November 18, 2011

Should we use living donor grafts for patients with hepatocellular carcinoma? Ethical considerations


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The paper examines whether living donor grafts for patients with hepatocellular carcinoma should even be used, and whether the same criteria that apply to deceased donor liver transplantation (DDLT) allocation (Milan and UCSF criteria) are applicable in this situation.  The authors explain that DDLT is governed by justice and utility concerns, but that living donor liver transplantation (LDLT) is more accurately a concern with “double equipoise” – the balance between the recipient’s survival benefit with or without LDLT and the probability of mortality for the donor. Since there is this difference, they argue LDLT to recipients outside of UCSF criteria may be acceptable and that it is important to include not only mortality and morbidity data but also quality of life, psychological, and social considerations related to both parties.

Liver Transplantation

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