[Living donor kidney transplantation: ethical aspects]

Fifty years after the first kidney grafts, the ethical problems raised by harvesting an organ from a living donor remain a difficult issue for the French nephrology community. We summarize here the ethical principles guiding biomedicine. Respect for human rights requires careful control ensuring that all potential donors receive complete neutral information and are spared from any type of pressure. The principle of not causing harm must be considered in the context of modern medicine where, under certain conditions, individual risk related to a medical intervention is considered acceptable. Living-donor transplantation can have a potentially beneficial effect for the donor and improves access to grafts for patients whose only other solution would be a cadaver graft. We also discuss nonconventional living donors: ABO or HLA incompatible spouses and at-risk donors, for example, elderly donors.