Grant: Project Grant - Priority Announcement: Patient-Oriented Research

Living kidney transplantation offers the best medical outcomes for end stage renal disease (ESRD) patients. Prior to the launch of kidney paired donation programs (KPDs), the living kidney donor had to be compatible with his intended recipient. KPD provides the ability to circumvent this incompatibility obstacle by matching a donor who is incompatible with his intended recipient with a different recipient who is also incompatible with his donor and vice versa. Since its beginning, the Canadian KPD program has facilitated 682 living donor kidney transplantations which would not have been possible before. Recently, advanced donation programs with vouchers have been developed in the US. This program allows the living donor to donate at the most appropriate moment for him and provides a voucher for named persons (up to five) who are not currently ready to receive or could potentially receive a kidney transplant, to receive a living donor kidney transplant at the end of KPD chain in the future. Advanced donation raises numerous ethical and logistical issues such informed consent, fairness and justice, gift-exchange, etc. The objective of this exploratory study is to gather key stakeholders' perspectives, with qualitative interviews and surveys, on the ethical and logistical issues related to advanced donation and to develop preliminary ethical guidelines adapted for the Canadian transplant context. The results of this study will provide important topical information to the transplant community and may inform future discussions on any advanced donation programs developed for the Canadian KPD program.