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Should minors be considered as potential living liver donors?
Author(s) -
Capitaine Laura,
Thys Kristof,
Assche Kristof,
Sterckx Sigrid,
Pennings Guido
Publication year - 2013
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.23633
Subject(s) - donation , psychosocial , medicine , minor (academic) , liver transplantation , maturity (psychological) , transplantation , family medicine , surgery , psychology , psychiatry , developmental psychology , law , political science
For many patients, living donor liver transplantation represents their only hope of receiving a lifesaving graft. In certain (albeit rare) cases, a minor will be the only suitable donor. Living liver donation by minors has been reported in several countries. In the academic literature and professional guidelines, little attention is paid to the development of an ethical framework for this practice. The focus is frequently limited to the donation of regenerative tissues and kidneys. However, liver donation differs in important respects because of the increased medical risks and the lack of substitute therapies. Therefore, in this article, we assess whether living liver donation by minors is ethically appropriate. We argue that living liver donation by minors is justifiable only if minors possess the capacity to consent to donation or if the procedure is in their best interests. Although minors may possess adult‐like levels of cognitive maturity, they lack sufficient psychosocial maturity to give valid consent to donation. In addition, living liver donation is generally not in a minor's best interests. With respect to the latter, the potential psychological benefits that a minor may experience as a result of living liver donation are insufficiently empirically supported and are unlikely to outweigh the short‐ and long‐term medical and psychological risks. Therefore, we conclude that minors should not be considered as potential living liver donors. Liver Transpl 19:649–655, 2013 . © 2013 AASLD.