Objective To recommend practice guidelines for transplant physicians, primary
care providers, health care planners, and all those who are concerned about
the well-being of the live organ donor.
Participants An executive group representing the National Kidney Foundation, and
the American Societies of Transplantation, Transplant Surgeons, and Nephrology
formed a steering committee of 12 members to evaluate current practices of
living donor transplantation of the kidney, pancreas, liver, intestine, and
lung. The steering committee subsequently assembled more than 100 representatives
of the transplant community (physicians, nurses, ethicists, psychologists,
lawyers, scientists, social workers, transplant recipients, and living donors)
at a national conference held June 1-2, 2000, in Kansas City, Mo.
Consensus Process Attendees participated in 7 assigned work groups. Three were organ specific
(lung, liver, and kidney) and 4 were focused on social and ethical concerns
(informed consent, donor source, psychosocial issues, and live organ donor
registry). Work groups' deliberations were structured by a series of questions
developed by the steering committee. Each work group presented its deliberations
to an open plenary session of all attendees. This information was stored and
shaped into a statement circulated electronically to all attendees for their
comments, and finally approved by the steering committee for publication.
The term consensus is not meant to convey universal
agreement of the participants. The statement identifies issues of controversy;
however, the wording of the entire statement is a consensus by approval of
Conclusion The person who gives consent to be a live organ donor should be competent,
willing to donate, free from coercion, medically and psychosocially suitable,
fully informed of the risks and benefits as a donor, and fully informed of
the risks, benefits, and alternative treatment available to the recipient.
The benefits to both donor and recipient must outweigh the risks associated
with the donation and transplantation of the living donor organ.