Living donation presents an exceptional medical-ethical situation: A healthy person undergoes a surgical intervention to donate an organ or parts thereof to another person. In light of recent developments, the currently applicable medical-ethical guidelines «Living donation of solid organs» need to be revised. On behalf of the Central Ethics Committee (CEC) of the SAMS, a subcommittee has revised the 2008 guidelines.
In living donation, donors make an organ available for transplantation while they are still alive. In this process, an operation is performed on a healthy individual for the benefit of another person (usually a relative), which gives rise to particular ethical challenges. The SAMS medical‑ethical guidelines «Living donation of solid organs» provide guidance for physicians, nurses, and other health professionals involved in the medical and psychosocial assessment of donors and in their aftercare.
Revision of the guidelines
Since the guidelines have come into force in 2008, various developments have taken place in the field of living donation: The Federal Act on the Transplantation of Organs, Tissues and Cells (Transplantation Act) has been revised and new international recommendations have been published. In 2019, the Central Ethics Committee (CEC) has appointed a broad-based subcommittee under the leadership of Professor Jürg Steiger, Basel to revise the SAMS guidelines.
The revised guidelines now address the ethical and practical aspects of so-called crossover donation, for instance when direct donation between spouses is not possible due to incompatibility. In addition, the recommendations on the evaluation of donors with residence abroad have been adapted and follow the resolutions from the Council of Europe.
The guideline proposal was open for public consultation from 1 December 2022 until 1 March 2023. The publication of the definitive version is planned for late summer 2023.
Outlook: Revision of the Transplantation Act
The guideline proposal is based on the legal framework that is currently in force. However, at present the Transplantation Act is under revision. Once the final revised version enters into force, the guidelines will be adjusted accordingly. Provided that the changes are not substantial, no new public consultation will be carried out.
Members of the subcommittee
Professor Jürg Steiger, Basel, Transplantation Medicine (Chair)
Christine Bally, Bern, Nursing (until April 2022)
PD Dr Vanessa Banz, Bern, Visceral and Transplantation Surgery
Dr Isabelle Binet, St. Gallen, Nephrology
Dr phil. Anne Dalle Ave, Lausanne, Ethics (until August 2021)
lic. phil. Irene Geiger, Basel, Psychology
Dr Manya Hendriks, SAMS (ex officio)
Professor Paul Hoff, Zollikon, CEC Chair
lic. iur. Ursula Hubschmid, Basel, Law/Donor Advocacy (until July 2022)
Anita Hurni, Bern, Nursing (from April 2022)
Dr Gundula Ludwig, Lausanne, Psychology/Psychotherapy
Professor Thomas Müller, Zürich, Nephrology
Professor Beat Müllhaupt, Zürich, Hepatology
Christa Nolte, M.A., Basel, Living Donor Registry
Professor Rouven Porz, Bern, Ethics (from August 2021)
lic. iur. Michelle Salathé, MAE, Basel, Law and Ethics (scientific support)
Professor Yvan Vial, Lausanne, Medicine/Recipient Advocacy
Professor Jean Villard, Genève, Immunology/Transplantation