看護とケアのジャーナル

Emotional and Psychological Support of Living Lung Donors Who Failed to Donate to their Child: A Case Report

Abstract

Mikiko Nakamura, Chie Yokoyama, Noriko Akimoto and Takahiro Oto

Objectives: Living-donor lung transplantation (LDLT) is a real therapeutic option for pediatric patients in Japan. However, not all families with sick children can take advantages of a LDLT because of luck of suitable donors. Mental care for such a family becomes important when the parents cannot be donor candidates due to their own illness. The aim of this report is to describe the emotional and psychological status of donor candidates who could not be a lung donor due to malignancy. Methods: A semi-structured interview was performed with a donor candidate who was unable to donate due to whose own malignancy. The recipient was a 12 year- old girl, and the donor candidates were her parents. Results were obtained by a qualitative inductive analysis. Results: Donor assessment revealed that the recipient’s mother had malignancy. She was excluded from being a donor candidate and the planned living donor transplant for her daughter was cancelled. The mother’s emotional responses when she failed to donate to her sick daughter were the major theme extracted from the data. In this context, nine codes were obtained and this theme was detected across three main categories including mood disturbances, anxiety symptoms, and affective reactions. A transplant team supported the donor’s and recipient’s emotional health. The donor developed a more positive attitude at overcoming her own disease and began to expect brain-dead donor could save her daughter’s life. Three years later, the recipient underwent a successful lung transplant from a brain-dead donor. Conclusion: These findings have the potential to help transplant nurses develop interventions to improve the emotional health of living donors who failed to have the ability to donate their organs. Mental health promotion, assessment, and treatment must become priorities to improve the overall domestic mental environment of having a sick child waiting for lung transplant.