Split liver transplantation: papering over the cracks of the organ shortage

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Split liver transplantation : papering over the cracks of the organ shortage. / Moorlock, Greg; Neuberger, James; Draper, Heather.

In: Clinical Ethics, Vol. 10, No. 3, 09.2015, p. 83-89.

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@article{2d73f084aaaa449ebf6b00fde116eccb,
title = "Split liver transplantation: papering over the cracks of the organ shortage",
abstract = "Splitting livers allows two people (usually an adult and a child) to receive a liver transplant from one donated adult liver, but the risks to the adult recipient are greater than if they had received the equivalent whole liver. It has been suggested, therefore, that splitting livers harms adult recipients. Without liver splitting, however, there would be few livers available for children, and paediatric waiting time and waiting list mortality would significantly increase. In this paper, we argue that although splitting livers makes adults worse off, this should be considered sub-optimal benefit rather than harm. We explore justifications for sub-optimally benefitting adults in this way and consider alternatives to the current approach. We argue that splitting livers masks the more fundamental problem of low paediatric donation rates and that increasing the number of paediatric donations would improve the situation for both adult and paediatric liver patients. ",
keywords = "Organ and tissue transplantation, allocation, donation and procurement",
author = "Greg Moorlock and James Neuberger and Heather Draper",
year = "2015",
month = sep,
doi = "10.1177/1477750915599703",
language = "English",
volume = "10",
pages = "83--89",
journal = "Clinical Ethics",
issn = "1477-7509",
publisher = "SAGE Publications",
number = "3",

}

RIS

TY - JOUR

T1 - Split liver transplantation

T2 - papering over the cracks of the organ shortage

AU - Moorlock, Greg

AU - Neuberger, James

AU - Draper, Heather

PY - 2015/9

Y1 - 2015/9

N2 - Splitting livers allows two people (usually an adult and a child) to receive a liver transplant from one donated adult liver, but the risks to the adult recipient are greater than if they had received the equivalent whole liver. It has been suggested, therefore, that splitting livers harms adult recipients. Without liver splitting, however, there would be few livers available for children, and paediatric waiting time and waiting list mortality would significantly increase. In this paper, we argue that although splitting livers makes adults worse off, this should be considered sub-optimal benefit rather than harm. We explore justifications for sub-optimally benefitting adults in this way and consider alternatives to the current approach. We argue that splitting livers masks the more fundamental problem of low paediatric donation rates and that increasing the number of paediatric donations would improve the situation for both adult and paediatric liver patients.

AB - Splitting livers allows two people (usually an adult and a child) to receive a liver transplant from one donated adult liver, but the risks to the adult recipient are greater than if they had received the equivalent whole liver. It has been suggested, therefore, that splitting livers harms adult recipients. Without liver splitting, however, there would be few livers available for children, and paediatric waiting time and waiting list mortality would significantly increase. In this paper, we argue that although splitting livers makes adults worse off, this should be considered sub-optimal benefit rather than harm. We explore justifications for sub-optimally benefitting adults in this way and consider alternatives to the current approach. We argue that splitting livers masks the more fundamental problem of low paediatric donation rates and that increasing the number of paediatric donations would improve the situation for both adult and paediatric liver patients.

KW - Organ and tissue transplantation

KW - allocation

KW - donation and procurement

U2 - 10.1177/1477750915599703

DO - 10.1177/1477750915599703

M3 - Article

VL - 10

SP - 83

EP - 89

JO - Clinical Ethics

JF - Clinical Ethics

SN - 1477-7509

IS - 3

ER -