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August 17, 2008


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As a person on the UNOS list for a kidney, how can I be sure my transplant center does not use donors who meet the traditional brain death definition of death? I have never heard of my transplant center using after cardiac death donors but since I am near the top of the list, is this a question I should now be asking when offered a kidney? Should I ask if the donor was brain dead or can I still assume he or she was? Thanks.

Peter Laird, MD

Dear Anonymous,

That is an excellent question that most likely is up to the discretion of your individual transplant center. In short, some are better at informing than others. I did write some related posts on similar issues that you may wish to look into further. The trend in the journals is to advocate for an involved informed consent procedure at the time a person is placed on the list and then no information about the actual donor at the time of transplant which makes this matter even more difficult if your center is using extended donor criteria or even more problematic, high risk donors.

Renal Transplantation: The Real Impact of Extended Donor Criteria


Substandard Organs or Substandard Ethics?


I would advise to discuss these issues with your transplant team to get their input on these issues. I further wish you all the best in finding your own optimal renal replacement therapy.


It is obviously insane for the medical community and the legal system to forbid buying a kidney for transplant from a perfectly willing donor because this is imagined by healthy people to be somehow 'immoral,' but then to give most people on the transplant waiting list no other choice but to take an organ for transplant by procedures which may arguably amount to murder! Even 'brain dead' people have a spontaneously functioning circulatory system, so they are arguably not dead either when organs are harvested from them.

Peter Laird, MD

In response to Somerville, why not then just shoot the donors that you would like to harvest and forget about these silly immoral prohibitions against things such as murder. There are absolutes of human behavior that should remain solid and stable for the sake of the survival of the specific society. We have all too many examples of nations that have transgressed against basic principles of human morals.

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