title: Suggestions on how to make suboptimal kidney transplantation an ethically viable option.
abstract: To overcome kidney donation, the pool of potentially eligible donors has been widened by using suboptimal organs harvested from living donors or cadavers. These organs may engender health complications as age, risk factors, and pathologies of donors fail to meet the standard donor criteria. After examining a wide array of literature on suboptimal kidney transplants, we evidenced two major issues: the lack of standardized terminology and the lack of longterm data on the health outcomes of both suboptimal living donors and recipients. Consequently, surgeons are still unable to provide patients with thorough information to obtain a well-informed consent. Suboptimal kidney transplantation still remains in its experimental stage, thereby raising many ethical and medico-legal concerns. We suggest that one possible solution to overcome some of the ethical shortcomings of suboptimal kidney donations is to provide living donors and recipients honest, accurate, and thorough information about its health risks. To this aim, we advocate adopting a widely standardized terminology that would embrace the whole concept of suboptimal kidney transplantation, increasing the number of future publications on the health outcomes of living donors and recipients, spurring ethical reflection to improve the experience of suboptimal kidney transplantation and reduce the waiting-list for kidney transplantation.
authors.affiliation: Department of Advanced Biomedical Sciences, University of Naples "Federico II". Via S. Pansini 5, 80131, Naples, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Graziano
authors.affiliation: Department of Advanced Biomedical Sciences, University of Naples "Federico II". Via S. Pansini 5, 80131, Naples, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Buccelli
authors.affiliation: Department of Advanced Biomedical Sciences, University of Naples "Federico II". Via S. Pansini 5, 80131, Naples, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Capasso
authors.affiliation: Department of Advanced Biomedical Sciences, University of Naples "Federico II". Via S. Pansini 5, 80131, Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: De Micco
authors.affiliation: Department of Advanced Biomedical Sciences, University of Naples "Federico II". Via S. Pansini 5, 80131, Naples, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Casella
authors.affiliation: Department of Advanced Biomedical Sciences, University of Naples "Federico II". Via S. Pansini 5, 80131, Naples, Italy.
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Di Lorenzo
authors.affiliation: Department of Advanced Biomedical Sciences, University of Naples "Federico II". Via S. Pansini 5, 80131, Naples, Italy.
authors.forename: Mariano
authors.initials: M
authors.lastname: Paternoster
keywords: Bioethics; Kidney transplantion; Medico-Legal