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Emerging Ethical Challenges in Living Kidney Donation

  • Live Kidney Donation (K Lentine and R Schaffer, Section Editors)
  • Published:
Current Transplantation Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Living-donor kidney transplantation (LDKT) offers the best medical outcomes in terms of graft and patient survival for end-stage renal disease (ESRD) patients. LDKT involves a medically and psychologically suitable individual willingly agreeing to donate a kidney to a loved one or stranger. It is a unique situation in which a healthy person consents to having a medical procedure for another person’s benefit. LDKT raises numerous ethical issues, particularly with respect to voluntary consent, risks and benefits, and vulnerability.

Recent Findings

In recent years, the discovery of APOL1, a gene associated with increased risk of chronic kidney disease and ESRD in African Americans, and unique situations arising from requests to undergo living donation from persons who are not traditionally healthy or have social circumstances that may challenge influence-free, informed decision making have challenged the ethics of LDKT.

Summary

In this article, we discuss the ethical issues surrounding three emerging situations in LDKT: living kidney donors with life-limiting illness, incarcerated living kidney donors, and APOL1 genotyping in the context of living donor candidate evaluation.

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Acknowledgments

Dr. Fortin is a research scholar of the Fonds de recherche du Québec–Santé (career award).

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Authors and Affiliations

  1. Faculty of Medicine, Université de Montréal, Montréal, Canada

    Virginie Vallée Guignard & Marie-Chantal Fortin

  2. Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), 900 Saint-Denis St., Room R12-418, Montréal, Quebec, H2X 0A9, Canada

    Marie-Chantal Fortin

  3. Canadian Donation and Transplant Research Program, Edmonton in Alberta, Canada

    Marie-Chantal Fortin

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  1. Virginie Vallée Guignard
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Correspondence to Marie-Chantal Fortin.

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Virginie Vallée Guignard and Marie-Chantal Fortin declare no conflict of interest.

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This article is part of the Topical Collection on Live Kidney Donation

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Guignard, V.V., Fortin, MC. Emerging Ethical Challenges in Living Kidney Donation. Curr Transpl Rep 6, 192–198 (2019). https://doi.org/10.1007/s40472-019-00241-6

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