Ethics and commerce in live donor renal transplantation: classification of the issues

Transplant Proc. 1990 Jun;22(3):922-4.


Renal transplantation is now very successful. A shortage of kidneys continues to be a problem. Attempts to increase the supply have recently led to unethical practices, but the issues in the discussion of the ethics need clarification. We propose a classification that we believe will help to achieve this for living donor renal transplantation. This can be considered under five categories: (1) living-related donation; (2) emotionally related donation; (3) altruistic donation; (4) "rewarded" gifting; and (5) rampant commercialism. Ethical issues for categories 1, 2, and 3 are either esoteric or have been resolved. Category 4 needs further discussion and elucidation and should be the area of concentration. Category 5 we perceive to be unethical.

MeSH terms

  • Altruism
  • Commerce*
  • Ethics, Medical*
  • Histocompatibility
  • Humans
  • Kidney Transplantation / classification*
  • Kidney Transplantation / economics
  • Tissue Donors / psychology
  • Tissue and Organ Procurement / economics*