Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-03T08:10:46.919Z Has data issue: false hasContentIssue false

20 - Organ transplantation

Published online by Cambridge University Press:  30 October 2009

Linda Wright
Affiliation:
Senior Bioethicist University of Toronto, Canada
Kelly Ross
Affiliation:
University of Toronto, Canada
Abdallah S. Daar
Affiliation:
Professor University of Toronto, Canada
Peter A. Singer
Affiliation:
University of Toronto
A. M. Viens
Affiliation:
University of Oxford
Get access

Summary

A 53-year-old single mother offers to donate a kidney to a work colleague whom she knows distantly. Although the recovery time needed away from work after donation will strain her modest income, the woman tells the transplant team that she understands this and is willing to go ahead. She explains that her motivation to donate is purely to help another human being.

A man involved in a serious road traffic accident has suffered severe injuries and has been placed on life support while investigations are completed. The results indicate he will not survive. His relatives are not present at the hospital. The junior physician treating the patient considers withdrawing supportive treatment. He wonders whether the patient would be a candidate for non-heart-beating donation after cardiac death is pronounced.

What is organ transplantation?

Organ transplantation is both a life-extending and a life-saving medical procedure in which a whole or partial organ (or cells in cell therapy) from a deceased or living person is transplanted into another individual, replacing the recipient's non-functioning organ with the donor's functioning organ. Advances in the science of organ transplantation since the 1980s have significantly broadened the range of transplantable organs and improved transplant outcomes. Transplant centers in different parts of the world successfully transplant kidneys, livers, lungs, hearts, pancreases, and intestinal organs, and the procedure is considered the preferred treatment for several indications.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abadie, A., and Gay, S. (2006). The impact of presumed consent legislation on cadaveric organ donation: A cross-country study. J Health Econ 25: 599–620.CrossRefGoogle ScholarPubMed
Abecassis, M., Adams, M., Adams, P., et al., for the Live Organ Donor Consensus Group (2000). Consensus statement on the live organ donor. JAMA 284: 2919–26.Google ScholarPubMed
Bagheri, A. (2005). Organ transplantation laws in Asian countries: a comparative study. Transplant Proc 37: 4159–62.CrossRefGoogle ScholarPubMed
BBC News (2006). China “selling prisoners” organs. http://news.bbc.co.uk/2/hi/asia-pacific/4921116.stm
Canadian Public Health Association (2001). Animal-to-Human Transplantation: Should Canada Proceed? A Public Consultation on Xenotransplantation. Ottawa: Supply and Services Canada (http://www.xeno.cpha.ca/english/bigissue/animal.htm).
Daar, A. S. (2002). Strangers, intimates, and altruism in organ donation. Transplantation 74: 424–6.CrossRefGoogle ScholarPubMed
Daar, A. S. (2003). Paid organ donation and organ commerce: continuing the ethical discourse. Transplant Proc 35: 1207–9.CrossRefGoogle ScholarPubMed
Daar, A. S. (2004a). Money and organ procurement: narratives from the real world. In Ethical, Legal and Social Issues in Organ Transplantation, ed. Gutmann, T., Daar, A. S., Sells, R. A., and Land, W.. Lengerich: Pabst Science, pp. 298–317.Google Scholar
Daar, A. S. (2004b). Non-heart-beating donation: ten evidence-based ethical recommendations. Transplant Proc 36: 1885–7.CrossRefGoogle Scholar
Daar, A. S. and Chapman, L. E. (2004). Xenotransplantation. In Encyclopedia of Bioethics, 3rd edn, Vol. 5, ed. Post, S. G.. New York: Macmillan Reference USA, pp. 2601–12.Google Scholar
Delmonico, F., Arnold, R., Scheper-Hughes, N., et al. (2002). Ethical incentives – not payment – for organ donation. N Engl J Med 346: 2002–5.CrossRefGoogle Scholar
Dossetor, J. B. and Daar, A. S. (2001). Ethics in transplantation: allotransplantation and xenotransplantation. In Kidney Transplantation: Principles and Practice, 5th edn, ed. Morris, P. J.. Philadelphia, PA: Saunders, pp. 732–44.Google Scholar
Ethics Committee of the Transplantation Society (2004). The consensus statement of the Amsterdam Forum on the Care of the Live Kidney Donor. Transplantation 78: 491–2.CrossRefGoogle Scholar
Evans, M. (1989). Organ donations should not be restricted to relatives. J Med Ethics 15: 17–20.CrossRefGoogle Scholar
Ghods, A. J. and Nasrollahzadeh, D. (2005). Transplant tourism and the Iranian model of renal transplantation program: ethical considerations. Exp Clin Transplant 3: 351–4.Google ScholarPubMed
Gohh, R. Y., Morrissey, P. E., Madras, P. N., and Monaco, A. P. (2001). Controversies in organ donation: the altruistic living donor. Nephrol Dial Transplant 16: 619–21.CrossRefGoogle ScholarPubMed
Henderson, A. J., Landolt, M. A., McDonald, M. F., et al. (2003). The living anonymous kidney donor: lunatic or saint?Am J Transplant 3: 203–13.CrossRefGoogle ScholarPubMed
