Martinelli Valentina, Lumer Estella L L, Chiappedi Matteo, Politi Pierluigi, Gregorini Marilena, Rampino Teresa, Peri Andrea, Pietrabissa Andrea, Fusar-Poli Laura
General Surgery Unit 2, IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
Harvey Medical Course, Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy.
Healthcare (Basel). 2024 Sep 13;12(18):1832. doi: 10.3390/healthcare12181832.
Living donor kidney transplantation (LDKT) currently represents the treatment of choice for patients with end-stage renal failure. LDKT is a serious event with profound psychological, interpersonal, familial, and social implications. Over the last few years, there has been an exponential growth in living donation programs involving genetically and emotionally related donors, as well as people who donate to an unrelated and unknown subject. The implementation of paired exchange programs, Samaritan donation, and preemptive transplantation raise further ethical issues, which are inextricably linked to the unique psychosocial context of both the donor and the recipient. The present narrative review aims to provide an update on the main ethical challenges related to LDKT. We conducted a comprehensive literature search in PubMed/Medline. The results of the most relevant studies were narratively synthesized from a psychosocial perspective around the four principles of biomedical ethics: autonomy, beneficence, non-maleficence, and justice. Finally, we discussed the potential future directions to provide an effective, patient-centered, and ethical psychosocial assessment and follow-up of living donors and recipients that underwent LDKT.
活体供肾移植（LDKT）目前是终末期肾衰竭患者的首选治疗方法。LDKT是一个具有深远心理、人际、家庭和社会影响的重大事件。在过去几年中，涉及基因和情感相关供体以及向不相关和未知受者捐赠的活体捐赠项目呈指数级增长。配对交换项目、慈善捐赠和抢先移植的实施引发了进一步的伦理问题，这些问题与供体和受体独特的社会心理背景有着千丝万缕的联系。本叙述性综述旨在提供与LDKT相关的主要伦理挑战的最新情况。我们在PubMed/Medline上进行了全面的文献检索。从生物医学伦理的四个原则：自主性、 beneficence、不伤害和公正的社会心理角度，对最相关研究的结果进行了叙述性综合。最后，我们讨论了潜在的未来方向，以便为接受LDKT的活体供体和受体提供有效、以患者为中心且符合伦理的社会心理评估和随访。
