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Ethical considerations in live donor transplantation: should complications be tolerated?

Gordon, Elisa J.

Current Opinion in Organ Transplantation: April 2013 - Volume 18 - Issue 2 - p 235–240
doi: 10.1097/MOT.0b013e32835f3f2c
REGULATORY, FINANCIAL AND ETHICAL CONSIDERATIONS IN TRANSPLANTATION: Edited by Anton I. Skaro
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Purpose of review Although living donor transplantation is considered an ethically acceptable undertaking for the purpose of saving another's life, its safety remains under investigation.

Recent findings Although living donors undertake considerable medical risks for no direct medical benefit, the question remains whether the risks are acceptable and should be tolerated by providers and patients or whether additional interventions and safeguards are needed to reduce and/or prevent complications. By reviewing complication risk statistics and synthesizing empirical research regarding risk-taking thresholds and attitudes, this paper examines the possibilities for determining an acceptable level of complication risk for living donors. This paper also delineates the ethical tensions surrounding protecting donors from unnecessary risk versus respecting donor autonomy to accept risks, and concludes by discussing the importance of donor follow-up and the value of donor registries.

Summary In the absence of information on long-term donor outcomes, transplant centers should take special precautions to protect prospective donors given increasing pressures to reduce the organ shortage and concerns that donors often disregard risks to themselves to save the lives of others.

Center for Healthcare Studies, Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University Chicago, Illinois, USA

Correspondence to Elisa J. Gordon, PhD, MPH, Research Associate Professor, Center for Healthcare Studies, Comprehensive Transplant Center, Feinberg School of Medicine, Northwestern University, 420 E. Superior St., 10th Floor, Chicago, IL 60611, USA. Tel: +1 312 503 5563; fax: +1 312 503 2777; e-mail: e-gordon@northwestern.edu

© 2013 Lippincott Williams & Wilkins, Inc.