The ethics statement of the vancouver forum on the live lung, liver, pancreas, and intestine donor

The use of organs from live donors is an important component of transplantation today. The Ethics Committee of the Transplantation Society (TTS) has previously published a statement on ethical considerations pertaining to the live kidney donor (1). Evolving technologies have now allowed for the successful transplantation of organs from the live lung, liver, pancreas and intestine (extrarenal) donors. TheEthicsCommitteeofTTSwasconvenedattheVancouver Forumtodeliberateupontheuseoflivedonorsforextrarenal transplantation. The following is a summary of the committee’s deliberations. We believe that live extrarenal donation should proceed within the context of the ethical principles established for live kidney donation. The physical and psychosocialwelfareofahealthydonormustbeputincontextof the needs of the recipient and impact of the recipient’s illness upon the donor. In principle, the Ethics Committee of TTS recommends that live lung, liver, pancreas and intestine donationshouldonlybeperformedwhentheaggregatebenefits to the donor-recipient pair (survival, quality of life, psychological,andsocialwellbeing)outweightheriskstothedonorrecipientpair(death,medical,psychological,andsocialmorbidities). At the Vancouver Forum, emerging data pertaining to the aggregate risks and benefits of live lung, liver, pancreas and intestine transplantation provided more information regardingthefactorsthatenterintotheethicaldecisiontoplace a healthy person in harms way. It is now evident that live donors are the sole source of organs for transplantation in many societies; however the limited availability of information about outcomes for the donors and recipients mandates that live lung, liver, pancreas and intestine organ donation and transplantation must proceed with thoughtful independent oversight and transparency. As organs recovered from deceased donors offer substantial (and sometimes superior) benefits to potential recipients, with no risk to a healthy, live donor, efforts to maximize the use of organs from deceased donors must not be impeded by the development of live organ donation. Thisconsensusstatementcomesfromthedeliberations oftheEthicsGroupoftheVancouverForumwhichwascharged withdefiningtheessentialethicalelementsoftheprocessforthe transplantcenterperforminglivelung,liver,pancreasandintestine donor. Special emphasis upon elements and issues of informed consent, assurance of donor autonomy and the patient selection process is included for clarity.