voices of those most interested in and impacted by this program remain unheard. This study aimed to assess the perspectives of potential living kidney donors regarding KPD.
Methods: We conducted a prospective observational study at a single center. From October
2022 to March 2023, all kidney donor candidates undergoing evaluation attended a comprehensive lecture on KPD. Subsequently, they anonymously responded to a questionnaire crafted by experts. The questionnaire delved into various aspects, including comprehension of the donation process, awareness of potential risks and benefits, donor intentions, considerations of gains and losses, and knowledge about KPD. All patients who agreed to participate answered the questionnaire and signed informed consent were included in the analysis.
Results: During the study period, 116 potential donors underwent evaluation, with 89 meeting the inclusion criteria. The patients, averaging 42 years of age, were 53.9% female. The majority (76.4%) were related to the potential recipients. A notable 23.6% believed they were their recipient's sole donor. Nearly half (48.3%) had engaged in volunteer activities, and 46.1% had donated blood. Regarding motivations, 76.4% cited ʻlove or affectionʼ and 66.3% expressed ʻwillingness to help. ʼ Concerning expectations, 97.8% wished ʻthe recipient to get well/better. ʼ Only 11.3% believed they might face financial challenges due to the donation. Respondents felt well-informed about treatment options for recipients (93.3%) and the risks of donation (94.4%). Although nearly 70% were unfamiliar with KPD, 80% expressed a willingness to participate if they were incompatible with their recipients.
Conclusions: KPD has the potential to significantly increase the number of LDKT, leading to
better outcomes for recipients. This analysis underscores a widespread acceptance of this modality within the donor community. Given that those are the two groups most directly impacted by the program, it is crucial to acknowledge and understand their perspectives.