At first, physicians preferred relatives as donors. Advantages of living donor kidney transplants include shorter wait times, better long-term graft and patient survival, fewer organ rejections, less immunosuppressive drugs and fewer posttransplant hospitalizations. However, when compared with left lateral segmentectomy, as performed for pediatric liver transplantation, a right or left lobectomy is a more formidable procedure that puts the donor at greater risk. Among the ethical issues to be weighed are the risks to the donor and recipient, the validity of informed consent and concerns about donor privacy and confidentiality. Risks of the procedure include surgical infections, bile duct leaks, blood clots, bleeding, intestinal blockage and liver failure, prolonged jaundice, and risks associated with anesthesia.
Informed consent is critical.
Individuals have claimed they were manipulated to donate an organ. In 1997, a Minnesota woman sued a man, claiming he promised to marry her then dumped her after he received her brother's kidney. A paper presented at the conference noted that live donor transplantation isn't always justified. He said the procedure should not be used for re-transplants, for patients with a primary diagnosis that carries the potential for recurrent disease, or for those with predictably low waiting list mortality. There are also concerns that cadaveric donation could fall.