The Ethics Statement of the Vancouver Forum on the Live Lung, Liver, Pancreas, and Intestine Donor

• DOI: 10.1097/01.tp.0000214976.36526.e3
• Publication Date: 2006-05-25T08:21:35Z
• Authors: Timothy L. Pruett; Annika Tibell; Abdulmajeed Alabd...; Mahendra Bhandari; David C. Cronin; Mary Amanda Dew; Arturo Dib-Kuri; Thomas Gutmann; Arthur Matas; Lisa McMurdo; Axel Rahmel; S Adibul Hasan Rizvi; Linda Wright; Francis L. Delmonico
• Keywords: Canada; Informed Consent; Organ Transplantation; Donor Selection; Liver Transplantation; 3. Good health; Intestines; 03 medical and health sciences; 0302 clinical medicine; Living Donors; Humans; Pancreas Transplantation; Lung Transplantation

The use of organs from live donors is an important component transplantation today. Ethics Committee the Transplantation Society (TTS) has previously published a statement on ethical considerations pertaining to kidney donor (1). Evolving technologies have now allowed for successful lung, liver, pancreas and intestine (extrarenal) donors. TTS was convened at Vancouver Forum deliberate upon extrarenal transplantation. following summary committee's deliberations. We believe that donation should proceed within context principles established donation. physical psychosocial welfare healthy must be put in needs recipient impact recipient's illness donor. In principle, recommends only performed when aggregate benefits donor-recipient pair (survival, quality life, psychological, social well being) outweigh risks (death, medical, morbidities). At Forum, emerging data provided more information regarding factors enter into decision place person harms way. It evident are sole source many societies; however limited availability about outcomes recipients mandates organ with thoughtful independent oversight transparency. As recovered deceased offer substantial (and sometimes superior) potential recipients, no risk healthy, donor, efforts maximize not impeded by development This consensus comes deliberations Group which charged defining essential elements process transplant center performing Special emphasis issues informed consent, assurance autonomy patient selection included clarity. Responsibility Transplant Team Performing Live Donation Information repetitively prospective order facilitate Medical, psychological suitability determined after complete thorough evaluation team expertise assess individual If medical conditions identified need treatment (some may preclude donation), then counsel encourage acquisition care treat such conditions. Recognizing stressful whether or it proceeds, support available throughout process. voluntary make assure donate been manipulated. Medical until there recovery procedure. Quality assurance/improvement procedures utilized decrease during long-term follow-up related acquired contribute general knowledge base reporting complications registries community. work appropriate authorities, agencies insurance companies (as applicable) minimize disincentives penalties towards A performs implement procedural safeguards enhance understanding, safety autonomous decision-making. These considered donation, particularly components include: Inclusion health professionals process, who exclusively responsible donor's welfare. Such direct contact overtly influenced concerns recipient. Repetition recognition consent event. Psychosocial evaluation, include capacity give consent. Additional Reflection period acceptance donate. Assessment retention understanding. External review committees. Informed Consent performance prerequisites cognitive sufficient voluntary. receive understand relevant predicated individual's receipt adequate become procedure possible consequences. disclosure associated risks, including but to: death, reported worldwide where proposed. morbidities. Changes function. Impact insurability/employability. Potential effects family life. Psychological nondonation. addition, given about: responsibility systems management discovered (such as discovery HIV, tuberculosis other transmissible diseases); Any specific donate; however, can permission obtained recipient; Expected (favorable un-favorable) alternative types treatments recipient, transplantation; results uncertainty outcomes; request participate gathering (registries) increase base. Donor Autonomy reassured that: freedom withdraw any time exists, without consequence supportive environment; reasons proceeding will kept confidential. However, necessary, donation; concurrence essential; does overrule judgment making. Selection Individuals legally incompetent lack decision-making rare instance these individuals might donors, advocate appointed using mechanisms particular society. event non-directed distant acquaintance entertained, special prevent exploitation made. Because consequences known, centers consider access prerequisite cost neutral provide voluntariness benefit outweighing adverse outcomes. recommendations hampered insufficient consequence, paramount safeguard personal system integrity, while minimizing Voluntariness willingness donate, understanding Without additional relating likely incomplete. There clear short long term intestinal organs. community collect share consistent comparable fashion. National, international and/or organizational maintained.