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Ethical challenges in kidney transplantation

Avantika Israni1, Abhishek Israni, Judith Benstein2

  • 1Nephrology Division, Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas.

Current Opinion in Nephrology and Hypertension
|November 28, 2025
PubMed
Abstract

Insights

This review examines ethical challenges in kidney transplantation, including organ allocation and new technologies like xenotransplantation and AI. It proposes strategies to restore public trust in the organ donation and transplantation system.

Area of Science:

  • Nephrology
  • Transplantation Science
  • Medical Ethics

Background:

  • Public trust in organ transplantation is declining due to recent controversies.
  • Emerging technologies like xenotransplantation and AI present novel ethical considerations.

Purpose of the Study:

  • To comprehensively review current inequities and ethical challenges in kidney transplantation.
  • To highlight urgent issues in organ allocation and the integration of new technologies.
  • To propose actionable steps for restoring trust in the transplantation system.

Main Methods:

  • Literature review of recent news, media reports, and scientific advancements.
  • Analysis of ethical dilemmas associated with organ allocation.
  • Exploration of ethical challenges posed by xenotransplantation and artificial intelligence in transplantation.

Main Results:

  • Recent controversies have eroded public confidence in organ transplantation and allocation.
  • Xenotransplantation, driven by gene editing, is a growing reality with ethical implications.
  • Integration of artificial intelligence in transplantation necessitates proactive ethical planning.

Conclusions:

  • Addressing ethical dilemmas in kidney transplantation is crucial.
  • Restoring public trust requires transparency and strategic interventions.
  • Ethical foresight is essential for navigating advancements in transplantation technology.
Keywords:
Organ Procurement and Transplantation NetworkUSRDSbrain deathdeceased donationequityethicskidney transplantationliving donationorgan allocation

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