Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
Division of Urology and Renal Transplantation, American University of Beirut Medical Center, Beirut, Lebanon.
Int Braz J Urol. 2018 Nov-Dec;44(6):1071-1080. doi: 10.1590/S1677-5538.IBJU.2017.0693.
Kidney transplantation for end-stage renal disease remains the preferred solution due to its survival advantage, enhanced quality of life and cost-effectiveness. The main obstacle worldwide with this modality of treatment is the scarcity of organs. The demand has always exceeded the supply resulting in different types of donations. Kidney donation includes pure living related donors, deceased donors, living unrelated donors (altruistic), paired kidney donation and more recently compensated kidney donation. Ethical considerations in live donor kidney transplantation have always created a debate especially when rewarding unrelated donors. In this paper, we examine the problems of financially driven kidney transplantation, the ethical legitimacy of this practice, and propose some innovative methods and policies that could be adopted to ensure a better practice with accepted ethical guidelines.
肾移植是治疗终末期肾病的首选方法,因为它具有生存优势、提高生活质量和成本效益。这种治疗方式在全球范围内的主要障碍是器官短缺。需求一直超过供应,导致出现了不同类型的捐赠。肾脏捐赠包括纯粹的活体亲属供者、已故供者、活体非亲属供者(利他主义)、配对肾脏捐赠,以及最近的有偿肾脏捐赠。活体供者肾移植中的伦理问题一直存在争议,尤其是在奖励非亲属供者时。本文探讨了金钱驱动的肾移植所带来的问题,以及这种做法在伦理上的合法性,并提出了一些创新的方法和政策,以确保在接受伦理准则的情况下更好地实践。