The challenge of informed consent for increased risk living donation and transplantation

E. J. Gordon*, N. Beauvais, N. Theodoropoulos, J. Hanneman, G. McNatt, D. Penrod, S. Jensen, J. Franklin, L. Sherman, M. G. Ison

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

13 Scopus citations


The Organ Procurement and Transplantation Network (OPTN) mandates that organ recipients provide "specific informed consent" before accepting organs that the OPTN defines as "increased risk". However, the OPTN does not provide specific guidelines for what information should be disclosed to potential recipients. Such vagueness opens the door to inadequate informed consent. This paper examines the ethical dimensions of informed consent when the prospective living donor has self-reported behaviors associated with increased risk for infection transmission. Donor privacy is a primary ethical concern that conflicts with recipients' informed consent for use of increased risk organs. We propose that both the increased risk status and the specific behavior be disclosed to the recipient. Because the actual risk posed is linked to the type of risk behavior, disclosure is therefore needed to make an informed decision. The donor's risk behavior is material to recipients' decision making because it may impact the donor-recipient relationship. This relationship is the foundation of the donation and acceptance transaction, and thus comprises a critical feature of the recipient's informed consent. Optimizing a recipient's informed consent is essential to protecting patient safety and autonomy.

Original languageEnglish (US)
Pages (from-to)2569-2574
Number of pages6
JournalAmerican Journal of Transplantation
Issue number12
StatePublished - Dec 1 2011


  • CDC
  • HBV
  • HCV
  • HIV
  • OPTN-increased risk
  • ethics
  • infectious disease transmission
  • informed consent
  • living donor
  • safety

ASJC Scopus subject areas

  • Transplantation
  • Pharmacology (medical)
  • Immunology and Allergy


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