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OREWORD

iving Unrelated Donation: Tackling the Problem With a Wrong Strategy

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OUR years ago we had the privilege of introducing thefirst genuinely Brazilian scientific publication from our

ransplant community. At that time, less than 50 papersere selected to be published in the proceedings. Now, weould like to share with you our happiness, indeed ouruphoria, and pride in this new and great achievement byembers of the Brazilian Organ Transplant Association

ABTO). In this issue of Transplantation Proceedings theumber of high-quality papers submitted for publicationas tripled and the topics range from immunobiology tolinical and experimental transplantation. The number ofapers dealing with non-renal organ transplants has also

ncreased as well as the number of other health carerofessionals that have become affiliated with the ABTO.The landmark of the IX Brazilian Congress was the

rm and clear position adopted by the vast majority ofhe 1500 attendants of the meeting against the matter ofnancial incentives to the Living Unrelated DonationLURD). With regard to, we asked “Do we need livingnrelated organ donation in Brazil?” In response to weeceived an emphatic “no.”

It is quite remarkable that such a strong position choseny ABTO members happens amidst a mainstream move-ent lead by several developed countries toward accep-

ance of buying and selling organs for transplants.We recognize the critical shortage of deceased donor

rgans and the urgent need to close the worldwide gapetween organ offers and demands. In addition, we accepthat Brazil, as well as any other developing country, may notave adequately exploited its potential deceased donorool. But which country can really claim to have succeeded

n this challenge? In any case, is this an adequate reason toustify buying and selling organs, an official acknowledge-

ent of organ commerce?“Nobody should be so poor that they want to sell their

rgans,” observed a bioethicist recently. Indeed, it seems toe a matter of socioeconomic inequities, of wealth versusoverty. Hence, developed nations would have rights toearch for alternative sources of human donors and notntervene in subjects of other countries that “are not theirwn business.” By doing so, the international transplantommunity would have to close its eyes to the prejudice

hey could be causing to the deceased donor transplant

2006 by Elsevier Inc. All rights reserved.60 Park Avenue South, New York, NY 10010-1710

ransplantation Proceedings, 38, 1863 (2006)

rograms of the non-developed nations neglecting thatore than half of the total transplants in the world are

eing performed by the developing/underdeveloped coun-ries. To have the rich countries promoting financial incen-ives for LURD, challenging ethical principles establishednd followed by themselves during decades, will be devas-ating for organ transplantation around the world.

In Brazil, even though we are also struggling with anrgan shortage, we are seeking the most ethical way to

ncrease cadaver organ donation. Indeed, debating on thessue of organ commerce during the Congress, Professorancy Scheper-Hughes publicly agreed that Brazil serves asgood example of a developing country that has succeeded

n banning organ traffic.We are convinced that LURD is not the best strategy to

ncrease organ transplantation, as far as we are concerned,ecause we have already experienced the problem of howuch this strategy serves as a disincentive to a cadaver

rgan donation program. We vehemently condemn the usef LURD with or without financial incentives, and there-ore the buying and selling organs (organ commerce). Ourecent results have demonstrated that less than 2% of thehree thousand renal transplants performed yearly in Brazilsed LURD (mostly spouses). Organ commerce will remain

llegal and aggressively combated. Without a doubt the IXrazilian Transplantation Congress marks a clear Brazilianosition against use of LURD and the acceptance of organommerce.

We hope that the Transplantation Society will urgentlyeek to establish principles of ethics and justice that mayerve as guidelines to nations worldwide, despite theiregree of human development, richness or poverty. Afterll, we live and share the same geographic situation: thearth.

Mario Abbud-FilhoInstituto de Urologia e Nefrologia e FAMERP

Sao Jose do Rio Preto

Henry H. CamposUniversidade Federal do Ceara, Fortaleza

Maria Cristina Ribeiro de Castro

Universidade de São Paulo, São Paulo

0041-1345/06/$–see front matterdoi:10.1016/j.transproceed.2006.06.091

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