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February 1991

Living Organ Donation: Shifting Responsibility

Author Affiliations

University of Maryland School of Medicine and the University of Maryland Health Center College Park, Md

Arch Intern Med. 1991;151(2):234-235. doi:10.1001/archinte.1991.00400020010002

Living donors have been with us since the birth of renal transplantation.1 They have served us well, often providing the recipient the best hope for a successful outcome. Yet, as Singer2 recently emphasized, after more than 30 years, the use of living kidney donors as a means of alleviating the severe organ shortage remains controversial. Most controversial is the use of unconventional living donors (ie, those who are genetically unrelated to the recipient and those who are at added risk).3 Furthermore, a few prominent transplant physicians have even questioned the continued acceptance of traditional living-related kidney donors.4,5 It seems timely to review some of the issues involved as living donors have recently been called on to provide other organs as well.6 I emphasize that the following discussion is directed only toward altruistic adults and should not be extrapolated to paid donors; the latter group raises

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