Ethical considerations on kidney transplantation from living donors
Identifieur interne : 002680 ( Main/Exploration ); précédent : 002679; suivant : 002681Ethical considerations on kidney transplantation from living donors
Auteurs : P. Bruzzone [Italie] ; R. Pretagostini [Italie] ; L. Poll [Italie] ; M. Rossi [Italie] ; P. B. Berloco [Italie]Source :
- Transplantation proceedings [ 0041-1345 ] ; 2005.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Santé publique, Médecine.
English descriptors
- KwdEn :
Abstract
Kidney transplantation from living donors is widely performed all over the world. Living nephrectomy for transplantation has no direct advantage for the donor other than increased self-esteem, but at least remains an extremely safe procedure, with a worldwide overall mortality rate of 0.03%. This theoretical risk to the donor seems to be justified by the socioeconomic advantages and increased quality of life of the recipient, especially in selected cases, such as pediatric patients, when living donor kidney transplantation can be performed in a preuremic phase, avoiding the psychological and physical stress of dialysis, which in children is not well tolerated and cannot prevent retarded growth. According to the Ethical Council of the Transplantation Society, commercialism must be prevented, not only for ethical but also medical reasons. The risks are too high not only for the donors, but also for the recipients, as a consequence of poor donor screening and evaluation with consequent transmission of human immunodeficiency virus or other infectious agents, as well as inappropriate medical and surgical management of donors and also of recipients, who are often discharged too early. Most public or private insurance companies are considering kidney donation a safe procedure without long-term impairment and, therefore, do not increase the premium, whereas recipient insurance of course should cover hospital fees for the donors. "Rewarded gifting" or other financial incentives to compensate for the inconvenience and loss of income related to the donation are not advisable, at least in our opinion. Our center does not perform anonymous living organ donation or "cross-over" transplantation.
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Bruzzone</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Divisione Trapianti d'Organo, Dipartimento "Paride Stefanini," Università di Roma "La Sapienza,"</s1><s2>Rome</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Pretagostini, R" sort="Pretagostini, R" uniqKey="Pretagostini R" first="R." last="Pretagostini">R. Pretagostini</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Divisione Trapianti d'Organo, Dipartimento "Paride Stefanini," Università di Roma "La Sapienza,"</s1><s2>Rome</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Poll, L" sort="Poll, L" uniqKey="Poll L" first="L." last="Poll">L. Poll</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Divisione Trapianti d'Organo, Dipartimento "Paride Stefanini," Università di Roma "La Sapienza,"</s1><s2>Rome</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Rossi, M" sort="Rossi, M" uniqKey="Rossi M" first="M." last="Rossi">M. Rossi</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Divisione Trapianti d'Organo, Dipartimento "Paride Stefanini," Università di Roma "La Sapienza,"</s1><s2>Rome</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Berloco, P B" sort="Berloco, P B" uniqKey="Berloco P" first="P. B." last="Berloco">P. B. Berloco</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Divisione Trapianti d'Organo, Dipartimento "Paride Stefanini," Università di Roma "La Sapienza,"</s1><s2>Rome</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Transplantation proceedings</title><title level="j" type="abbreviated">Transplant. proc.</title><idno type="ISSN">0041-1345</idno><imprint><date when="2005">2005</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Transplantation proceedings</title><title level="j" type="abbreviated">Transplant. proc.</title><idno type="ISSN">0041-1345</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Ethics</term><term>Graft</term><term>Homotransplantation</term><term>Kidney</term><term>Kidney transplantation</term><term>Living donor</term><term>Medicine</term><term>Public health</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Homotransplantation</term><term>Ethique</term><term>Santé publique</term><term>Rein</term><term>Donneur vivant</term><term>Médecine</term><term>Greffe</term><term>Traitement</term><term>Transplantation rénale</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Santé publique</term><term>Médecine</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Kidney transplantation from living donors is widely performed all over the world. Living nephrectomy for transplantation has no direct advantage for the donor other than increased self-esteem, but at least remains an extremely safe procedure, with a worldwide overall mortality rate of 0.03%. This theoretical risk to the donor seems to be justified by the socioeconomic advantages and increased quality of life of the recipient, especially in selected cases, such as pediatric patients, when living donor kidney transplantation can be performed in a preuremic phase, avoiding the psychological and physical stress of dialysis, which in children is not well tolerated and cannot prevent retarded growth. According to the Ethical Council of the Transplantation Society, commercialism must be prevented, not only for ethical but also medical reasons. The risks are too high not only for the donors, but also for the recipients, as a consequence of poor donor screening and evaluation with consequent transmission of human immunodeficiency virus or other infectious agents, as well as inappropriate medical and surgical management of donors and also of recipients, who are often discharged too early. Most public or private insurance companies are considering kidney donation a safe procedure without long-term impairment and, therefore, do not increase the premium, whereas recipient insurance of course should cover hospital fees for the donors. "Rewarded gifting" or other financial incentives to compensate for the inconvenience and loss of income related to the donation are not advisable, at least in our opinion. Our center does not perform anonymous living organ donation or "cross-over" transplantation.</div></front></TEI><affiliations><list><country><li>Italie</li></country><region><li>Latium</li></region><settlement><li>Rome</li></settlement></list><tree><country name="Italie"><region name="Latium"><name sortKey="Bruzzone, P" sort="Bruzzone, P" uniqKey="Bruzzone P" first="P." last="Bruzzone">P. Bruzzone</name></region><name sortKey="Berloco, P B" sort="Berloco, P B" uniqKey="Berloco P" first="P. B." last="Berloco">P. B. Berloco</name><name sortKey="Poll, L" sort="Poll, L" uniqKey="Poll L" first="L." last="Poll">L. Poll</name><name sortKey="Pretagostini, R" sort="Pretagostini, R" uniqKey="Pretagostini R" first="R." last="Pretagostini">R. Pretagostini</name><name sortKey="Rossi, M" sort="Rossi, M" uniqKey="Rossi M" first="M." last="Rossi">M. Rossi</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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