Posts Tagged ‘ethics’

November 18, 2011

Better off living–the ethics of the new UNOS proposal for allocating kidneys for transplantation


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This article, part of CJASN’s new section on public policy, critically analyzes the new policy proposal by UNOS to allocate deceased donors kidneys in the UNOS.  The authors examine several potential objections: 1. Is waiting time a fair way to rank order patients since there are disparities in gaining access to listing? 2. It is […]

No Comments Posted in Renal Transplantation
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 […]

No Comments Posted in Liver Transplantation
November 18, 2011

Patient decision making about organ quality in liver transplantation


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This study reports on a series of semi-structured interviews (n=10) and a subsequent survey of liver waitlist candidates and their risk tolerance towards allografts of varying quality.  Risk tolerance was affected by gender (men tended to prefer lower-risk organs) and how the information was presented (acceptance of high-risk organs can be facilitated by presenting risks […]

No Comments Posted in Liver Transplantation
November 18, 2011

The Ethical Complexities of Online Organ Solicitation via Donor-Patient Websites: Avoiding the “Beauty Contest”.


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This study criticizes websites which attempt to match potential organ donors and recipients as violating the principles of altruism and justice on which the traditional organ allocation process has been based.  The authors posit that such sites devolve into high tech “beauty contests” in which candidates whose story or physical appearance is more attractive are […]

No Comments Posted in Cardiac Transplantation, Liver Transplantation, Lung Transplantation, Renal Transplantation
November 18, 2011

Potential Limitations of Presumed Consent Legislation


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Presumed consent (PC) legislation has been touted as a potential solution to the disparity between supply and demand for deceased donor organs.  This study examines the legislation in European countries with and without presumed consent legislation and reports on interviews with senior transplant physicians in these countries.  The authors conclude that there are multiple country-specific, […]

No Comments Posted in Cardiac Transplantation, Liver Transplantation, Lung Transplantation, Renal Transplantation
August 14, 2011

Sex-based disparities in liver transplant rates in the United States.


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This article uses the SRTR database to examine whether males and female candidates in the US receive deceased donor liver transplant at comparable rates.  They determine that women have markedly lower transplant rates than male candidates, that there are significant geographic differences in this disparity, and that the disparity has worsened in the MELD era.  […]

No Comments Posted in Liver Transplantation
August 14, 2011

Organ donation from children: time for legal, ethical and cultural change.


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This article examines the child as an organ donor, both while alive and after death, from a European perspective.  Differences between the European and North American systems (e.g. allowable definition of brain death in infants, donation after cardiac death and allowing capable adolescents to be living donors) are discussed, and a re-examination of the laws […]

No Comments Posted in Cardiac Transplantation, Liver Transplantation, Lung Transplantation, Renal Transplantation
August 14, 2011

2010 consensus conference on liver transplantation for HCC: Should we use living donor grafts for patients with hepatocellular carcinoma (HCC)?


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This article examines the ethical considerations around using living donors for liver transplantation for recipients with hepatocellular carcinoma. The authors summarize the discussion and recommendations of a 2010 consensus conference on this issue and answer three questions:  Why is live donation necessary at all and is it different for patients with HCC? What is double […]

No Comments Posted in Liver Transplantation
June 18, 2011

Patient Participation in Research Among Solid Organ Transplant Recipients in the United States


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The authors examined the SRTR and compared solid organ transplant recipients listed as participating in research protocols to those not listed as research participants (PRPs).  They found that there were significant differences between PRPs and non-participants.  This is an ethical issue because it leads to the question of whether all potential subjects get the same […]

No Comments Posted in Cardiac Transplantation, Liver Transplantation, Lung Transplantation, Renal Transplantation
June 18, 2011

Spanish experience as a leading country: what kind of measures were taken?


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This article is a must-read for anyone wanting to understand better why some countries enjoy higher donation rates than others and the importance of a multi-pronged strategy to increasing deceased donor rates long term.  This article clearly explains the “Spanish system” of organ procurement that is held up as an international example of success due […]

No Comments Posted in Cardiac Transplantation, Liver Transplantation, Lung Transplantation, Renal Transplantation