Paired kidney exchanges are being used with increasing frequency to overcome humoral immunologic incompatibilities between patients in need of renal transplantation and their potential live donors. Altruistic unbalanced exchanges utilize compatible donor/recipient pairs in order to facilitate the transplantation of a patient with an incompatible donor. We have now performed several altruistic unbalanced paired kidney exchanges at our institution. Also, we have surveyed potential donors and recipients regarding their attitudes toward participating in altruistic unbalanced paired kidney exchanges. Patients are most amenable to participation if they perceive a benefit from trading away a compatible donor. Given the number of compatible live donor transplants performed annually, if practiced on a broad scale, altruistic unbalancedpaired kidney exchanges can have a profound impact upon the supply of kidneys for transplantation. These exchanges can be performed at individual centers without the requirement for largesharing pools or complex computer algorithms. However, there are a number of ethical and logistical considerations that must be addressed. Altruistic unbalanced paired kidney exchanges represent a major paradigm shift in renal transplantation, in that a private resource (i.e. the live kidney donor) is converted to a shared or public one.
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Asian Bioeth Rev
July 2022
Department of Philosophy, Ramanujan College, University of Delhi, Delhi, India.
Surrogacy is one of the desired reproductive technologies for family formation, yet surrogate mothers are subjected to unethical treatments and unbalanced power relations in India. Such treatment obscures women's free decision-making and can be detrimental to their maternal self. Recently, the Surrogacy (Regulation) Act, 2021, has received the President's approval to regulate surrogacy practices by limiting them for the altruistic motives which have again provoked the burning debates regarding reproductive technologies, women's emancipation and procreative labour.
View Article and Find Full Text PDFFront Psychol
March 2021
Collaborative Innovation Center of Assessment Toward Basic Education Quality, Beijing Normal University, Beijing, China.
Previous studies have shown that adolescents are experiencing growing pains due to their unbalanced physical and mental development. Their life satisfaction showed a steady downward trend with age. Altruism may be an effective way to improve their life satisfaction.
View Article and Find Full Text PDFPLoS One
March 2019
North West Hub for Trials Methodology Research/ Clinical Trial Research Centre, Biostatistics, University of Liverpool, Liverpool, United Kingdom.
Background: The recruitment and retention of patients are significant methodological challenges for trials. Whilst research has focussed on recruitment, the failure to retain recruited patients and collect outcome data can lead to additional problems and potentially biased results. Research to identify effective retention strategies has focussed on influencing patient behaviour through incentives, reminders and alleviating patient burden, but has not sought to improve patient understanding of the importance of retention.
View Article and Find Full Text PDFTransplantation
October 2014
1 Centre de recherche du Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Canada. 2 Bioethics Program, Department of Social and Preventive Medicine, École de santé publique de l'Université de Montréal, Montreal, Canada. 3 Nephrology and Transplantation Division, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Canada. 4 Address correspondence to: Marie-Chantal Fortin M.D., Ph.D., F.R.C.P.C., Nephrology and Transplantation Division, Centre Hospitalier de l'Université de Montréal, 1560 Sherbrooke Street East, Montreal, Quebec H2L 4M1, Canada.
Background: Kidney recipients in the O blood group are at a disadvantage in kidney exchange programs (KEPs) because they can only receive an organ from O blood group donors. A way to remedy this unfair situation is through altruistic unbalanced paired kidney exchange (AUPKE) where a compatible pair (CP) consisting of an O donor and a non-O recipient is invited to participate in a KEP. There is no established AUPKE program in Canada.
View Article and Find Full Text PDFJ Med Ethics
December 2013
Department of Nephrology and Transplantation, Centre Hospitelier de l'Université de Montréal, , Montreal, Quebec, Canada.
Living kidney transplantation offers the best results for patients with end-stage renal disease (ESRD). This form of transplantation is no longer restricted to genetically or emotionally related donors, as shown by the acceptance of non-directed living anonymous donors, and the development of exchange programmes (EPs). EPs make it possible to perform living kidney transplantation among incompatible pairs, but while such programmes can help increase living organ donation, they can also create a degree of unfairness.
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