Understanding barriers and outcomes of unspecified kidney donation

ISRCTN ISRCTN23895878
DOI https://doi.org/10.1186/ISRCTN23895878
Secondary identifying numbers 20571
Submission date
17/03/2016
Registration date
03/05/2016
Last edited
21/05/2020
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Urological and Genital Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
The waiting list for a kidney transplant in the UK includes over 7000 people, and is increasing. The best available treatment for kidney failure is a kidney transplant from a living donor. The donor is usually a friend or relative. In 2006 donation to a stranger (referred to as unspecified altruistic donation) was introduced in the UK. Since then the number of unspecified altruistic donations has increased year on year. In 2012, 60 transplants used kidneys from unspecified altruistic donors, accounting for around 1 in 20 of all kidney transplants from living donors. These donations provide a high quality kidney to patients on the national transplant list and to someone in the paired/pooled scheme who would not otherwise obtain a transplant due to incompatibility with their donor. The number of unspecified altruistic donations varies widely across transplant centres. In 2012, three (out of a total of 23) centres accounted for 45% of all unspecified altruistic donations. There is considerable variation between centres in the proportion of people making contact in order to donate a kidney, who actually proceed to donation. Reasons for this variation are unknown but may include resource issues, concerns regarding an individual's motivations, or that the individual may develop physical or psychological issues after donation. The aim of this study is to perform a comprehensive assessment of the unspecified altruistic donor programme in the UK to explore variation between centres, and identify barriers and facilitators to donation for those that have expressed a willingness to do so.

Who can participate?
Any adult who contacts a transplant centre to enquire about donating an organ to a stranger.

What does the study involve?
Potential donors recruited into the study are asked to complete a questionnaire at four time points: one soon after they come forward as a potential donor, one before the donor operation and twice after donation (3 and 12 months after surgery). Those who do not proceed with the donation for whatever reason complete the questionnaires at the same timepoints, in order to understand more about the psychological impact of not proceeding to donation. The local living donor team is also contacted to gather further information about the donation or circumstances of the withdrawal. Three samples of 15 participants (those who donated, those who withdrew from the transplantation proceed and those who were withdrawn from the process) are also invited to take part in an interview about their experiences that will last up to 90 minutes. The interview is with an experienced researcher and will ideally be face-to face, but may be by telephone or skype.

What are the possible benefits and risks of participating?
There are no direct benefits to participants, although participating will give them the opportunity to contribute to improved understanding of the process of unspecified donation in the UK. There is a risk that some questions that participants are asked may make them upset or distressed, however this is unlikely.

Where is the study run from?
Guys Hospital (UK)

When is the study starting and how long is it expected to run for?
December 2015 to March 2021

Who is funding the study?
1. National Institute for Health Research (UK)
2. University of Southampton (UK)

Who is the main contact?
Anna Taylor
anna.taylor@nhs.net

Contact information

Ms Anna Taylor
Public

Guy's and St. Thomas' NHS Foundation Trust
Renal Offices
6th floor Borough Wing
Great Maze Pond
London
SE1 9RT
United Kingdom

Phone +44 79 3920 7381
Email anna.taylor@nhs.net

Study information

Study designProspective mixed-methods cohort study
Primary study designObservational
Secondary study designCohort study
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleUnderstanding barriers and outcomes of unspecified (altruistic) kidney donation (BOUnD)
Study objectivesThe aim of this study is to perform a comprehensive assessment of the unspecified altruistic donor programme in the UK to explore variation between centres, and identify barriers and facilitators to donation for those that have expressed a willingness to do so.
Ethics approval(s)South Central - Berkshire B Research Ethics Committee, 27/11/2015, ref: 15/SC/0637
Health condition(s) or problem(s) studiedKidney transplantation
InterventionFocus group:
The Focus Groups represent the smallest aspect of the study and serve to help fine-tune the questionnaire design and interview topic guides. One focus group will involve those that have proceeded to donation with another of those that did not proceed. Participants will be asked about their experience of the donation process and services, barriers and enablers to donation and outcomes from either donating or withdrawing from the process.

Questionnaires:
The questionnaire part of the study will have three research populations on which questionnaire data will be collected at four intervention points (Q1-Q4): baseline, preoperatively and at 3 and 12 months post-donation or withdrawal in the form of a study questionnaire bundle. Additional data (such as gender, age or ethnic group) will be collected at the time of recruitment into the study. Follow up of these individuals will be for 12 months.

