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The Risk in Living Kidney Donation

Published online by Cambridge University Press:  07 December 2017

WALTER GLANNON
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Abstract:

This article examines two questions. (1) If prospective living kidney donors knew of the lifetime risk of end-stage renal disease (ESRD) in their remaining kidney, then would they be as willing to give it up? and (2) What should transplant organizations and physicians be telling those who express an interest in donating a kidney about risk? Based on the principle that prospective donors must be fully informed of the risk, I raise the issue of a possible obstacle to closing the gap between the availability and need of transplantable kidneys. Some strategies are offered to address this problem.

Keywords

kidney transplantliving kidney donorsend-stage renal disease (ESRD)donor risk
Type
Special Section: Open Forum
Information
Cambridge Quarterly of Healthcare Ethics , Volume 27 , Issue 1 , January 2018 , pp. 29 - 35
Copyright
Copyright © Cambridge University Press 2017 

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References

Notes

1. Peters, T, Fisher, J, Gish, R, Howard, R. Views of US voters on compensating living kidney donors. JAMA Surgery 2016;151:710–6.CrossRefGoogle ScholarPubMed

2. Hadjianastassiou, V, Johnson, R, Ridge, C, Mamode, N. 2509 living donor nephrectomies: Morbidity and mortality, including the UK introduction of laparoscopic donor surgery. American Journal of Transplantation 2007;7:2532–7.CrossRefGoogle ScholarPubMed

3. Steiner, R. The risks of living kidney donation. New England Journal of Medicine 2016;374:479–80.CrossRefGoogle ScholarPubMed

4. Segev, D, Muzaale, A, Caffo, B, Mehta, S, Singer, A, Taranto, S, et al. Perioperative mortality and long-term survival following live kidney donation. Journal of the American Medical Association 2010;303:959–66.CrossRefGoogle ScholarPubMed See also Ibrahim, H, Foley, R, Tan, L, Rogers, T, Bailey, R, Guo, H, et al. Long-term consequences of kidney donation. New England Journal of Medicine 2009;360:459–69;CrossRefGoogle ScholarPubMed Muzaale, A, Massie, A, Wang, M-C, Montgomery, R, McBride, M, Wainwright, J, et al. Risk of end-stage renal disease following live kidney donation. JAMA 2014;311:579–86;CrossRefGoogle ScholarPubMed and Gill J, Tonelli M. Understanding rare adverse outcomes following living kidney donation. JAMA 2014;311:577–8.

5. Steiner, R. Addressing the ESRD risks of the young living kidney donor: Putting “normal for now” into practice. Current Transplantation Reports 2016;3:15–23.CrossRefGoogle Scholar See also note 3, Steiner 2016, at 479; and Steiner R. A very different paradigm for living kidneydonor risk. American Journal of Transplantation 2017;17:1701–2.

6. Grams, M, Sang, Y, Levey, A, Matsushita, K, Ballew, S, Chang, A, et al. Kidney-failure risk projection for the living kidney-donor candidate. New England Journal of Medicine 2016;374:411–21.CrossRefGoogle ScholarPubMed

7. See note 3, Steiner 2016, at 479; and note 5, Steiner 2016, at 20.

8. Beauchamp, T, Childress, J. Principles of Biomedical Ethics, 7th ed. New York: Oxford University Press; 2012;Google ScholarPubMed chap. 4 and 5. See also Radcliffe Richards, J, The Ethics of Transplantation: Why Careless Thought Costs Lives. Oxford: Oxford University Press; 2012;Google Scholar and Veatch, R, Ross, L. Transplantation Ethics, 2nd ed. Washington, DC: Georgetown University Press; 2015.Google Scholar

9. See note 5, Steiner 2016, at 20.

10. Glannon W. Is it unethical for doctors to encourage healthy adults to donate a kidney to a stranger? Yes. BMJ 2011;343:1040–1.

11. Erin, C, Harris, J. An ethical market in human organs. Journal of Medical Ethics 2003;29:137–8.CrossRefGoogle ScholarPubMed Also, Matas A. The case for living kidney sales: Rationale, objections and concerns. American Journal of Transplantation 2004;4:2007–17. See also note 8, Veatch, Ross 2015, at chap. 11.

12. Bingaman, A, Wright, F, Murphey, C. Kidney paired donation in live-donor kidney transplantation. New England Journal of Medicine 2010;363:1091–2.CrossRefGoogle ScholarPubMed Also, Montgomery R. Living donor exchange programs: Theory and practice. British Medical Bulletin 2011;98:21–30.

13. Orandi, B, Luo, X, Massie, A, Garonzik-Wang, J, Lonze, B, Ahmed, R, et al. Survival benefit with kidney transplants from HLA-incompatible live donors. New England Journal of Medicine 2016;374:940–50.CrossRefGoogle ScholarPubMed

14. See note 5, Steiner 2016, at 20.