Open AccessLiver transplantation for non-resectable colorectal liver metastases at a single centre in South Africa: A report of the ethics and regulatory approval process
Author(s) -
Harriet Etheredge,
J. R. Botha,
Peter CleatonJones
Publication year - 2017
Publication title -
south african journal of bioethics and law
Language(s) - English
Resource type - Journals
ISSN - 1999-7639
DOI - 10.7196/sajbl.534
Subject(s) - contraindication , medicine , liver transplantation , informed consent , declaration of helsinki , transplantation , declaration , norwegian , colorectal cancer , general surgery , family medicine , alternative medicine , cancer , political science , pathology , law , linguistics , philosophy
Non-resectable colorectal liver metastases (CLMs) are generally considered an absolute contraindication for liver transplantation. However, a 2013 Norwegian study transplanted livers in 21 patients with CLMs and reported excellent outcomes. The current article reports on the deliberations of the Wits Human Research Ethics Committee (Medical), which resulted in approval of the first liver transplant for a patient with CLMs in South Africa (SA). Factors considered included the scarcity of donor organs in SA, weighing the best interests of different groups of patients and the requirement for extensive and careful information provision. Originally under the auspices of Section 37 of the World Medical Association Declaration of Helsinki (2013), the protocol has now been formalised as a research project