Main Article Content
Abstract
Introduction: In living donor kidney transplantation, women are the most frequent donors. Nephrology professionals play a very important role in informing about renal replacement treatments and assisting in decision-making.
Objective: To explore how gender perspective influences living donor renal transplantation from the views of nephrology professionals.
Methodology: A qualitative phenomenological study was carried out. Thirteen professionals from the Nephrology and Renal Transplant Units in Catalonia participated in this study. Semi-structured interviews were conducted and analysed using a thematic analysis.
Results: The opinions and perceptions of female nephrology professionals were classified according to the following topics: 1) way of informing about treatments; 2) habitual donation; 3) predisposition to donate and 4) attitude of the donor. Women are more likely to donate due to gender mandates, as well as to inequalities in the labour market. It should be noted that the decision-making process is the same for men and women, that women are better psychologically prepared and recover more quickly from the postoperative period.
Conclusions: Feminization in kidney donation is the sum of medical, socio-cultural and economic factors. Gender roles influence women’s attitudes and behaviours throughout the living kidney transplantation process. The female nephrology professionals interviewed describe the differences between men and women in kidney donation.
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References
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- Matesanz R, Martínez Castelao A, Arias M. Recomendaciones de la Sociedad Española de Nefrología (SEN) y de la Organización Nacional de Trasplantes (ONT) sobre trasplante renal de donante vivo. Nefrologia. 2010;30:0. DOI: https://doi.org/10.1016/S1886-2845(09)70975-0
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- Global Observatory on Donation and Transplantation. Annual organ transplantation activity [consultado 17 May 2021]. Disponible en: http:// http://www.transplant-observatory.org/.
- Valentín MO, Domínguez Gil B, Martín Escobar E, Matesanz Acedos R. No indicar el trasplante de vivo es una mala práctica. Nefrologia. 2009;29(5):379-81.
- Trachtman H, Parent B, Kirshenbaum A, Caplan A. Physician attitudes toward living kidney donation. Prog Transplant. 2019;29(1):78-83. DOI: https://doi.org/10.1177/1526924818817063
- Documento Marco sobre la Enfermedad Renal Crónica dentro de la Estrategia de Abordaje a la Cronicidad en el SNS. Subdirección General de Calidad y Cohesión, Dirección General de Salud Pública, Calidad e Innovación, Ministerio de Sanidad, Servicios Sociales e Igualdad, Consejerías de Sanidad de las CCAA. 2015.
- Salter ML, McAdams Demarco MA, Law A, Kamil RJ, Meoni LA, Jaar BG, et al. Age and sex disparities in discussions about kidney transplantation in adults undergoing dialysis. J Am Geriatr Soc. 2014; 62(5):843-9. DOI: https://doi.org/10.1111/jgs.12801
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- Monson RS, Kemerley P, Walczak D, Benedetti E, Oberholzer J, Danielson KK. Disparities in completion rates of the medical pre-renal transplant evaluation by race/ethnicity and ender. Transplant. 2015;99(1):236. DOI: https://doi.org/10.1097/TP.0000000000000271
- Lipford KJ, McPherson L, Hamoda R, Browne T, Gander JC, Pastan SO, et al. Dialysis facility staff perceptions of racial, gender, and age disparities in access to renal transplantation. BMC Nephr 2018;19(1),1-11. DOI: https://doi.org/10.1186/s12882-017-0800-6
- Jindal RM, Ryan JJ, Sajjad Murthy MH, Baines LS. Kidney transplantation and gender isparity. Am J Nephrol. 2005;25(5):474-83. DOI: https://doi.org/10.1159/000087920
