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Aaron Spital

Publications and source records attributed to Aaron Spital.

30 records · Page 2Linked to original sources
PubMed2003

The report of a national conference on the wait list for kidney transplantation.

In March, 2002, over 100 members of the transplant community assembled in Philadelphia for a meeting designed to address problems associated with the growing number of patients seeking kidney transplantation and added to the waiting list each year. The meeting included representatives of nine US organizations with interests in these issues. Participants divided into work groups addressing access to the waiting list, assigning priority on the list, list management, and identifying appropriate candidates for expanded criteria donor kidneys. Each work group outlined problems and potential remedies within each area. This report summarized the issues and recommendations regarding the waiting list for kidney transplantation addressed in the Philadelphia meeting.

Congresses as Topic↗
PubMed2003

Conscription of cadaveric organs for transplantation: neglected again.

The March 2003 issue of the Kennedy Institute of Ethics Journal was devoted to cadaveric organ procurement. All the discussed proposals for solving the severe organ shortage place a higher value on respecting individual and/or family autonomy than on maximizing recovery of organs. Because of this emphasis on autonomy and historically high refusal rates, I believe that none of the proposals is likely to achieve the goals of ensuring an adequate supply of transplantable organs. An alternative approach, conscription of cadaveric organs for transplantation, reverses the rank order of these priorities by placing greater value on maximizing recovery of organs than on respect for autonomy. Although conscription of organs initially may appear to be a radical and even ridiculous proposal, careful consideration reveals that it might well solve the organ shortage in an ethically acceptable way.

Cadaver↗
PubMed2002

Life insurance for kidney donors: another update.

BACKGROUND: Previous studies concluded that healthy kidney donors should be able to obtain life insurance at standard rates. However, we have become aware of a few donors for whom this was not the case. Clearly, this important issue needs to be readdressed. METHODS: To investigate how American life insurance companies currently view and treat living kidney donors, we mailed a survey to the medical directors of 70 U.S. life insurance companies in the winter of 2001; we included the 20 largest companies ranked by assets. RESULTS: Thirty-eight companies, including 16 of the top 20, chose to participate. All of them said they would offer life insurance to a healthy kidney donor and only one believed it might raise the premium. Only one company thought that kidney donation might adversely affect longevity, and a majority of the companies did not consider healthy donors to be at increased risk for future medical problems. CONCLUSIONS: These data suggest that most life insurance companies are still willing to insure healthy kidney donors at standard rates. Nevertheless, occasional donors may encounter difficulty when applying for life insurance. When this occurs, transplant centers should be prepared to help the donor obtain insurance.

Data Collection↗
PubMed2002

Conscription of cadaveric organs for transplantation: let's at least talk about it.

Renal transplantation is the optimal treatment for many patients with end-stage renal disease, and for people with other end-stage organ diseases, transplantation may offer the only hope for survival. Unfortunately, the ability to deliver this medical miracle is limited by a severe shortage of human organs. As a result, many people with irreversible organ failure die while waiting for an organ to become available. Compounding this tragic situation is the fact that many usable organs are being buried instead of being transplanted because of the relatively low efficiency of cadaveric organ procurement. One of the major barriers to procurement is family refusal. Several proposals designed to increase consent rates have been suggested, but it is highly unlikely that any of them would approach the 100% efficiency of organ procurement that patients with end-stage organ failure so desperately need. However, there is a rarely discussed alternative that would likely achieve this important goal---conscription of cadaveric organs. Under this plan, all usable organs would be removed from recently deceased people and made available for transplantation; consent would be neither required nor requested and, with the possible exception of people with religious objections, opting-out would not be possible. In this article, we review the advantages and disadvantages of this approach. We conclude that consent for cadaveric organ removal is not ethically required and that, from an ethical point of view, conscription is actually preferable.

Cadaver↗
PubMedDate not supplied

Increasing the pool of transplantable kidneys through unrelated living donors and living donor paired exchanges.

Renal transplantation is the best therapy for eligible patients with end-stage renal disease (ESRD). Unfortunately the ability to perform this procedure is limited by a severe shortage of transplantable kidneys. One of the most successful approaches to this serious problem has been to expand the pool of living donors. This has been accomplished primarily by lifting restrictions on the use of genetically unrelated volunteers. As a result, acceptable living kidney donors now include individuals who are related to their recipients only through emotional bonds (e.g., spouses) and, at some centers, even people who are not related to their recipients at all. Living donor paired kidney exchanges provide a novel means for increasing further the number of kidneys available for transplantation. Each of these approaches will be reviewed.

Ethics, Medical↗