Clinical and Ethical Framework for Liver Re‐transplantation using Living Donor Grafts: A Western Perspective

2021 ◽  
Author(s):  
Ramesh K. Batra ◽  
David C. Mulligan
Keyword(s):  
Living Donor ◽  
Ethical Framework ◽  
Western Perspective

Ethical Analysis of Living Organ Donation

2005 ◽  
Vol 15 (3) ◽  
pp. 303-309 ◽  
Author(s):  
Benita J. Walton-Moss ◽  
Laura Taylor ◽  
Marie T. Nolan
Keyword(s):  
Living Donor ◽  
Empirical Work ◽  
Ethical Analysis ◽  
Ethical Framework ◽  
Johns Hopkins Hospital ◽  
Living Donation ◽  
Kidney Donor ◽  
Living Kidney Donor ◽  
Autonomous Choice ◽  
Autonomous Decision

In 2003, the first 3-way living kidney donor-swap was performed at Johns Hopkins Hospital in Baltimore, Md. Three new donor protocols including paired donation now allow unrelated individuals to serve as donors. Some ethicists have suggested that emotionally unrelated individuals not be permitted to donate because they will not experience the same satisfaction that a family member who is a donor experiences. Others who frame living donation as an autonomous choice do not see emotionally unrelated or even nondirected donation as ethically problematic. This article uses an ethical framework of principlism to examine living donation. Principles salient to living donation include autonomy, beneficence, and nonmaleficence. The following criteria are used to evaluate autonomous decision making by living donors, including choices made (1) with understanding, (2) without influence that controls and determines their action, and (3) with intentionality. Empirical work in these areas is encouraged to inform the ethical analysis of the new living donor protocols.

Developing a Living Donor Ethics Framework

2021 ◽  
pp. 53-80
Author(s):  
Lainie Friedman ◽  
J. Richard Thistlethwaite, Jr
Keyword(s):  
Living Donor ◽  
Human Subjects ◽  
Ethical Framework ◽  
Vulnerable Groups ◽  
Belmont Report ◽  
Ethics Framework ◽  
Special Obligations ◽  
Starting Point ◽  
Living Donor Transplantation ◽  
Special Relationships

This chapter advances an ethical framework for living donor transplantation. Given the analogies between living donor transplantation and human subjects research, the three principles enumerated in the National Commission’s Belmont Report are adopted as the starting point: respect for persons, beneficence, and justice. Two additional principles are also adopted: the principle of vulnerability and the principle that special relationships create special obligations. Whereas the Belmont Report discussed vulnerable groups, vulnerability is more aptly understood as an assortment of vulnerabilities that may apply to different people in different circumstances at different times of their lives. Eight distinct but overlapping vulnerabilities are described: capacitational, juridic, deferential, social, medical, situational, allocational, and infrastructural. The living donor advocate team (LDAT) stands in special relationship with the potential living donor and supports living organ donation provided that the living donor successfully addresses the challenges to autonomy and voluntariness that these vulnerabilities pose.

Adult-to-Adult Living-Donor Liver Transplantation

Swiss Surgery ◽  
2003 ◽  
Vol 9 (5) ◽  
pp. 227-236 ◽  
Author(s):  
Majno ◽  
Mentha ◽  
Berney ◽  
Bühler ◽  
Giostra ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Therapeutic Option ◽  
Donor Liver ◽  
Donor Liver Transplantation ◽  
Multidisciplinary Program ◽  
First Case ◽  
Living Donor Transplantation ◽  
The Right

Living donor liver transplantation is a relatively new procedure in which the right side of the liver is harvested in a healthy donor and transplanted into a recipient. After the first case in 1994, over 3000 cases have been done worldwide. This review summarizes the reasons why the procedure is needed, describes its main technical aspects, highlights the boundaries in which it can be done safely, summarizes the current experience worldwide and describes the main points of the program in our unit. We argue that living-donor transplantation is a viable alternative to a long time on the waiting list for several patients, and it can be performed safely and successfully provided that all precautions are undertaken to minimize the risks in the donor and to increase the chances of a good outcome in the recipients. If these prerequisites are met, and within the framework of a structured multidisciplinary program, we believe that living-donor liver transplantation should be funded by health insurances as a recognized therapeutic option.

Impact of ABO-Incompatible Living Donor Kidney Transplantation on Patient Survival

2020 ◽  
Vol 76 (5) ◽  
pp. 616-623 ◽  
Author(s):  
Allan B. Massie ◽  
Babak J. Orandi ◽  
Madeleine M. Waldram ◽  
Xun Luo ◽  
Anh Q. Nguyen ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Living Donor ◽  
Patient Survival ◽  
Donor Kidney ◽  
Living Donor Kidney Transplantation ◽  
Donor Kidney Transplantation ◽  
Living Donor Kidney
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