Ethical Evaluation of Risks Related to Living Donor Transplantation Programs

Panocchia, Nicola; Bossola, Maurizio; Silvestri, Patrizia; Midolo, Emanuela; Teleman, A.A.; Tazza, Luigi; Sacchini, Darío; Minacori, Roberta; Pietro, Maria Luisa Di; Spagnolo, Antonio G.

doi:10.1016/j.transproceed.2013.07.026

Cited by 12 publications

(11 citation statements)

References 26 publications

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“…In any living donor situation, the harms and burdens to the donor are justified by the significant benefit to the recipient . Because there is an alternative to living donor transplantation in the kidney transplant situation, kidney transplant programs often require that the recipient of a living donor kidney have an equal or better prospect of long‐term survival than the recipient of a deceased donor organ would.…”

Section: Discussionmentioning

confidence: 99%

“…The important difference between living donor transplantation and other medical interventions is the risks and harms that are imposed on another person. Because of this unique feature of LDLT, we have to consider the amount of benefit to the potential recipient in relation to the risks incurred by the donor …”

Section: Setting the Limits: The Not “Unreasonable” Standardmentioning

confidence: 99%

“…Donor safety is given the utmost priority in live donor liver transplantation (LDLT) . It requires comprehensive informed consent and judicious medical assessment for both donor and recipient .…”

Section: Introductionmentioning

confidence: 99%

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The Ethics of living related liver transplantation when deceased donation is not an option

Schiano

2015

Clinical Liver Disease

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Section: Discussionmentioning

confidence: 99%

Section: Setting the Limits: The Not “Unreasonable” Standardmentioning

confidence: 99%

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The Ethics of living related liver transplantation when deceased donation is not an option

Schiano

2015

Clinical Liver Disease

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“…Third, men may have less postdonation kidney function and may be at greater risk for developing kidney failure themselves, especially black American men . Kidney function normally declines with age, leading to more men being excluded from kidney donation in donor‐recipient pairs with an older man.…”

Section: Possible Medical Reasons For Increased Living Kidney Donatiomentioning

confidence: 99%

“…While the recipient with kidney failure clearly benefits from receiving a transplant, especially a living donor transplant, there is no medical benefit to the donor. Despite documented psychological benefits to kidney donation, there is a real medical risk to the donor who faces an estimated mortality rate of 0.03% from the kidney procurement operation . The living kidney donor must also face potential complications like postoperative pain, constipation, and deep vein thrombosis.…”

Section: Introductionmentioning

confidence: 99%

Understanding the sex disparity in living kidney donation

Prasad

2018

Evaluation Clinical Practice

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Living donors are the preferred source of organs for kidney transplantation, which is the treatment modality of choice for end-stage kidney disease. Health care systems widely promote living kidney donation. However, women are consistently overrepresented among living donors. The reasons behind the sex-based disparity in living kidney donation remain poorly understood. Compared to women, men possess a greater amount of kidney function, and the higher deceased donation rate among men reflects their higher overall kidney quality. A plausible medical explanation for the sex-based disparity in living kidney donation includes an uncompromising emphasis on preserving donor health, with less emphasis placed on organ quality, which is the main criterion in deceased donor selection. On the other hand, consent to deceased donation is also greater in women, indicating their greater desire to donate even though fewer women actually become deceased donors. Therefore, nonmedical reasons for the sex disparity in living donation must be sought. Increased empathic distress or emotional memory; a greater sense of responsibility, urgency, and impulsiveness with increased reaction to empathy; a different body image; and a different social status may all contribute to greater living kidney donation in women. Economic inequity may be the singular explanation when personal worth links to economic worth. To better understand the sex disparity in living kidney donation, we need better data on the reasons behind both nondonation and donor rejection after evaluation in clinical practice. Nondirected living kidney donation provides unique opportunities to minimize factors such as emotional distress, empathy, and impulsiveness. More liberal acceptance criteria for donors with isolated medical abnormalities and testing legitimate donor reimbursement strategies based on actual income levels rather than a fixed amount can assist in both ascertaining the reasons behind the sex disparity in living kidney donation and increasing overall living kidney donation rates.

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