8.6.1 Loss of imagined future: Grieving the loss of a transplanted kidney (179)

Paul Gill, Senior Post-Doctoral Research Fellow, Faculty of Health, Sport and Science, University of Glamorgan, Pontypridd, United Kingdom pwgill@glam.ac.uk

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 & 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 & 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.

Biography:

I am a Registered Nurse with over 15 years clinical nursing experience in critical care. I have an academic background in nursing and social anthropology and I am currently a Fellow of the Royal Anthropological Institute, London. My academic interests are in critical care and organ transplantation and my PhD, undertaken at the School of Nursing and Midwifery Studies, Cardiff University, explored donor and recipient experiences of live kidney transplantation. In 2006 I was awarded the RCN, Marjorie Simpson New Researcher Award for this research. I am currently a Senior Post-Doctoral Research Fellow at the Faculty of Health, Sports and Science, University of Glamorgan, where I am conducting a 2 year study, exploring recipients’ experiences kidney of transplant failure.