Y Anonymous Nondirected Living Liver Donation: Has the Time Come to Formalize the Process?

"Repetitive donor disorder?" A fair question to be asked when reviewing the authors case series(1) of altruistic (now termed anonymous non-directed) live liver donation when almost 70% had previously donated a kidney. In many respects, it is completely natural to react cautiously. Relative to much of society, medicine is by nature a conservative field. After all, primum nihil nocere is significantly more conservative than "move fast and break things." And yet, Yoeli et al present compelling data regarding the outcomes of 13 non-directed donors. In addition, they clearly relate the current state of transplantation, in which, the number of deceased and directed live donors does not meet the current needs of the listed pediatric candidates. So, when considering the application of non-directed donation in liver transplantation, significant reflection is required.