Hot topics in kidney transplantation by Dr. Dorry Segev – Paradigm 3: tangible benefits for donors

A normal person going through a major surgical operation, not for his benefit, is an old paradigm. For many donors, there are tangible benefits. That may not be a direct medical benefit, but there can be tangible benefits for them in all sorts of ways if they donate. They may benefit, and those benefits may offset some of the extra risks they are taking. Bad things happen to many people if we don’t let them donate a kidney. One of the ethical principles of medicine is "autonomy," so we should let them do what they want, and another ethical principle is "nonmaleficence," meaning we should not harm.

There are also benefits to donating. The donors we are most interested in for their benefit are those who are interdependent. Interdependent donors account for only about half of the donor pool in the United States because the other half comes from outside the donor family. In India, interdependent donors are the most common donors, with a father donating to his child. That person who donates is often a caregiver for the recipient and is impacted directly by the recipient’s medical problem. So if they fix the recipient by donating, sure, they may have some risk, but there are huge benefits from this happening. They can benefit from their health and well-being because now they can eat whatever they want; they don’t have to eat a renal diet. They have less stress, their lives return to normalcy, and their caregiver burden is reduced. They will have financial benefits and more resources in the family.

When making decisions, we must consider interpersonal benefits such as improved marital quality and household dynamics, among others.