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Living liver donor mortality: where do we stand?
1Department of Bioethics Cleveland Clinic Foundation, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio 44195, USA.
The American Journal of Gastroenterology
|February 24, 2006
Summary
Accurate information on living liver donor mortality is difficult to access. A global registry and published data are needed to inform potential donors about risks, including non-surgical causes of death.
Area of Science:
- Hepatology
- Transplantation Surgery
- Medical Ethics
Background:
- Living liver donation is a critical procedure for addressing organ shortages.
- Ensuring donor safety and informed consent requires comprehensive mortality data.
- Current data sources for living liver donor mortality are fragmented and incomplete.
Purpose of the Study:
- To evaluate the availability and reporting of living liver donor mortality in various information channels.
- To assess how transplant centers communicate donor mortality risks on their websites.
Main Methods:
- Systematic literature review of medical journals and lay media for reported donor deaths.
- Inquiry into organ sharing registries (UNOS) and European Liver Transplant Registry (ELTR).
- Analysis of transplant center websites in the United States for stated donor mortality risks.
Main Results:
- Identified 14 worldwide living liver donor deaths; reporting was inconsistent across sources.
- Only 19% of US transplant center websites mentioned death as a risk, with reported mortality rates varying widely (0.2%-2%).
- Non-surgical complications were implicated in at least five donor deaths, highlighting the complexity of mortality factors.
Conclusions:
- Potential living liver donors require accurate and accessible mortality data for informed decision-making.
- Existing information channels are insufficient for comprehensive reporting of donor mortality.
- Establishment of a global living liver donor registry and standardized peer-reviewed publication of mortality data are recommended.