Live Donor Kidney Transplants: Psychological Aspects of the Donor-Receiver Relationship

Ethico-legal issues related to ovarian tissue transplantation

“…As Capron rightly notes, the reproductive rights (reproductive autonomy) of the donor, including if, when and with whom she will have a child, are violated. 31 Besides, after removal of the graft, the donor may have negative feelings, [65][66][67][68] including depression, anger, disillusionment, sense of betrayal, decreased sexual dysfunction or decrease in sexual satisfaction, and may pursue a psychological relationship with the recipient carrier of the graft, which is of a great symbolic nature. In cases where the donor has become a male transsexual (transgender), it is possible that her OT, which is under cryopreservation, and the duty to inform the offspring of the mode of his/her conception prevent the psychological break up with her past as a female and have a negative effect on her well-being (health).…”

“…The recipient is mostly at risk of: (a) ovarian stimulation, which may result in hypersensitivity syndrome (with a risk of vein thrombosis) 69 ; (b) immunosuppression 70 and anti-rejection treatment (in cases where there is an allograft), for example with a risk of presenting diabetes mellitus or malignancies 71 ; (c) potential reseeding of cancer cells in her body, in case of reimplantation of OT autograft to an oncology patient (especially a patient suffering from lymphoma or leukaemia), 63,72,73 although recently, this has been reduced through screening 74 and potential transplantation of insulated follicles, which is still in an experimental phase; (d) potential carcinogenicity (especially breast or endometrial cancer) or thromboembolic disease due to the production of ovarian hormones after the menopause 54,56,57,75 ; (e) serious risks of complications if the donor is at perimenopausal age, or if the recipient is at perimenopausal age before her pregnancy, and risks of harm to the child, as mentioned above; and (f) risks of considerable negative mental effects due to OTT, including feelings of shame, stress, guilt towards the donor, and sexual and reproductive identity disorders, although these seem to reduce whenever there is a good relationship with the donor. [65][66][67][68] Attempting a phenomenological approach in combination with Elson's theory of hormonal hierarchy, we believe that for the receptor, the graft of ovarian tissue may be significantly similar to an organ transplanted in her body. Actually, its low internal visibility as a small piece of tissue may become high in so far as it bears great symbolic meaning related to its magnitude.…”