Adult living donor liver transplantation: Preferences about donation outside the medical community

An increasing number of transplant centers are performing adult living dono r liver transplantation (LDLT). We evaluated peoples' perspectives on possi ble outcomes of living donation, thresholds for donating, and views regardi ng the donation process, One hundred fifty people were surveyed; half were from a medical care group serving an indigent population and half were from a private clinic. Preferences about outcomes of adult living donation were ranked and quantified on a visual analogue scale, Thresholds for donation to a loved one were quantified. Sixty percent of the respondents suggested they would prefer to donate and die and have the transplant recipient live rather than forgo donation and have the potential transplant recipient die of liver failure. Participants' stated threshold For living donation was a median survival for themselves of only 79%. They would require that their l oved one have a median survival of 55% with transplantation before they wou ld agree to donate. Respondents from the medical care group reported higher survival thresholds for themselves and the transplant recipient, and race was the most statistically significant predictor of those thresholds, Sex w as more predictive of threshold probabilities from the private clinic. Eigh ty-one percent of the respondents believed that the potential donor, not a physician, should have the final say regarding candidacy for living donatio n. In conclusion, the findings of this survey support the use of adult LDLT , Most respondents were willing to accept mortality rates that far exceed t he estimated risk of donation and favored outcomes in which a loved one was saved.