Existential questions and modifications in the context of renal transplantation: a qualitative longitudinal research

Abstract

This study was aimed at exploring comprehensively the experience of 30 patients registered for first kidney transplantation. They participated to qualitative interviews before and 6-12-24 months after transplantation. Thematic analysis was applied, leading to a 10 final themes analytic framework among which existential questionings take an important place. Before transplantation, while in dialysis, existential rupture is described, and life projects are set aside. Death as a way-out is considered when life on dialysis becomes unbearable. Concerns about brain death of the donor are expressed. After transplantation perspectives on life are modified: implementation of changes in in life style and existential reappraisal. Experiences about deceased or living donation modify the perspectives on life and death. In deceased donation, brain death and the limits between life and death are present in the interviews as important existential concerns. In living donation, when possible, living donation is ultimately accepted when the strains of dialysis increase psychologically and physically. Transplantation allows patients to think about future, make projects anew. They become more open to other people, and must learn to trust life again, rediscover happiness. Being responsible towards the graft, the donor and the donor’s family leads patients to follow their medication regimen and modify their life-style in being more careful towards their body and to lead a more healthy life. Transplantation remains a complex and intense human experience and is accompanied by existential reappraisal. Patients know that these positive changes are limited in time and closely related to the graft’s care and continuing function.