Have we reached the limits in altruistic kidney donation?

Rachel Thomas, Henrietta Consolo, Gabriel Oniscu

Research output: Contribution to journalArticlepeer-review


Altruistic donation (unspecified donation) is an important aspect of living donor kidney transplantation. Although donation to a stranger is lawful and supported in many countries, it remains uncommon and not actively promoted. Herein, we ask the question if we have reached the limit in altruistic donation. In doing so, we examine important ethical questions that define the limits of unspecified donation, such as the appropriate balance between autonomous decision-making and paternalistic protection of the donor, the extent of outcome uncertainty and risk-benefit analyses that donors should be allowed to accept. We also consider the scrutiny and acceptance of donor motives, the potential for commercialisation, donation to particular categories of recipients (including those encountered through social media) and the ethical boundaries of active promotion of unspecified kidney donation.
We conclude that there is scope to increase the number of LD kidney transplants further by optimising existing practices to support and promote unspecified donation. A number of strategies including optimisation of the assessment process, innovative approaches to reach potential donors together with reimbursement of expenses and a more specific recognition of unspecified donation are likely to lead to a meaningful increase in this type of donation.
Original languageEnglish
JournalTransplant international
Publication statusPublished - 19 May 2021


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