Saving lives, protecting donors: Transplantation presents update on living-donor organ transplantation

The special issue presents new research, reviews, and commentaries for an up-to-the-minute look at the present and future of living-donor transplantation. "This very special issue of Transplantation is dedicated to the approximately 33,000 living kidney and 5,000 living liver donors who provided organs for transplantation in 2014 across the world," comments Prof. Jeremy R. Chapman, Editor-in-Chief of Transplantation.

New Research, Updated Guidelines, and International Perspective on Living-Donor Transplantation

Contributed by leading international experts, the special issue papers highlight ongoing efforts to improve the selection and evaluation of living donors, their surgical and medical care during donation, and follow-up after the procedure. Lifelong follow-up is essential for gaining a more complete understanding of the true risks of living donation.

"This is all about living donors and their care -- providing us all a cause for introspection about what we ask of living donors and our responsibilities to them," says Dr. Chapman. Several papers highlight the complex challenges of collecting long-term information on donor health, including data on the causes of health problems that do occur.

Living-organ donation confronts patients, healthcare professionals, and society with a challenging set of concerns unlike any other type of procedure. "We use global professional guidelines and consensus statements to help clinicians with this complex area of clinical practice," Dr. Chapman comments. The special issue publishes the evidence base for the KDIGO guidelines (http://kdigo.org/home/guidelines/livingdonor/) on evaluation and follow-up care of living kidney donors, currently under development.

While living-donor liver transplantation (LDLT) accounts for less than five percent of liver transplants in the United States and Europe, it has become the principal form of liver transplantation worldwide. The special issue presents the International Liver Transplantation Society guidelines on LDLT, as well as a summary of recent UK guidelines. A special article highlights the promising experience with LDLT in Latin America, while acknowledging the numerous challenges that remain. Another paper provides a thoughtful update on Iran's controversial paid living organ donation program.

A special review marks the 50th anniversary of the original Ciba symposium examining ethical and legal issues in transplantation -- "Since that time, much has changed and much has remained the same," Dr. Chapman reflects. The special issue also presents new data on the long-term outcomes of living pancreas donors and the safety systems established for hematopoietic stem cell transplant donors.

Dr. Chapman adds, "This issue will provide food for thought for everyone involved in living-donor organ transplantation: donor, recipient, physician, surgeon, transplant nurse, patient association, transplant coordinator, public policy analyst, lawmaker and the most important families who share the burden of decision-making."