4.3 Review

Ethical Aspects of Kidney Donation and Transplantation for Migrants

Journal

SEMINARS IN NEPHROLOGY
Volume 42, Issue 4, Pages -

Publisher

W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.semnephrol.2022.07.005

Keywords

Dialysis; kidney transplantation; migrant; refugee; ethics

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The article discusses the ethical obligations and dilemmas related to providing kidney care for migrants, including international refugees, stateless persons, and expatriate workers. It also explores the implications of using residency status and citizenship as eligibility criteria for access to treatment. The article concludes with general recommendations for managing ethical dilemmas in kidney care for migrants.
Migrants represent a large and diverse population globally that includes international refugees, stateless persons, expatriate workers, and more. Many migrants face significant barriers in accessing health care, especially scarce and costly resources such as dialysis and kidney transplantation. Improving equity of access to these kidney replacement therapies for migrant populations may present a range of complex ethical dilemmas, particularly in the setting of crises and when considering the use of residency status and citizenship as eligibility criteria for access to treatment. In this article, we discuss ethical obligations to provide kidney care for migrants, the implications of the self-sufficiency concept with regard to access to deceased donation and transplantation, factors that may influence evaluation of the risks and benefits of transplantation for migrants with insecure access to care, and the vulnerability of migrants to organ trafficking. We also present a set of general recommendations to assist in preventing and man-aging ethical dilemmas when making decisions about policy or practice regarding kidney care for migrants. Semin Nephrol 42:151271 (c) 2022 Elsevier Inc. All rights reserved.

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