Ethical Considerations Living Donor Research Living Kidney Donor Psychosocial Risks

Potential Kidney Donors Are Ambivalent

According to this Irish transplant center. 15.5% of potential LKDs voluntarily writhdrew from the evaluation process. However, the number is actually higher than they’re reporting. Apparently, In Ireland, if multiple potential LKDs come forward for a recipient and they are all acceptable blood and HLA matches, only *one* is permitted to continue with the evaluation (How they make the determination of which potential LKD proceeds is unclear). So, the authors are including *all* the potential LKDs who were adequate blood/tissue matches.

Their calculation is 95/614 (15.5%), whereas 261 of those 614 didn’t progress past the immunological test because of multiple potential LDs.

When those are removed, the statistic beomes 95/353, which is 26.9%.


Someone asked me why it was significant that over 1 in 4 potential living kidney donors deemed “acceptable” matches for a would-be recipient did not continue the evaluation progress.

First: coercion. It’s been well-established that potential living donors experience “pressure” to donate, and the closer (biologically/emotionally) one is to the prospective recipient, the greater that pressure, Ireland, unlike the US, is not as keen on random members of the living public donating their organs to strangers. Therefore, the potential LKDs in this study were emotionally and/or biologically related to their would-be recipient. That nearly 27% of them still decided not to be evaluated speaks volumes to the ambivalence present in many donor candidates.

This above fact is crucial because the public perception of living donation (which is carefully crafted by the transplant industry, specially selected living donors, and complicit media types) is that living donation is positively “life changing”* for the kidney donor. The knowledge that more than 1 out of 4 people who “match” their intended recipient choose not to donate can be comforting to other people who are suffocating under the pressure to continue with the process.

Living donation should be a *choice*, a fully informed and un-coerced choice, free from the pro-recipient foundation of the transplant system. Information like this helps to make that happen, and that’s invaluable.


*A rabbi is contacting living donors through social media to gather their quotes/words on how donating was “life-changing” for them. I’d like to link to the source material, but it was shared in a “closed” FB group and I have to respect the group’s rules.

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