Should living donor liver transplantation be an option when deceased donation is not?

JOURNAL OF HEPATOLOGY

卷:68

Article

Lieber, Sarah R.¹  Schiano, Thomas D.^2,3  Rhodes, Rosamond² 

[1] Univ North Carolina Hosp, Dept Gastroenterol & Hepatol, Chapel Hill, NC USA

[2] Mt Sinai Hosp, Icahn Sch Med, New York, NY 10029 USA

[3] Recanati Miller Liver Transplantat Inst, New York, NY USA

关键词: Ethics;    Liver transplantation;    Living donor;    Organ transplantation;    Justice;    Trust;    Risks;    Benefits;   

DOI  :  10.1016/j.jhep.2017.10.024

来源: Elsevier

【 摘 要 】

When a liver transplantation candidate is declined for listing to receive a deceased organ, sometimes a loved one comes forward and offers to be a living donor. This raises the ethical question of whether a patient who is not eligible for deceased donor liver transplantation should be eligible for living donor liver transplantation. We compare living organ donation in kidney and liver transplantation and explore key ethical concepts of justice, fairness, and societal trust. Ultimately, because there is no alternative life-preserving therapy in end-stage liver disease, and because transplantation with a living donor organ does not involve removing a resource from the common pool of transplant organs, we argue that a standard of slightly less benefit than that required for deceased transplantation should be used to determine the acceptability of living donor liver transplantation. (C) 2017 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

【 授权许可】

Free