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01 July 2004

Ethical considerations on kidney transplantation from living donors.

Pasquale B Berloco, Massimo Rossi, Renzo Pretagostini, Paolo Bruzzone

Ann Transplant 2004; 9(2): 46-47 :: ID: 142782


Our study population consisted of 402 Living Related Donors (LRD)--of which344 pairs shared 1 haplotype (Group A) and of 209 Living Unrelated Donors (LURD) (Group B): 175 betweenspouse pairs (Group C)--132 from wife to husband (Group C1) and 43 from husband to wife (Group C2) aswell as 32 between relatives in law or emotionally related patients and 2 between members of clergy (GroupD). 199 pairs showed 3-6 HLA A B Dr mismatches (MM) with the donor and in 10 cases 0-2 MM. Donor andrecipient mean age was 49 +/- 13.4 and 29 +/- 10.3 in Group A and respectively 46 +/- 11.2 and 48 +/-9.6 in Group B. The post-transplant immunosuppression therapy was based on Cyclosporin A (CsA). Chi2test was used to assess statistical significance. Donor mortality was 0%; perioperative morbidity was15.2%. Graft function immediately started after surgery. The actuarial 1 yr, 5 yrs, 10 yrs and 15 yrsgraft survival was in Group A: 94%, 86%, 84%, 75% vs. Group B: 89%, 78%, 71%, 70% (NS), Group C1: 90%,75%, 67%, 69% vs. Group C2: 81%, 74%, 72%, 62% (NS) and Group C: 88%, 78%, 66%, 60% vs. Group D: 91%,80%, 71%, 61% (NS). There was no statistically significant difference between LURD and LRD as far asgraft survival. In conclusion, we certainly agree with the guidelines issued by the International Congresson Ethics in Organ Transplantation (Munich, December 10-13,2002): kidney transplantation from livingdonors is a safe and effective procedure and should not be discouraged.

Keywords: Kidney Transplantation - ethics, Kidney Transplantation - mortality

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358