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Evolution of attitudes at U.S. transplant centers toward kidney donation by friends and altruistic strangers.

A severe shortage of organs is one of the major barriers facing transplantation today. One of the proposals designed to overcome this serious problem is to increase the use of genetically unrelated living kidney donors. Excellent results have been achieved with these volunteers and cogent arguments have been made that this practice is ethically acceptable. These considerations have encouraged many transplant centers to break with tradition and accept spousal donors. To see if there has been a similar change in attitudes toward other types of unrelated living donors, a survey was mailed to 208 U.S. renal transplant centers; 129 (62%) were returned. Ninety-three percent of responding centers said they would accept a close friend as a kidney donor. Although the majority of centers would not consider an altruistic stranger, a sizeable minority (38%) would. When compared with the results of previous surveys, these data show that attitudes toward unrelated living kidney donors have gradually become much more liberal.