{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T16:52:40Z","timestamp":1790959960011,"version":"4.1.0"},"reference-count":49,"publisher":"BMJ","issue":"4","funder":[{"DOI":"10.13039\/501100000923","name":"Australian Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000923","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,2,13]]},"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Many donors and recipients report an improved bond posttransplantation; however, unexpected conflicts and tension may also occur. Insights into the lived experiences of the donor\u2013recipient relationship can inform strategies for interventions and support. We aimed to describe donor and recipient expectations and experiences of their relationship before and after living kidney donor transplantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting and participants<\/jats:title>\n                    <jats:p>Semistructured interviews were conducted with 16 donor\u2013recipient pairs before the transplant and 11\u201314 months post-transplant. Transcripts were analysed thematically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified seven themes (with respective subthemes): donation as enacting familial responsibility for care; analytical decision making to mitigate regret (avoiding anticipated regret and maintaining control, removing emotional impulsivity); strengthened interpersonal ties (gaining a deeper appreciation among family members, stronger empathy for each other, improving social participation); instability of relational impacts (anger and aggression threatening dynamics, unanticipated stress and emotional lability, triggering familial tension); renegotiating social roles (unexpected continuation of caregiving responsibilities, inability to relinquish the caregiving role, disappointment with unfulfilled renewal of intimacy, dissatisfaction over discrepant energy levels); guilt over unmet expectations and inevitability of the gift relationship (vague and transient indebtedness, expectation of reciprocity, transferring kidney ownership).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Donor\u2013recipient relationships may be improved through increased empathy, appreciation, and ability to participate in life together; however, unfulfilled expectations and behavioural and emotional changes in recipients (a side effect related to immunosuppression) remain unresolved consequences of living kidney donor transplantation. Education and counselling to help donors and recipients adjust to potential changes in relationship dynamics may help protect and foster relational stability postdonation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-026629","type":"journal-article","created":{"date-parts":[[2019,4,4]],"date-time":"2019-04-04T19:37:59Z","timestamp":1554406679000},"page":"e026629","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Living kidney donor and recipient perspectives on their relationship: longitudinal semi-structured interviews"],"prefix":"10.1136","volume":"9","author":[{"given":"Angelique F","family":"Ralph","sequence":"first","affiliation":[{"name":"School of Psychology, The University of Sydney, Sydney, New South Wales, Australia"},{"name":"Centre for Kidney Research, The Children\u2019s Hospital at Westmead, Westmead, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phyllis","family":"Butow","sequence":"additional","affiliation":[{"name":"School of Psychology, The University of Sydney, Sydney, New South Wales, Australia"},{"name":"Psycho-oncology Co-operative Research Group, The University of Sydney, Sydney, New South Wales, Australia"},{"name":"Centre for Medical Psychology and Evidence-Based Decision-Making, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan C","family":"Craig","sequence":"additional","affiliation":[{"name":"Centre for Kidney Research, The Children\u2019s Hospital at Westmead, Westmead, New South Wales, Australia"},{"name":"College of Medicine and Public Health, Flinders University, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Germaine","family":"Wong","sequence":"additional","affiliation":[{"name":"Centre for Kidney Research, The Children\u2019s Hospital at Westmead, Westmead, New South Wales, Australia"},{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve J","family":"Chadban","sequence":"additional","affiliation":[{"name":"Central Clinical School, University of Sydney, Camperdown, New South Wales, Australia"},{"name":"Transplantation Services, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant","family":"Luxton","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Talia","family":"Gutman","sequence":"additional","affiliation":[{"name":"Centre for Kidney Research, The Children\u2019s Hospital at Westmead, Westmead, New South Wales, Australia"},{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla S","family":"Hanson","sequence":"additional","affiliation":[{"name":"Centre for Kidney Research, The Children\u2019s Hospital at Westmead, Westmead, New South Wales, Australia"},{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Ju","sequence":"additional","affiliation":[{"name":"Centre for Kidney Research, The Children\u2019s Hospital at Westmead, Westmead, New South Wales, Australia"},{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Tong","sequence":"additional","affiliation":[{"name":"Centre for Kidney Research, The Children\u2019s Hospital at Westmead, Westmead, New South Wales, Australia"},{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,4,4]]},"reference":[{"key":"2025120519532066000_9.4.e026629.1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2000.07407.x"},{"key":"2025120519532066000_9.4.e026629.2","unstructured":"ANZDATA. 39th Annual Report. 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