Elective Surgical Patients as Living Organ Donors: A Clinical and Ethical

American Journal of Transplantation
Volume 9 Issue 10, Pages 2400 - 2405

Elective Surgical Patients as Living Organ Donors: A Clinical and Ethical Innovation
G. Testa a,*, P. Angelos b , M. Crowley-Matoka c and M. Siegler d
a Department of Surgery, Director of Liver Transplantation and Hepatobiliary Surgery, The University of Chicago, Chicago, IL b Department of Surgery, MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, IL c University of Pittsburgh and Research Scientist, Center for Health Equity Research and Promotion, Pittsburgh Veterans Affairs Medical Center, Pittsburgh, PA d Department of Medicine, MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, IL
* Corresponding author: Giuliano Testa, gtesta@surgery.bsd.uchicago.edu

ABSTRACT

We propose a new model for living organ donation that would invite elective laparoscopic cholecystectomy patients to become volunteer, unrelated living kidney donors. Such donors would be surgical patients first and living donors second, in contrast to the current system, which 'creates' a surgical patient by operating on a healthy individual. Elective surgery patients have accepted the risks of anesthesia and surgery for their own surgical needs but would face additional surgical risks when a donor nephrectomy is combined with their cholecystectomy procedure. Because these two procedures have never been performed together, the precise level of additional risk entailed in such a combined approach is unknown and will require further study. However, considering the large number of elective cholecystectomies performed each year in the United States, if as few as 5% of elective cholecystectomy patients agreed to also serve as living kidney donors, the number of living kidney donors would increase substantially. If this proposal is accepted by a minority of patients and surgeons, and proves safe and effective in a protocol study, it could be applied to other elective abdominal surgery procedures and used to obtain other abdominal donor organs (e.g. liver and intestinal segments) for transplantation.

DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1600-6143.2009.02773.x

http://www3.interscience.wiley.com/journal/122540320/abstract