Organ Transplants in Need of Up-Front Consent Policy

Potential recipients can state acceptability of 'non-standard' organs when they go on waiting list

WEDNESDAY, June 25 (HealthDay News) -- The United Network for Organ Sharing (UNOS) should create a policy requiring potential organ transplant recipients to go through a comprehensive consent process that allows them to specify whether they'll accept or decline all non-standard organs, according to a Sounding Board feature in the June 26 issue of the New England Journal of Medicine.

Scott D. Halpern, M.D., Ph.D., of the University of Pennsylvania School of Medicine in Philadelphia, and colleagues discuss so-called "non-standard" organs, such as those from high-risk donors (such as men who've had sex with men or people who used non-medical drug injections in the past five years) or donors with "expanded criteria" (such as advanced age or hypertension). Though trends are pointing toward disclosure of risk to recipients for specific organs, the authors point out several problems with this approach.

Patients have little time to weigh the risks -- which are very imprecise -- and benefits of a particular organ, but the time this does require could reduce the chance of getting the organ to the optimal candidate. The authors urge transplantation programs to disclose all foreseeable transplantation risks when patients are put on the waiting list, at which time patients can assert whether they find organs from non-standard donors acceptable.

"Standards for the disclosure of risk and consent in solid-organ transplantation require far more standardization and formality than are currently available. UNOS should develop a single policy that requires a comprehensive consent process when all candidates for transplantation are placed on the waiting list," the authors write.

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