- Piccoli GB, Alrukhaimi M, Liu ZH, Zakharova E, Levin A. What we do and do not know about women and kidney diseases; questions unanswered and answers unquestioned: reflection on World Kidney Day and International Woman’s Day. BMC Nephrol. 2018;19(1):66. DOI: https://doi.org/10.1186/s12882-018-0864-y
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- Puoti F, Ricci A, Nanni Costa A, Ricciardi W, Malorni W, Ortona E. Organ ransplantation and gender differences: a paradigmatic example of intertwining between biological and sociocultural determinants. Biology of sex differences. 2016;7(1):1-5. DOI: https://doi.org/10.1186/s13293-016-0088-4
- Crowley-Matoka M & Hamdy SF. Gendering the gift of life: Family politics and kidney donation in Egypt and Mexico. Medical anthropology. 2016;35(1):31-44. DOI: https://doi.org/10.1080/01459740.2015.1051181
- Scheper–Hughes N. The tyranny of the gift: sacrificial violence in living donor transplants. Am J Transplant. 2007;7(3):507-11. DOI: https://doi.org/10.1111/j.1600-6143.2006.01679.x
- Hanson CS, Ralph AF, Manera KE, Gill JS, Kanellis J, Wong G, et al. The lived experience of “being evaluated” for organ donation: focus groups with living kidney donors. Clin J Am Soc Nephrol. 2017;12(11):1852-61. DOI: https://doi.org/10.2215/CJN.03550417
- Garg PP, Diener-West M, Powe NR. Income-based disparities in outcomes for patients with chronic kidney disease. Semin Nephrol 2001;21:377. DOI: https://doi.org/10.1053/snep.2001.23764
- Oien CM, Reisæter AV, Leivestad T, Pfeffer P, Fauchald P, Os I. Gender imbalance among donors in living kidney transplantation: the Norwegian experience. Nephrol Dial Transplant. 2005;20(4):783-9. DOI: https://doi.org/10.1093/ndt/gfh696
- Scott JW. El género: una categoría útil para el análisis histórico. México: PUEG; 1986.
- Cantero, MTR. Sesgos de género en la atención sanitaria. Escuela Andaluza de Salud Pública. 2009.
- Mauvais Jarvis F, Merz NB, Barnes PJ, Brinton RD, Carrero JJ, DeMeo DL el al. Sex and gender: modifiers of health, disease, and medicine. The Lancet. 2020;396(10250):565-82. DOI: https://doi.org/10.1016/S0140-6736(20)31561-0
- Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psych. 2006;3:77-101. DOI: https://doi.org/10.1191/1478088706qp063oa
- Prieto Velasco M, Quiros P, & Remon C. The concordance between patients’ renal replacement therapy choice and definitive modality: is it a Utopia?. PLoS One. 2015;10(10), e0138811. DOI: https://doi.org/10.1371/journal.pone.0138811
- Stolcke V. ¿Es el sexo para el género como la raza para la etnicidad? Mientras Tanto. 1992; 48:87-111.
- Rubin G. El tráfico de mujeres: notas sobre la economía política del sexo. En: El género: la construcción cultural de la diferencia sexual, compilado por Marta Lamas. México: Puegunam, 1996; 35-98.
- Rota-Musoll L, Brigidi S, Molina-Robles E, Oriol-Vila E, Perez-Oller L, & Subirana-Casacuberta M. An intersectional gender analysis in kidney transplantation: women who donate a kidney. BMC nephrology. 2021;22(1):1-10. DOI: https://doi.org/10.1186/s12882-021-02262-9
- Legato MJ. Gender-specific issues in organ transplantation. En: Sanfey IH, Legato MJ, editores. Principles of gender-specific medicine. 1st edition. New York: Academic Press; 2004. 1116-27. DOI: https://doi.org/10.1016/B978-012440905-7/50378-9
- Sanahuja YII, ME. Cuerpos sexuados, objetos y prehistoria. Madrid: Ediciones Cátedra, 2002.
- Segura A, Zurriaga O, Rohlfs I, Marrugat J, Marco R, Riera M, et al. Estudio IBERICA. Gac Sanit. 2002;16(Supl 1):S90.
- Informe del Mercado de Trabajo de las Mujeres Estatal. Datos 2019. Servicio Público de Empleo. [consultado 1 Jun 2021]. Disponible en: https://sepe.es.
