Reuters Health Information: Liver transplant recipients want more power to choose their organs
Liver transplant recipients want more power to choose their organs
Last Updated: 2014-07-23
By Rob Goodier
NEW YORK (Reuters Health) - Most recipients of donor livers
want to know if the organ may carry higher than normal risks and
many want a say in whether they will go through with such a
transplant, a new survey of Dutch patients has found.
"At the time of organ offer for transplantation,
donor-related risks such as disease transmission and graft
failure are weighed against the patient's risk of remaining on
the waiting list," Dr. Robert Porte from University Medical
Center Groningen in the Netherlands and colleagues write in
their report, online May 24 in Liver Transplantation.
The researchers surveyed 179 liver transplant recipients and
40 transplant candidates. They found that nearly 75% would like
to be informed if there are elevated risks of infectious disease
or malignant tumors, and nearly 60% wound want to know if there
is an increased risk of bile duct strictures.
More than 53% of the patients said they would like to be
informed of the risks when the organ is offered. Of those,
nearly all of them wound want to be involved in the decision to
accept the organ, or to make the decision entirely on their own.
The degree of information and choice that transplant
candidates have varies among European countries and the US, the
In the US, patients sign consent forms at different stages
during the process, but the law does not require medical centers
to obtain patients' consent for extended-criteria donors whose
organs might carry higher risks.
Medical centers do give potential recipients information
about higher-risk donors, however, and they inform the patients
throughout the process, Dr. Patricia Sheiner, director of the
liver transplantation program at Hartford Hospital in
Connecticut, who was not involved in the survey, told Reuters
Health by email.
"My experience is that only a few turn down the organ and
the sicker they are and the more faith they have in their
transplant team, the more likely they are to accept an organ,"
Dr. Sheiner said.
Even with risk information, many patients still defer the
decision to the transplant team, said Dr. David Foley, a liver
transplantation surgeon and associate professor of surgery at
the University of Wisconsin-Madison.
But maybe that can change.
"I believe that surgeons and centers would be in favor of
having patients play a more active role. Surgeons do not want to
transplant an organ to a patient who does not want to receive
that specific organ. If they did have a more active role, then
it is possible that more organs would be turned down and the
center would have to identify another recipient. This would not
be a significant problem for the center or the organ procurement
organization," Dr. Foley said.
Whatever the final decisions on information and consent,
medical centers should standardize their operations across the
board so that patients get equal treatment wherever they go, Dr.
Porte and his team write.
Dr. Porte could not be reached for comment.
Liver Transpl 2014.