Published online August 1, 2008
PEDIATRICS Vol. 122 No. 2 August 2008, pp. 454-461 (doi:10.1542/peds.2008-1525)
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CLINICAL REPORT

Minors as Living Solid-Organ Donors

Lainie Friedman Ross, MD, PhD, J. Richard Thistlethwaite, Jr, MD, PhD and the Committee on Bioethics

In the past half-century, solid-organ transplantation has become standard treatment for a variety of diseases in children and adults. The major limitation for all transplantation is the availability of donors, and the gap between demand and supply continues to grow despite the increase in living donors. Although rare, children do serve as living donors, and these donations raise serious ethical issues. This clinical report includes a discussion of the ethical considerations regarding minors serving as living donors, using the traditional benefit/burden calculus from the perspectives of both the donor and the recipient. The report also includes an examination of the circumstances under which a minor may morally participate as a living donor, how to minimize risks, and what the informed-consent process should entail. The American Academy of Pediatrics holds that minors can morally serve as living organ donors but only in exceptional circumstances when specific criteria are fulfilled.

Key Words: living donors • organ transplantation • psychosocial risks • child • adolescent • siblings

Abbreviations: AAP—American Academy of Pediatrics • UNOS—United Network for Organ Sharing