Children as Renal Donors

Abstract

With the exception of identical twins, preadolescent children have been excluded as renal donors. The justification for this policy appears to be based on a notion that renal donation is an altruistic act, primarily for the benefit of another, and that stringent standards of informed consent must be followed. This paper challenges the present policy on two grounds: consent from adults who donate kidneys is generally not informed, and therefore it is inconsistent to use the consent requirement as a justification for excluding children; and renal donation by adults can be seen as a procedure done for the benefit of the donor (as well as the recipient), and the appropriate rules for using children as donors should therefore be those pertaining to beneficial intrusions on non-consenting subjects. (N Engl J Med 296:363–367, 1977)