Ethics Committee: Review and Expansion

The Ethics Committee published its first statement of ethical considerations related to live kidney donation, based on a forum held in Amsterdam in 2004. In 2006, a subsequent forum was held in Vancouver to review the ethical considerations involved in the expanded areas of lung, liver, pancreas and intestine living donor transplantation. The rapid evolution of all areas of transplantation has resulted in even more complex ethical issues in the last decade concerning altruistic donors, multiple organ donors, domino liver transplants, paired exchange, advanced donation programs, and the use of social media. Liz Pomfret (USA) will be leading the Ethics Committee in updating the documents of the Amsterdam and Vancouver forums, as well as reviewing the complex newer issues related to expansion of the living donor pool.

The Ethics Committee will also be reviewing the Global Kidney Exchange (GKE) initiative, which has recently emerged. There has been significant concern that the GKE program should be halted due to ethical considerations. The intent to globally exchange living kidney donors between low/middle income countries (LMIC) and high income countries challenges established ethical principles in organ donation. Multiple organizations, including TTS, the Declaration of Istanbul Custodian Group, the Council of Europe Committee on Organ Transplantation and the Ibero-Latinamerican Council for Organ Donation, have come out in strong opposition to GKE between economically disparate countries. Rudolf Garcia-Gallont (Guatemala) will be leading the Ethics Committee in reviewing the current ethical challenges associated with GKE at the meeting of the committee in Madrid, with the intent of identifying the ethical issues it encompasses, and identifying sounder strategies for facilitating transplant services in the LMIC.

Finally, the ethics committee has planned for two exciting sessions at the TTS 2018 Meeting in Madrid. The State of the Art (SOTA) is scheduled on Monday, July 2, and is entitled Upholding the Ethics of Transplantation: The Global View. This symposium includes talks from transplant leaders in Pakistan, Iran, and China – and will review ethical strategies for increasing transplant rates without compromising ethical standards. The second session is scheduled for Wednesday, July 4, and will address the challenging issues involved with informed consent with living and deceased donors – another area the Ethics Committee will be tackling during the next two years.