More on Donor's Choice or Hobson's Choice

Aaron Spital, MD; Max Spital, MD
Arch Intern Med. 1986;146(1):203. doi:10.1001/archinte.1986.00360130245041.
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To the Editor.  —We feel compelled to reply to the editorial1 that accompanied our article,2 "Donor's Choice or Hobson's Choice?" in the July 1985 issue of the Archives. Drs Caplan and Siegler suggest that increasing the supply of cadaveric kidneys would solve the dilemma faced by transplant centers when confronted with the problem of potential living-related donors at added risk. This formulation implies that the results of transplantation with cadaveric kidneys equal those using living-related donors. This is not the case. In a recent review of this subject, Dr Sutherland has said3: "... even with the best immunosuppressive protocols currently available, there is no question that the transplant results are better with living-related donors." Dr Sutherland concludes that3: "... living-related donors should be used whenever possible."We also disagree that potential donors will be no "more eager than their physicians to undertake minimal... risk." Indeed, the available


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