The KPD "Advanced Donation Program": Is Informed Consent Enough?

[Clark]

http://onlinelibrary.wiley.com/doi/10.1111/ajt.13615/abstract

Letter to the Editor

Is Informed Consent Enough?
Wenhao Liu1, Kimberly D. Krawiec2 andMarc L. Melcher3,*
DOI: 10.1111/ajt.13615
American Journal of Transplantation
Accepted Article (Accepted, unedited articles published online and citable. The final edited and typeset version of record will appear in future.)

Abstract
As illustrated by Flechner et al (1), patients with renal failure continue to benefit from rapid innovations within multiple Kidney Paired Donation (KPD) registries. The development of the Advanced Donation Program (ADP) facilitates transplants by enabling the donors to donate even when their intended recipients (IR) are not matched yet. However, as with any innovation, ADP introduces new challenges including risks to the IRs and registries, vagueness in the definition of priority granted to the IR, and concerns about fairness to the donor should the IR become untransplantable.

[Clark]

http://onlinelibrary.wiley.com/doi/10.1111/ajt.13640/abstract

Letter to the Editor

Do the Right Thing. It Will Gratify Some People and Astonish the Rest
S. M. Flechner1,*, D. Leeser2, R. Pelletier3, M. Morgievich4, K. Miller5, L. Thompson2, S. McGuire6, J. Sinacore7 andG. Hil7
DOI: 10.1111/ajt.13640

American Journal of Transplantation
Accepted Article (Accepted, unedited articles published online and citable. The final edited and typeset version of record will appear in future.)

Abstract
In their letter Liu, Krawiec, and Melcher bring up several important considerations when incorporating an Advanced Donation Program (ADP) into a Kidney Paired Donation (KPD) Network such as the National Kidney Registry (NKR) (1). Their questions raise issues that are fundamental when attempting to provide informed consent and "fairness" in the delivery of KPD transplantation. There are perhaps three domains to consider.