The Living Donor As Patient

"This is a book about living solid organ donors as patients in their own right. This book is premised on the supposition that the field of living donor organ transplantation is ethical, even if some specific applications are not. Living donor organ transplantation is controversial at its core because it exposes one patient (the living donor) to clinical risks for the clinical benefit of another (the candidate recipient). It is different than obstetrics which also involves 2 patients-a pregnant woman and her fetus-- because transplantation involves two physically individuated patients who, in most cases, individually consent to the medical interventions. And in many cases, the donor-recipient interdependence is optional because deceased donor organs may be available. So before one can begin, one must ask, even if only rhetorically: Is living donation ethical? The question is not new: one of the first to ask about the ethics of living donor transplantation was Joseph Murray, the surgeon credited with performing the first successful living donor kidney transplant which paved the way for the broad adoption of kidney and other solid organ transplantation around the world"--

"This is a book about living solid organ donors as patients in their own right. This book is premised on the supposition that the field of living donor organ transplantation is ethical, even if some specific applications are not. Living donor organ transplantation is controversial at its core because it exposes one patient (the living donor) to clinical risks for the clinical benefit of another (the candidate recipient). It is different than obstetrics which also involves 2 patients-a pregnant woman and her fetus-- because transplantation involves two physically individuated patients who, in most cases, individually consent to the medical interventions. And in many cases, the donor-recipient interdependence is optional because deceased donor organs may be available. So before one can begin, one must ask, even if only rhetorically: Is living donation ethical? The question is not new: one of the first to ask about the ethics of living donor transplantation was Joseph Murray, the surgeon credited with performing the first successful living donor kidney transplant which paved the way for the broad adoption of kidney and other solid organ transplantation around the world"--

Rates of organ donation lag far behind the increasing need. At the start of 2006, more than 90,000 people were waiting to receive a solid organ (kidney, liver, lung, pancreas, heart, or intestine). Organ Donation examines a wide range of proposals to increase organ donation, including policies that presume consent for donation as well as the use of financial incentives such as direct payments, coverage of funeral expenses, and charitable contributions. This book urges federal agencies, nonprofit groups, and others to boost opportunities for people to record their decisions to donate, strengthen efforts to educate the public about the benefits of organ donation, and continue to improve donation systems. Organ Donation also supports initiatives to increase donations from people whose deaths are the result of irreversible cardiac failure. This book emphasizes that all members of society have a stake in an adequate supply of organs for patients in need, because each individual is a potential recipient as well as a potential donor.

Edited by leaders at one of the acclaimed transplant institutions in the United States, this reference covers all aspects of living donor solid organ and cellular transplantation in current clinical practice, including the kidney, liver, pancreas, lung, small bowel, islet, and hematopoietic stem cell transplantation. Detailed, engaging, and organ-

This book provides a complete guide to the evaluation, care, and follow-up of living kidney donors. Living donor kidney transplantation is established as the best treatment option for kidney failure. However, despite the tremendous benefits of living donation to recipients and society, the outcomes and optimal care of donors themselves have received relatively less attention. Fortunately, things are changing – including recent landmark developments in living donor risk assessment, policy and guidance. This volume offers authoritative, evidence-based guidance on the full range of clinical scenarios encountered in the evaluation and care of living kidney donors. The approach to key elements of risk assessment, ethical considerations and informed consent is accompanied by recommendations for patient-centered care before, during, and after donation. Advocacy initiatives and policies to remove disincentives to donation and advance a defensible system of practice are also discussed. General and transplant nephrologists, as well as related allied health professionals, can look to this book as a comprehensive resource addressing contemporary clinical topics in the practice of living kidney donation.

Living donor kidney (LDK) transplantation has become the definitive approach to the treatment of end-stage renal failure, providing a better quality of life and the best opportunity for survival when compared with dialysis or transplantation from a deceased donor. A timely compendium of the modern day practice of LDK transplantation from a group of outstanding international experts, this text explores a number of controversial aspects of this innovative new technique. Discussing in detail the current situation, the authors also focus on the responsibility of the medical community to the live kidney donor as a patient, and the potential for complacency regarding donor risk. Emphasizing the ethical principles that must dictate medical practice in LDK transplantation for the foreseeable future - voluntarism, informed consent and medical follow-up - this book comprehensively records the best practices currently available.

The inadequate supply of organs in the United States and other countries continues to drive the reliance on living donor transplantation. In 2000, representatives of the transplant community convened for a meeting on living donation in an effort to provide guidelines to promote the welfare of living donors. The consensus statement that resulted from this meeting recommended that transplant centers retain an Independent Living Donor Advocate (ILDA) to focus on the best interest of the donor. A decade later, nearly every transplant center in the United States, performing living donor surgeries, has incorporated an ILDA into their living donor screening and/or evaluation process Living Donor Advocate provides an overview of living donation and its risks, ethical challenges and future developments​, as well as details about the role a Living Donor Advocate plays in the transplantation process. This book will interest health professionals across various disciplines and patients undergoing transplantation or living donor surgery.

Non-heart-beating donors (individuals whose deaths are determined by cessation of heart and respiratory function rather than loss of whole brain function) could potentially be of major importance in reducing the gap between the demand for and available supply of organs for transplantation. Prompted by questions concerning the medical management of such donorsâ€"specifically, whether interventions undertaken to enhance the supply and quality of potentially transplantable organs (i.e. the use of anticoagulants and vasodilators) were in the best interests of the donor patientâ€"the U.S. Department of Health and Human Services asked the Institute of Medicine to examine from scientific and ethical points of view "alternative medical approaches that can be used to maximize the availability of organs from [a] donor [in an end-of-life situation] without violating prevailing ethical norms...." This book examines transplantation supply and demand, historical and modern conceptions of non-heart-beating donors, and organ procurement organizations and transplant program policies, and contains recommendations concerning the principles and ethical issues surrounding the topic.