Public Solicitation of Anonymous Organ Donors

Fortin, Marie-Chantal; Buchman, Daniel Z.; Wright, Linda; Chandler, Jennifer A.; Delaney, Sean J.; Fairhead, Todd; Gallaher, Rob; Grant, David; Greenberg, Rebecca; Hartell, David; Holdsworth, Sandra; Landsberg, David; Paraskevas, Steven; Tibbles, Lee Anne; Young, Kimberly; West, Lori J.; Humar, Atul

doi:10.1097/tp.0000000000001514

Cited by 22 publications

(10 citation statements)

References 8 publications

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“…Develop ethically-grounded, practical strategies to consider and manage evaluation of living kidney donor candidates identified by the intended recipient or their representatives through mass advertising and social media. 84 …”

Section: Research Recommendationsmentioning

confidence: 99%

See 1 more Smart Citation

KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors

et al. 2017

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The 2017 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors is intended to assist medical professionals who evaluate living kidney donor candidates and provide care before, during and after donation. The guideline development process followed the Grades of Recommendation Assessment, Development, and Evaluation (GRADE) approach and guideline recommendations are based on systematic reviews of relevant studies that included critical appraisal of the quality of the evidence and the strength of recommendations. However, many recommendations, for which there was no evidence or no systematic search for evidence was undertaken by the Evidence Review Team, were issued as ungraded expert opinion recommendations. The guideline work group concluded that a comprehensive approach to risk assessment should replace decisions based on assessments of single risk factors in isolation. Original data analyses were undertaken to produce a “proof-in-concept” risk-prediction model for kidney failure to support a framework for quantitative risk assessment in the donor candidate evaluation and defensible shared decision making. This framework is grounded in the simultaneous consideration of each candidate's profile of demographic and health characteristics. The processes and framework for the donor candidate evaluation are presented, along with recommendations for optimal care before, during, and after donation. Limitations of the evidence are discussed, especially regarding the lack of definitive prospective studies and clinical outcome trials. Suggestions for future research, including the need for continued refinement of long-term risk prediction and novel approaches to estimating donation-attributable risks, are also provided.In citing this document, the following format should be used: Kidney Disease: Improving Global Outcomes (KDIGO) Living Kidney Donor Work Group. KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors. Transplantation. 2017;101(Suppl 8S):S1–S109.

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Section: Research Recommendationsmentioning

confidence: 99%

“… 497 Recently, the Canadian Society of Transplantation issued a position paper that addressed issues such as privacy, informed consent, and donor follow-up associated with public donor solicitation. 84 …”

Section: Rationalementioning

confidence: 99%

KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors

et al. 2017

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“…Surprisingly, despite anecdotal evidence that several North American centers have experience with ANLLD including the University of Southern California, University of Colorado, Cleveland Clinic, University of Alberta, University of Pittsburgh, and Washington University, no further reports of experience using this category of donor have been published in recent years. It is important to note that there are no data surrounding the best practice for allocating nondirected living liver donor organs to the transplant waiting list.…”

Section: Part I: Data Surrounding the Utilization Of Anonymous Nondirmentioning

confidence: 99%

Global experience and perspective on anonymous nondirected live donation in living donor liver transplantation

Raza

Aziz

Kaur

et al. 2020

Clinical Transplantation

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Anonymous nondirected living liver donation (ANLLD), sometimes referred to as "altruistic" donation, occurs when a biologically unrelated person comes forward to donate a portion of his/her liver to a transplant candidate who is unknown to the donor.Here, we explore the current status of ANLLD with special consideration of published reports; US experience; impact on donor psychosocial outcomes; barriers to donation; and current global trends with respect to ethical considerations. Between 1998 and 2019, 105 anonymous nondirected living liver donor (ND-LLD) transplants have been documented in the US Scientific Registry of Transplant Recipients. Sixteen donors (15%) were reported to experience a postoperative complication. Currently, 89 donors remain alive (85%), 16 (15%) have unknown status, and none are confirmed deceased. Although there are only a handful of case series, these data suggest that ANLLD is a feasible option. While there are no liver-specific data, studies involving anonymous nondirected kidney donors suggest that anonymous donation does not adversely impact psychosocial outcomes in donors or recipients. There are substantial financial burdens and ethical considerations related to ANLLD. Further studies are required to assess donor demographics, psychosocial motivations, long-term health-related quality of life, and financial impact of ANLLD. K E Y W O R D S altruistic, anonymous; living liver donation, living donor liver transplantation, nondirected

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“…In 2017, the CST published a position statement on the issue of public solicitation. 91 It is legally and ethically acceptable for transplant centers to consider potential living organ donor from public solicitation provided that it is made in compliance with the Canadian laws; however, it is not mandatory for transplant programs to assess these donors. Transplant professionals could have conscientious objection towards public solicitation.…”

Section: Commentary On Chapter 18: Ethical Legal and Policy Considerationsmentioning

confidence: 99%

Canadian Society of Transplantation and Canadian Society of Nephrology Commentary on the 2017 KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors

Lam

Dipchand

Fortin

et al. 2020

Can J Kidney Health Dis

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Purpose of review: To review an international guideline on the evaluation and care of living kidney donors and provide a commentary on the applicability of the recommendations to the Canadian donor population. Sources of information: We reviewed the 2017 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors and compared this guideline to the Canadian 2014 Kidney Paired Donation (KPD) Protocol for Participating Donors. Methods: A working group was formed consisting of members from the Canadian Society of Transplantation and the Canadian Society of Nephrology. Members were selected to have representation from across Canada and in various subspecialties related to living kidney donation, including nephrology, surgery, transplantation, pediatrics, and ethics. Key findings: Many of the KDIGO Guideline recommendations align with the KPD Protocol recommendations. Canadian researchers have contributed to much of the evidence on donor evaluation and outcomes used to support the KDIGO Guideline recommendations. Limitations: Certain outcomes and risk assessment tools have yet to be validated in the Canadian donor population. Implications: Living kidney donors should be counseled on the risks of postdonation outcomes given recent evidence, understanding the limitations of the literature with respect to its generalizability to the Canadian donor population.

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Public Solicitation of Anonymous Organ Donors

Cited by 22 publications

References 8 publications

KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors

KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors

Global experience and perspective on anonymous nondirected live donation in living donor liver transplantation

Canadian Society of Transplantation and Canadian Society of Nephrology Commentary on the 2017 KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors

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