- Rota Musoll L, Subirana Casacuberta M, Oriol Vila E, Homs Del Valle M, Molina Robles E & Brigidi, S. The experience of donating and receiving a kidney: a systematic review of qualitative studies. J Ren Care. 2020;46(3):169-84. DOI: https://doi.org/10.1111/jorc.12309
References
Jay LJ, Dean PG, Helmick RA, Stegall MD. Reassessing Preemptive Kidney Transplantation in the United States: Are we making progress? Transplantation. 2016;100(5):1120-7. DOI: https://doi.org/10.1097/TP.0000000000000944
Matesanz R, Martínez Castelao A, Arias M. Recomendaciones de la Sociedad Española de Nefrología (SEN) y de la Organización Nacional de Trasplantes (ONT) sobre trasplante renal de donante vivo. Nefrologia. 2010;30:0. DOI: https://doi.org/10.1016/S1886-2845(09)70975-0
Registro Español de Enfermos Renales. Informe de diàlisis y trasplante 2019 (datos preliminares). Sociedad Española de Nefrología. [consultado 1 Feb 2021] Disponible en: https://www.senefro.org/contents/webstructure/INFORME_REER_SEN_2020_WEB_SEN.pdf.
Global Observatory on Donation and Transplantation. Annual organ transplantation activity [consultado 17 May 2021]. Disponible en: http:// http://www.transplant-observatory.org/.
Valentín MO, Domínguez Gil B, Martín Escobar E, Matesanz Acedos R. No indicar el trasplante de vivo es una mala práctica. Nefrologia. 2009;29(5):379-81.
Trachtman H, Parent B, Kirshenbaum A, Caplan A. Physician attitudes toward living kidney donation. Prog Transplant. 2019;29(1):78-83. DOI: https://doi.org/10.1177/1526924818817063
Documento Marco sobre la Enfermedad Renal Crónica dentro de la Estrategia de Abordaje a la Cronicidad en el SNS. Subdirección General de Calidad y Cohesión, Dirección General de Salud Pública, Calidad e Innovación, Ministerio de Sanidad, Servicios Sociales e Igualdad, Consejerías de Sanidad de las CCAA. 2015.
Salter ML, McAdams Demarco MA, Law A, Kamil RJ, Meoni LA, Jaar BG, et al. Age and sex disparities in discussions about kidney transplantation in adults undergoing dialysis. J Am Geriatr Soc. 2014; 62(5):843-9. DOI: https://doi.org/10.1111/jgs.12801
Federación nacional de asociaciones para la lucha contra las enfermedades del riñón [consultado 17 May 2021]. Disponible en: https://alcer.org/page/1/?s=encuesta.
Hill NR, Fatoba ST, Oke JL, Hirst JA, O’Callaghan CA, Lasserson DS, et al. Global prevalence of chronic kidney disease–a systematic review and metaanalysis. PloS one. 2016;11(7): e0158765. DOI: https://doi.org/10.1371/journal.pone.0158765
Carrero JJ, Hecking M, Chesnaye NC, Jager KJ. Sex and gender disparities in the epidemiology and outcomes of chronic kidney disease. Nat Rev Nephrol. 2018;14(3):151. DOI: https://doi.org/10.1038/nrneph.2017.181
Monson RS, Kemerley P, Walczak D, Benedetti E, Oberholzer J, Danielson KK. Disparities in completion rates of the medical pre-renal transplant evaluation by race/ethnicity and ender. Transplant. 2015;99(1):236. DOI: https://doi.org/10.1097/TP.0000000000000271
Lipford KJ, McPherson L, Hamoda R, Browne T, Gander JC, Pastan SO, et al. Dialysis facility staff perceptions of racial, gender, and age disparities in access to renal transplantation. BMC Nephr 2018;19(1),1-11. DOI: https://doi.org/10.1186/s12882-017-0800-6
Jindal RM, Ryan JJ, Sajjad Murthy MH, Baines LS. Kidney transplantation and gender isparity. Am J Nephrol. 2005;25(5):474-83. DOI: https://doi.org/10.1159/000087920
Piccoli GB, Alrukhaimi M, Liu ZH, Zakharova E, Levin A. What we do and do not know about women and kidney diseases; questions unanswered and answers unquestioned: reflection on World Kidney Day and International Woman’s Day. BMC Nephrol. 2018;19(1):66. DOI: https://doi.org/10.1186/s12882-018-0864-y
Domínguez-Gil B, Matesanz R. Newsletter Transplant. International Figures on Donation and Transplantation 2016. Eur Dir Qual Med Healthc Counc Eur. 2017;22.