Qualitative interviews:
Qualitive interviews will be completed with a sample of 15 donors who completed their donation, 15 who withdrew and 15 who were withdrawn by the transplant team from the process. Participants will be asked about their experience of the donation process and services, barriers and enablers to donation and outcomes from either donating or withdrawing from the process. The interview questions have been informed by our previous grounded qualitative work, focus groups and current research
Intervention typeOther
Primary outcome measurePhysical and mental health-related quality of life is measured at baseline, pre-operatively or at withrawal, 3 months post donation or withdrawal, 12 months post donation or withdrawal using:
Mental:
1. Quality of life questionnaire (SF-12)
2. General Anxiety Disorder-7 (GAD-7)
3. Patient Health Questionnaire-9 (PHQ-9)
4. Satisfaction With Life Scale
5. Rosenberg Self-Esteem Scale
6. In house questionnaire
Physical:
NHSBT pre and post donation physiological and clinical outcomes.
Secondary outcome measures1. Barriers to donation is measured using qualitative data from interviews and focus groups at baseline, pre-operatively or at withrawal, 3 months post donation or withdrawal, 12 months post donation or withdrawal
2. Healthcare resource utilisation data is determined using the Client Service Receipt Inventory (CSRI) at baseline, pre-operatively or at withrawal, 3 months post donation or withdrawal, 12 months post donation or withdrawal
Overall study start date16/12/2015
Completion date31/03/2021

Eligibility

Participant type(s)Patient
Age groupAdult
SexBoth
Target number of participantsPlanned Sample Size: 1085; UK Sample Size: 1085
Total final enrolment833
Key inclusion criteria1. Any individual contacting a transplant centre to enquire about unspecified donation (to a stranger)
2. Those who proceeds beyond the initial phone conversation
3. Able to give informed consent, will be included as the part of the main study group
Key exclusion criteria1. Declining to participate
2. Lacking capacity to provide informated consent
3. Those not eligible to donate in the UK
Date of first enrolment16/12/2015
Date of final enrolment31/01/2020

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Guys Hospital
Great Maze Pond
London
SE1 9RT
United Kingdom

Sponsor information

Guy's and St. Thomas' NHS Foundation Trust
Hospital/treatment centre

Research & Development Dept
2nd Floor Conybeare House
Westminster Bridge Road
London
SE1 7EH
England
United Kingdom

ROR logo "ROR" https://ror.org/00j161312

Funders

Funder type

Government

National Institute for Health Research
Government organisation / National government
Alternative name(s)
National Institute for Health Research, NIHR Research, NIHRresearch, NIHR - National Institute for Health Research, NIHR (The National Institute for Health and Care Research), NIHR
Location
United Kingdom
University of Southampton
Government organisation / Universities (academic only)
Alternative name(s)
University of Southampton UK
Location
United Kingdom

Results and Publications

Intention to publish date31/08/2020
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot expected to be made available
Publication and dissemination planThere will be several specific outputs in addition to published manuscripts and conference presentations:
1. A report to NHSBT and the BTS, summarising the findings of the study
2. National guidelines, produced in conjunction with NHSBT and the BTS
3. A protocol for management of those presenting for unspecified donation
4. A report to the Renal Transplant Clinical Reference Group, which reports to NHS England (which commissions transplant services in England), and to the Scottish, Welsh and Northern Irish Departments of Health
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article protocol 21/09/2017 23/07/2019 Yes No
HRA research summary 28/06/2023 No No

Editorial Notes

21/05/2020: The following changes have been made:
1. The recruitment end date has been changed from 31/10/2019 to 31/01/2020.
2. The overall trial end date has been changed from 30/04/2020 to 31/03/2021.
3. The intention to publish date has been changed from 30/04/2021 to 31/08/2020.
4. The total final enrolment number has been added.
5. The plain English summary has been updated to reflect the changes above.
01/11/2019: The public contact has been changed and the plain English summary updated accordingly.
23/07/2019: Publication reference added.
02/04/2019: The condition has been changed from "Topic: Renal Disorders; Subtopic: Renal Disorders; Disease: All Renal Disorders" to "Kidney transplantation" following a request from the NIHR.
15/01/2019: The following changes have been made to the trial record:
1. The recruitment end date has been changed from 31/12/2018 to 31/10/2019.
2. Marriam Ghaffar was added as a contact.
3. Rebecca Gare was removed from contacts.