Katrina A Bramstedt1. 1. Department of Bioethics Cleveland Clinic Foundation, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio 44195, USA.
Abstract
OBJECTIVE: To explore the use of medical journals, lay media, registries, and transplant center websites to discuss living liver donor mortality. METHODS: To study the incidence of and circumstances relating to living liver donor death, medical journals and lay print media were searched to create a case summary of worldwide living liver donor deaths. The United Network for Organ Sharing (UNOS) and European Liver Transplant Registry (ELTR) were also queried for information regarding living liver donor deaths. Lastly, the Websites of United States transplant centers offering living liver donation were reviewed to identify whether or not death was stated as a donor risk. RESULTS: Literature review revealed 14 living liver donor deaths. One of the five deaths occurring in the United States had been reported to UNOS. One of the 14 cases had been reported only in lay literature, and another only in the ELTR. In at least five cases, surgical complications were not the cause of donor death. Among the 62 transplant center Websites, only 12 centers (19%) specifically mentioned death as a donation risk. Eight of these 12 centers (67%) mentioned death in terms of percent mortality risk; however, risk rates spanned a 10-fold range from 0.2% to 2%. CONCLUSION: Potential living liver donors are best served by accurate information about donor mortality. Access to such data is difficult and these individuals would benefit by a worldwide living liver donor registry and peer-reviewed publication of donor mortality.
OBJECTIVE: To explore the use of medical journals, lay media, registries, and transplant center websites to discuss living liver donor mortality. METHODS: To study the incidence of and circumstances relating to living liver donordeath, medical journals and lay print media were searched to create a case summary of worldwide living liver donor deaths. The United Network for Organ Sharing (UNOS) and European Liver Transplant Registry (ELTR) were also queried for information regarding living liver donor deaths. Lastly, the Websites of United States transplant centers offering living liver donation were reviewed to identify whether or not death was stated as a donor risk. RESULTS: Literature review revealed 14 living liver donor deaths. One of the five deaths occurring in the United States had been reported to UNOS. One of the 14 cases had been reported only in lay literature, and another only in the ELTR. In at least five cases, surgical complications were not the cause of donordeath. Among the 62 transplant center Websites, only 12 centers (19%) specifically mentioned death as a donation risk. Eight of these 12 centers (67%) mentioned death in terms of percent mortality risk; however, risk rates spanned a 10-fold range from 0.2% to 2%. CONCLUSION: Potential living liver donors are best served by accurate information about donor mortality. Access to such data is difficult and these individuals would benefit by a worldwide living liver donor registry and peer-reviewed publication of donor mortality.