title: Organ donation and pre-emptive kidney transplantation: ethical issues.
abstract: There is considerable evidence that pre-emptive transplants have several clinical advantages. However, pre-emptive transplants raise a number of ethical issues. Pre-emptive transplants from living donors offer distinctly greater benefits than those from deceased donors and some pre-emptive transplantation programmes actively encourage living organ donations. Moreover, the offer of a pre-emptive transplant to a patient who is not yet on dialysis unquestionably penalises patients already on dialysis who may have been on the waiting list for a long time. Therefore preemptive transplants give rise to conflicts between justice and utility. Several factors should be considered: health conditions, clinical urgency, probability of imminent worsening of a patient's clinical condition, the future chances of finding a matching organ, and others. From the various values at stake, ethical issues are analysed in search of an acceptable synthesis.
authors.affiliation: Italian National Institute of Health, Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Petrini
mesh_terms: D026688:Bioethical Issues; D006801:Humans; D016030:Kidney Transplantation / Q000941:ethics*; D065286:Prophylactic Surgical Procedures / Q000941:ethics*; D009927:Tissue and Organ Procurement