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Ethical Challenges in Pediatric Kidney Transplantation

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Challenges in Pediatric Kidney Transplantation

Abstract

Kidney transplant is a lifesaving procedure that comes with lifelong responsibility. Eligibility for transplant is ideally focused on medical factors including likelihood of benefit, and the principles of equity and utility guide the just allocation of organs to potential candidates. Medical teams must make difficult decisions in the assessment of pediatric transplant candidates. This chapter will deal with four situations that can raise ethical challenges for kidney transplant eligibility: the child with intellectual disability, the undocumented resident child, the child with suspected or predicted non-adherence, and the child who is under-vaccinated. We will explore the evidence for whether or not these challenges should limit transplant eligibility and the ethical principles that underlie these decisions.

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Abbreviations

ADA:

Americans with Disability Act

CKiD:

Chronic Kidney Disease in Children

COVID-19:

coronavirus Sars-Cov-2

DSM:

Diagnostic and Statistical Manual of Mental Disorders

ESKD:

End-stage kidney disease

HPV:

Human papillomavirus

ID:

Intellectual disability

IQ:

Intelligence quotient

NA:

NA

OPTN:

Organ Procurement and Transplant Network

QOL:

Quality of life

RRT:

Renal replacement therapy

SRTR:

Scientific Registry of Transplant Recipients

UNOS:

United Network for Organ Sharing

VPI:

Vaccine preventable illness

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  1. Department of Pediatrics and Child Health, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada

    James Johnston & Aviva Goldberg

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Correspondence to Aviva Goldberg .

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  1. Department of Pediatrics, Division of Pediatric Nephrology, MUSC Shawn Jenkins Children’s Hospital/Medical University of South Carolina, Charleston, SC, USA

    Katherine E. Twombley

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Johnston, J., Goldberg, A. (2021). Ethical Challenges in Pediatric Kidney Transplantation. In: Twombley, K.E. (eds) Challenges in Pediatric Kidney Transplantation . Springer, Cham. https://doi.org/10.1007/978-3-030-74783-1_15

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