The findings show that patients are reluctant to accept higher-risk organs. Of those completing the survey, 58 percent would only accept organs with a 25 percent (or less) risk of graft failure and 18 percent would only accept the lowest possible risk of 19 percent at three years following transplantation.
Women were slightly more accepting of high-risk organs than men. Researchers found that risk tolerance was increased by presenting organ quality as "average quality" rather than "best quality," and by providing feedback about the implications of these preferences on the likelihood of receiving a transplant. Additionally, 83 percent of candidates were found to prefer an equal or dominant role in deciding whether to accept a higher-risk organ. This finding is striking given that, in most transplant centers, patient involvement in these decisions is minimal.
"Up until now, it has not been clear how much patients want to be involved in this complicated decision," says Volk.
"Furthermore, explaining the intricacies of this topic to sick patients is easier said than done. Our findings offer transplant physicians some useful guidelines for how to council transplant candidates on issues of organ quality."
The authors suggest future studies are needed to develop validated patient education tools that will enhance discussions between physicians and patients in need of liver transplantations.
|Contact: Mary Masson|
University of Michigan Health System