title: Could minors be living kidney donors? A systematic review of guidelines, position papers and reports.
abstract: The purpose of this study is to systematically review guidelines, position papers, and reports on living kidney donation by minors. We systematically searched the databases such as Medline, Embase, ISI Web of knowledge, Google scholar as well as the websites of various bioethics committees, transplant organizations and societies. Guidelines were included if they provided recommendations for or against living kidney donation by minors. Data were analyzed using qualitative content analysis. We included 39 documents in this study. Twenty seven of these endorse an absolute prohibition of living kidney donation by minors, because of concerns regarding the decision-making capacity of minors, the impartiality of parental authorization, the best interests of the minor, and the necessity of the donation. Twelve guidelines, however, would exceptionally allow living kidney donation by minors, provided that adequate safeguards are put in place, including an assessment of the minor's autonomy and maturity, authorization by an independent body, assuring that the anticipated psychosocial benefits outweigh the medical and psychosocial risks for the donor and the restriction to situations of last resort. A more adequate medical and psychosocial follow-up of living kidney donors may likely contribute to a more unified approach towards living kidney donation by minors.
authors.affiliation: Centre for Biomedical Ethics and Law, University of Leuven, Belgium.
authors.forename: Kristof
authors.initials: K
authors.lastname: Thys
authors.forename: Kristof
authors.initials: K
authors.lastname: Van Assche
authors.forename: Hélène
authors.initials: H
authors.lastname: Nobile
authors.forename: Marion
authors.initials: M
authors.lastname: Siebelink
authors.forename: Isabelle
authors.initials: I
authors.lastname: Aujoulat
authors.forename: Paul
authors.initials: P
authors.lastname: Schotsmans
authors.forename: Fabienne
authors.initials: F
authors.lastname: Dobbels
authors.forename: Pascal
authors.initials: P
authors.lastname: Borry
mesh_terms: D003657:Decision Making; D006801:Humans; D038622:Internationality; D007668:Kidney / Q000473:pathology; D016030:Kidney Transplantation / Q000941:ethics* / Q000331:legislation & jurisprudence* / Q000523:psychology; D019520:Living Donors; D009392:Nephrectomy / Q000523:psychology; D018579:Patient Selection / Q000941:ethics; D017410:Practice Guidelines as Topic; D051437:Renal Insufficiency / Q000628:therapy; D012306:Risk; D009927:Tissue and Organ Procurement / Q000941:ethics
keywords: kidney donation; living donation; pediatric donation and transplantation