UNRELATED LIVING KIDNEY DONORS - AN UPDATE OF ATTITUDES AND USE AMONGUS TRANSPLANT CENTERS

A severe shortage of organs is perhaps the most important obstacle fac ing transplantation today. In an attempt to address this serious probl em, several transplant centers have suggested a reconsideration of gen etically unrelated living kidney donors. Recently, there have been rep orts of excellent results using such unconventional donors, and cogent arguments have been made that this approach is ethically acceptable, at least when the donor is motivated by altruism. To see what impact t his new information has had on the transplant community, I mailed a qu estionnaire to all adult renal transplant centers in the United States asking for their views and practices regarding unrelated living kidne y donation. Of the 127 (64%) responding, 88% would accept spouses as d onors, 63% would accept friends, and 15% would even consider altruisti c strangers. When compared with the results of a similar survey comple ted six years ago, it became clear that support for unrelated living k idney donation had increased, as the great majority of centers now bel ieve that emotionally related donors are acceptable. On the other hand , while more of these donors are being used, they still account for on ly a small fraction of all kidney transplants. It appears that medical successes and favorable ethical arguments have generated broad suppor t for some types of unrelated living donors, but more in principle tha n in practice, as there still seems to be some hesitation to actually proceed. It is hoped that dissemination of the favorable attitudes unc overed will reduce anxiety and thereby encourage greater use of unrela ted living donors, a large and valuable source of kidneys.