The Ethical Implications of Emerging Genetic Predictors of Poor Organ Transplant Outcomes

[摘要] Emerging research is beginning to identify genetic risk factors which may predict an increased likelihood of rejection following transplantation.The identification of these predictors prompt us to consider how we should incorporate this information into the process of transplant candidate evaluation and organ allocation, as well as the ethical implications of such incorporation. In order to ground this analysis, this thesis begins with an examination of how we consider other predictors of poor transplant outcomes currently, as interpreted in concordance with the US transplant system’s dual goals of efficacious and just organ allocation.It then proceeds with a brief summary of the current research on genetic predictors of poor transplant outcome, followed by a specific examination of the mechanisms by which these genes are investigated.This allows an examination of the challenges of appropriately applying the data gained through common methods of genetic research. Next, it examines the complex ethical and social conflicts which may arise from a decision to incorporate genetic predictors within the current US transplantation system.It then concludes with a proposal for a mechanism for including genetic risk profiles into the transplant evaluation process on a national level that will seek to mitigate these conflicts and support both a just allocation system and ongoing research into this area of medicine.

[发布机构] the University of Pittsburgh