Puoti F, Ricci A, Nanni Costa A, Ricciardi W, Malorni W, Ortona E. Organ ransplantation and gender differences: a paradigmatic example of intertwining between biological and sociocultural determinants. Biology of sex differences. 2016;7(1):1-5. DOI: https://doi.org/10.1186/s13293-016-0088-4
Crowley-Matoka M & Hamdy SF. Gendering the gift of life: Family politics and kidney donation in Egypt and Mexico. Medical anthropology. 2016;35(1):31-44. DOI: https://doi.org/10.1080/01459740.2015.1051181
Scheper–Hughes N. The tyranny of the gift: sacrificial violence in living donor transplants. Am J Transplant. 2007;7(3):507-11. DOI: https://doi.org/10.1111/j.1600-6143.2006.01679.x
Hanson CS, Ralph AF, Manera KE, Gill JS, Kanellis J, Wong G, et al. The lived experience of “being evaluated” for organ donation: focus groups with living kidney donors. Clin J Am Soc Nephrol. 2017;12(11):1852-61. DOI: https://doi.org/10.2215/CJN.03550417
Garg PP, Diener-West M, Powe NR. Income-based disparities in outcomes for patients with chronic kidney disease. Semin Nephrol 2001;21:377. DOI: https://doi.org/10.1053/snep.2001.23764
Oien CM, Reisæter AV, Leivestad T, Pfeffer P, Fauchald P, Os I. Gender imbalance among donors in living kidney transplantation: the Norwegian experience. Nephrol Dial Transplant. 2005;20(4):783-9. DOI: https://doi.org/10.1093/ndt/gfh696
Scott JW. El género: una categoría útil para el análisis histórico. México: PUEG; 1986.
Cantero, MTR. Sesgos de género en la atención sanitaria. Escuela Andaluza de Salud Pública. 2009.
Mauvais Jarvis F, Merz NB, Barnes PJ, Brinton RD, Carrero JJ, DeMeo DL el al. Sex and gender: modifiers of health, disease, and medicine. The Lancet. 2020;396(10250):565-82. DOI: https://doi.org/10.1016/S0140-6736(20)31561-0
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psych. 2006;3:77-101. DOI: https://doi.org/10.1191/1478088706qp063oa
Prieto Velasco M, Quiros P, & Remon C. The concordance between patients’ renal replacement therapy choice and definitive modality: is it a Utopia?. PLoS One. 2015;10(10), e0138811. DOI: https://doi.org/10.1371/journal.pone.0138811
Stolcke V. ¿Es el sexo para el género como la raza para la etnicidad? Mientras Tanto. 1992; 48:87-111.
Rubin G. El tráfico de mujeres: notas sobre la economía política del sexo. En: El género: la construcción cultural de la diferencia sexual, compilado por Marta Lamas. México: Puegunam, 1996; 35-98.
Rota-Musoll L, Brigidi S, Molina-Robles E, Oriol-Vila E, Perez-Oller L, & Subirana-Casacuberta M. An intersectional gender analysis in kidney transplantation: women who donate a kidney. BMC nephrology. 2021;22(1):1-10. DOI: https://doi.org/10.1186/s12882-021-02262-9
Legato MJ. Gender-specific issues in organ transplantation. En: Sanfey IH, Legato MJ, editores. Principles of gender-specific medicine. 1st edition. New York: Academic Press; 2004. 1116-27. DOI: https://doi.org/10.1016/B978-012440905-7/50378-9
Sanahuja YII, ME. Cuerpos sexuados, objetos y prehistoria. Madrid: Ediciones Cátedra, 2002.
Segura A, Zurriaga O, Rohlfs I, Marrugat J, Marco R, Riera M, et al. Estudio IBERICA. Gac Sanit. 2002;16(Supl 1):S90.
Informe del Mercado de Trabajo de las Mujeres Estatal. Datos 2019. Servicio Público de Empleo. [consultado 1 Jun 2021]. Disponible en: https://sepe.es.
Rota Musoll L, Subirana Casacuberta M, Oriol Vila E, Homs Del Valle M, Molina Robles E & Brigidi, S. The experience of donating and receiving a kidney: a systematic review of qualitative studies. J Ren Care. 2020;46(3):169-84. DOI: https://doi.org/10.1111/jorc.12309