Should living liver donation be available in the NHS?

September 18, 2003

Living liver donation should be available on the NHS, although it should not be adopted without full public debate and agreement because of the risks to donors, argue researchers in this week's BMJ.

Living liver donation could benefit patients who are likely to die or deteriorate before a cadaveric donor becomes available. It involves a minimum graft to donor weight ratio of 1% and the donor's liver usually regenerates completely in about 12 months. It is currently offered in the United States and parts of Europe, but not in the UK.

The risk of illness to donors is 40-60% and risk of death is 0.5-1%. In comparison, living kidney donors have a risk of death of about 0.03%, with a 2% risk of major illness and a 10-20% risk of minor illness.

If living liver donation becomes available in the NHS, procedures must be set up to ensure that donors are not coerced and fully understand the risks and benefits, and it should not be introduced without public debate and approval, say the authors.

Making living liver donation available in the NHS will have a small but important effect on the number of people able to receive a graft. It is time for a full public debate on the risks and benefits, they conclude.
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BMJ

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