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Review
. 2021 Jul 16;7(8):e726.
doi: 10.1097/TXD.0000000000001181. eCollection 2021 Aug.

Anonymous Living Liver Donation: Literature Review and Case Series Report

Sarah Shan  1 , Paola Vargas  2 , Jakob Durden  1 , Tara Seay  2 , Tessa Williams  2 , Emily Lyster  2 , Anita Sites  2 , Patrick Northup  3 , Shawn Pelletier  2 , Jose Oberholzer  2 , Curtis Argo  3 , Nicolas Goldaracena  2
Affiliations
Review

Anonymous Living Liver Donation: Literature Review and Case Series Report

Sarah Shan et al. Transplant Direct. .

Abstract

Background: Anonymous living liver donations (ALLDs) raise ethical concerns regarding the donors' motivations. Thus, ALLDs are not as widely accepted as directed donations from friends and family. Literature on ALLDs is limited. Understanding this particular group of individuals is crucial, as they could further help mitigate the shortage of liver grafts worldwide.

Methods: A literature review was performed to identify current definitions, ethical considerations, different approaches, and barriers to ALLD worldwide. Furthermore, we present our current experience after the establishment of a protocol to enable an ALLD program in our center and surveyed potential donors to better understand their motives throughout the process.

Results: Literature regarding ALLD is scarce. Canada leads the experience with the majority of case reports published to date. Survey-based evaluation of this unique group of individuals reflects the selflessness nature of anonymous living donors and shows that most of them experience the donation as a positive and life-changing event. In our experience, 41 individuals initiated the process of ALLD during the study period. Most were lost to follow-up or deemed ineligible. Five candidates fully completed the donation process and successfully underwent living liver donation. Given that 2 candidates have a follow-up period <3 mo from donation, we have only included data on the first 3 donors in this analysis. Eight individuals (19.5%) responded to the survey with respondents sharing similar reasons for initiating ALLD but varied and multifactorial reasons for terminating.

Conclusions: Different institutional protocols can be used to accomplish ALLD, including the one utilized by our institution. Adopting policies to allow for ALLDs and reducing modifiable factors that contribute to ending donation has the potential to increase grafts and decrease wait times.Supplemental Visual Abstract: http://links.lww.com/TP/C251.

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Conflict of interest statement

The authors declare no funding or conflicts of interest.

Figures

FIGURE 1.
FIGURE 1.
Number of potential male and female donors progressing through each step of the donation process.
FIGURE 2.
FIGURE 2.
Survey responses from potential and realized donors (N = 8). A, Donor source of learning about ALLD. B, Donor reasons for initiating ALLD evaluation. C, Donor prior history of altruistic acts. D, Donor reasons for terminating ALLD evaluation. ALLDs, Anonymous living liver donations.
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References

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