Is there a role for living donor intestine transplants?
The medical-ethical implications of living donation are unique in that an individual must undergo a surgical procedure that carries all of the inherent risks but none of the potential medical benefits of most other medical or surgical interventions. Therefore, it is important to carefully evaluate the need for using living donors in intestinal transplantation. A more basic, underlying controversy pertains to the indications for intestinal transplantation in general. Although intestinal transplantation may be the only option for individuals who have failed TPN therapy,24 most patients are being referred for intestine transplants too late. As a consequence, most intestinal transplantations are being performed in patients who have already developed end-stage liver disease (ESLD), and therefore require combined liver and intestine transplants. These candidates are generally much sicker25 than those requiring only intestine transplants, and they are listed on the much more congested liver t