Hilhorst, M. T., Kranenburg, L. W., Zuidema, W., et al. (2005). Altruistic living kidney donation challenges psychosocial research and policy: a response to previous articles. Transplantation 79: 1470–4.CrossRefGoogle ScholarPubMed
Kennedy, I., Sells, R. A., Daar, A. S., et al. (1998). The case for “presumed consent” in organ donation. International Forum for Transplant Ethics. Lancet 351: 1650–2.CrossRefGoogle ScholarPubMed
Landolt, M. A., Henderson, A. J., Gourlay, W., et al. (2003). They talk the talk: surveying attitudes and judging behavior about living anonymous kidney donation. Transplantation 76: 1437–44.CrossRefGoogle ScholarPubMed
Larijani, B., Zahedi, F., and Ghafouri-Fard, S. (2004). Rewarded gift for living renal donors. Transplant Proc 36: 2539–42.CrossRefGoogle ScholarPubMed
Lazar, N. M., Shemie, S., Webster, G. C., and Dickens, B. M. (2001). Bioethics for clinicians: 24. Brain death. CMAJ 164: 833–6.Google ScholarPubMed
Matas, A. J., Garvey, C. A., Jacobs, C. L., and Kahn, J. P. (2000). Nondirected donation of kidneys from living donors. N Engl J Med 343: 433–6.CrossRefGoogle ScholarPubMed
Morioka, M. (2001). Reconsidering brain death: a lesson from Japan's fifteen years of experience. Hasting Cent Rep 31: 41–6.CrossRefGoogle ScholarPubMed
O'Connor, K. J. and Delmonico, F. L. (2005). Increasing the supply of kidneys for transplantation. Semin Dial 18: 460–2.CrossRefGoogle ScholarPubMed
Phadke, K. D. and Anandh, U. (2002). Ethics of paid organ donation. Pediatr Nephrol 17: 309–11.CrossRefGoogle ScholarPubMed
Powner, D. J., Hernandez, M., and Rives, T. E. (2004). Variability among hospital policies for determining brain death in adults. Crit Care Med 32: 1284–8.CrossRefGoogle ScholarPubMed
Radcliffe-Richards, J., Daar, A. S., Guttmann, R. D., et al. (1998). The case for allowing kidney sales. International Forum for Transplant Ethics. Lancet 27: 1950–2.CrossRefGoogle Scholar
Ridley, S., Bonner, S., Bray, K., et al., for the Intensive Care Society's Working Group on Organ and Tissue Donation (2005). UK guidance for non-heart-beating donation. Br J Anaesth 95: 592–5.CrossRefGoogle ScholarPubMed
Rios, A. R., Conesa, C. C., Ramirez, P., Rodriguez, M. M., and Parrilla, P. (2004). Public attitude toward xenotransplantation: opinion survey. Transplant Proc 36: 2901–5.CrossRefGoogle ScholarPubMed
Ross, L. F., Glannon, W., Josephson, M. A., and Thistlethwaite, J. R. (2002). Should all living donors be treated equally?Transplantation 74: 418–21.CrossRefGoogle ScholarPubMed
Schmidt, V. H. and Lim, C. H. (2004). Organ transplantation in Singapore: history, problems, and policies. Soc Sci Med 59: 2173–82.CrossRefGoogle ScholarPubMed
Spital, A. (2001). Public attitudes toward kidney donation by friends and altruistic strangers in the United States. Transplantation 71: 1061–4.CrossRefGoogle ScholarPubMed
Spital, A. (2002). Justification of living-organ donation requires benefit for the donor that balances the risk: commentary on Rosset al. Transplantation 74: 423–4.CrossRefGoogle ScholarPubMed
Spital, A. (2003). Should people who donate a kidney to a stranger be permitted to choose their recipients? Views of the United States public. Transplantation 76: 1252–6.CrossRefGoogle Scholar
Taylor, J. S. (2002). Autonomy, constraining options, and organ sales. J Appl Philos 19: 273–85.CrossRefGoogle ScholarPubMed
Truog, R. D. (2005). Are organs personal property or a societal resource? Am J Bioethics 5: 14–16.CrossRefGoogle ScholarPubMed
United Network for Organ Sharing. Richmond, VA: United Network for Organ Sharing. www.unos.org/.
US President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioural Research (1981). Defining Death. Washington, DC: Government Printing Office.Google Scholar
Veatch, R. M. (2000). Transplantation Ethics. Washington, DC: Georgetown University Press.Google Scholar
Warren, J. (2003). Commerce in organs acceptable in some cultures, guidelines needed, ethics congress recommends. Transplant News 13: 1–3.Google Scholar
Wright, J. R. Jr. (2004). Public consultation on xenotransplantation. Transplantation 78: 1112–13.CrossRefGoogle ScholarPubMed
Wright, L. and Campbell, M. (2006). Soliciting kidneys on web sites: is it fair? Semin Dial 19: 5–7.CrossRefGoogle ScholarPubMed
Wright, L., Faith, K., Richardson, R., et al., for the Joint Centre for Bioethics of the University of Toronto (2004). Ethical guidelines for the evaluation of living organ donors. Can J Surg 47: 408–13.Google ScholarPubMed
Young, E. (2005). Laws fail to stop India's organ trade. New Sci 188: 20.Google ScholarPubMed
Zink, S., Weinreib, R., Sparling, T., and Caplan, A. L. (2005). Living donation: focus on public concerns. Clin Transplant 19: 581–5.CrossRefGoogle ScholarPubMed
British Columbia Transplant Society. Vancouver, BC: British Columbia Transplant Society (www.transplant.bc.ca/.
Eurotransplant International Foundation. Leiden, Germany: Eurotransplant International Foundation. www.transplant.org/.
Trillium Gift of Life Network. www.unos.org/.

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×