Ethics of Lung Transplantation With Live Donors

Abstract

Lung transplantation has become a viable treatment option for many patients with terminal pulmonary disease but the scarcity of donor lungs is a severe constraint. Hence many patients accepted into lung transplant programmes die while awaiting transplantation -- as have nearly a quarter of patients admitted to the lung transplant programme in Toronto since 1984. The use of live donors might relieve donor lung scarcity. Live donors have been used in kidney transplantation since 1954 and in liver transplantation since 1989. In October, 1990, the Stanford group did the world's first live-donor lung transplant. Ethical questions have been raised about this procedure. Recent experience with live-donor liver transplantation has demonstrated the potential benefit of analysing ethical considerations before embarking on innovative transplant procedures, which is what we plan to do here for lung transplantation.