{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T23:41:24Z","timestamp":1783467684055,"version":"3.55.0"},"reference-count":16,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,6,2]],"date-time":"2021-06-02T00:00:00Z","timestamp":1622592000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pre\u2010emptive kidney transplantation for end\u2010stage kidney disease in children has many advantages and may lead to the consideration of marginal parent donors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using the example of the transplant of a kidney with medullary sponge disease from a parent to the child, we review the ethical framework for working up such donors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The four principles of health ethics include autonomy (the right of the patient to retain control over his\/her own body); beneficence (healthcare providers must do all they can do to benefit the patient in each situation); non\u2010maleficence (\u201cfirst do no harm\u201d\u2014providers must consider whether other people or society could be harmed by a decision made, even if it is made for the benefit of an individual patient) and justice (there should be an element of fairness in all medical decisions). Highly motivated donors may derive significant psychological benefit from their donation and may thus be willing to incur more risk. The transplantation team and, ideally, an independent donor advocate team must make a judgment about the acceptability of the risk\u2010benefit ratio for particular potential donors, who must also make their own assessment. The transplantation team and donor advocate team must be comfortable with the risk\u2010benefit ratio before proceeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>An independent donor advocacy team that focuses on the donor needs is needed with sufficient multidisciplinary ethical, social, and psychological expertise. The decision to accept or reject the donor should be within the authority of the independent donor advocacy team and not the providers or the donor.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14062","type":"journal-article","created":{"date-parts":[[2021,6,2]],"date-time":"2021-06-02T18:09:06Z","timestamp":1622657346000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Marginal parent donors\u2014Process and ethics"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1891-6765","authenticated-orcid":false,"given":"Guido","family":"Filler","sequence":"first","affiliation":[{"name":"Departments of Paediatrics and Medicine Schulich School of Medicine &amp; Dentistry University of Western Ontario  London ON Canada"},{"name":"The Lilibeth Caberto Kidney Clinical Research Unit Western University  London ON Canada"},{"name":"Department of Pathology and Laboratory Medicine Schulich School of Medicine &amp; Dentistry University of Western Ontario  London ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1694-886X","authenticated-orcid":false,"given":"Maria E. Diaz\u2010Gonzalez","family":"de Ferris","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The University of North Carolina at Chapel Hill  Chapel Hill NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Launa","family":"Elliott","sequence":"additional","affiliation":[{"name":"Department of Ethics London Health Sciences Centre  London ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6,2]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2010.01439.x"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOT.0000000000000477"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.13992"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJNRD.S169336"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.4081\/aiua.2019.2.102"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfv107"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfv100"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.4045\/tidsskr.10.1403"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/tri.13284"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2019.08.020"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2017.00564"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0000000000000740"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/medethics-2013-101988"},{"key":"e_1_2_11_15_1","volume-title":"Principles of Bioethics: Seventh Edition","author":"Beauchamp T","year":"2015"},{"key":"e_1_2_11_16_1","volume-title":"Organ Donation: Opportunities for Action","author":"Chapter 9: Ethical Considerations in Living Donation. 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