Expanding living kidney donation: ethical and policy considerations

In 1954 the first successful living donor kidney transplant was performed between identical twins. With the improvement in immunosuppression, ABO compatible friends, spouses and even strangers can now donate kidneys to waitlist candidates. In this lecture, Lainie Friedman Ross, M.D., Ph.D., will discuss some of the ethical and policy challenges that arise by the expansion of living donor kidney transplants including 1) when strangers serve as non-directed donors; 2) when ABO-incompatible donor-recipient pairs trade kidneys; and 3) the new practice of asynchronous kidney chains catalyzed by nondirected donors. But all of these expansions must be understood with a caveat: she concludes by discussing the ethical concerns raised by the practice of living kidney donation, as well as what is known and what is not known about the short- and long-term risks that living donors face and what research is needed to ensure that prospective donors give an informed and voluntary consent.