Bootcongres

Although public solicitation of organs from living donors has been contemplated with hesitance by the transplant community, it has become a clinical reality. Our aim was to critically assess this phenomenon, from a legal, moral and practical perspective, and to offer some recommendations. From a legal point of view, we analyzed the current situation in the EU and the US. After clarifying the terminology concerning public solicitation, we elaborated an operational definition of public solicitation that is consistent with the ELPAT classification for living organ donation. From a moral perspective, we evaluated the various arguments used in the literature, both in favour and against. Although they look contradictory, in most cases the same type of arguments are used both to defend and to condemn the legitimacy of public solicitation. The arguments were classified according to the way they influence the actions of recipients and donors and affect the transplantation process at individual and societal level. We also examined the practical aspects of this phenomenon, reviewing the possible barriers that may arise: the individual barriers (various misconceptions concerning solicitation), and the organizational barriers (the safety issue, the pressure issue, the possible system failure, the reputational risk, selling and buying). Finally, we offer a set of recommendations aimed at maximizing the living organ donor pool, while safeguarding the interests of potential donors. Transparency and accountability are important issues if the transplant community wants to deal responsibly with donation following public solicitation.