A 27yo male would like to donate his liver (part of it), he already
has donated with one of his kidneys 4 years ago. He is in very good
health, the question is: (Away from all known medical tests required
in this case) Is there any general medical restrictions for those who
have already donated with their kidney not to donate with their Liver?
any recorded cases ?

Hi  rodman21,

Organ donations from a living person are limnited. In addition,
donating part of your liver leaves you at a much higher risk of
developing liver problems yourself.  Reference:

New High Set for Organ Transplants (4th paragraph)
http://www.hhs.gov/news/press/2005pres/20050329.html
..."Organ donations from living persons are limited to a single organ,
usually the kidney, or piece of a single organ. Human beings have two
kidneys but can lead healthy lives with only one..."

Kidney Transplantation - 
The Donate Life California Registry is Launched
http://www.ikidney.com/iKidney/InfoCenter/NephrologyIncite/Archive/KidneyTransplantation17.htm
..."Donations from a living person are limited to a single organ,
usually the kidney, or a piece of a single organ such as the liver. 
Deceased donors can give multiple organs aimed at improving or saving
the lives of several people.  During 2004, there were more than 20,000
operations using organs from more than 7,000 deceased donors.  This
was an increase of nearly 11% over the 2003 total..."


Note that these sites say LIMITED, not USUALLY LIMITED.


Note this interesting article:

Giving 'Til it Hurts: How Far to Go in Living Organ Donation?
http://www.cnn.com/HEALTH/bioethics/9910/organ.donation/


Here's some more information for you about liver donations:

Human Dignity and the Organ Supply: Do Proposed Solutions to the
Current Crisis Measure Up?
http://www.cbhd.org/resources/healthcare/rutecki_2003-02-11.htm
..."Another questionable supply-side solution is called the living
adult liver donation. Presently, organ donations from the living 
outnumber those from the dead. Unfortunately, however, living
individuals who donate part of their liver to adults die at a rate
exceeding live kidney donors (1% vs. .03%, respectively). Some donors
in this context have required liver transplants themselves due to
liver failure incurred as a result of the donation. Although this
model has increased the supply of livers, at what cost has this end
been accomplished?.."

UNOS Facts and Figures
http://www.unos.org/SharedContentDocuments/UNOS_Fact_Sheet.pdf

Living Donor Liver Transplant at Mayo Clinic in Rochester and Scottsdale
http://www.mayoclinic.org/liver-transplant/livingdonorlivertransplant.html


I hope this helps. If I can be of further assistance, please ask for a
clarification. There is a lot of information available on the internet
about organ donations, you can use my search string below to find more
information.


~~Cynthia


Search terms used at Google:
"Living Donor" organ donor limits
"Living Donor" "organ donation" limited

---

Request for Answer Clarification by rodman21-ga on 13 Dec 2005 01:25 PST

The only URL that seems to give a real answer to my question is the
one of hho.gov, It was mentioned only in a single sentence without
reasoning, and since it is a US department, the information might
reflect the legal view of the issue.

 My concern is mainly the MEDICAL regulations. Is there any medical
rules or barriers that prevent someone who already have donated with a
kidney to donate with part of his liver ? and if there are registered
cases i'd like to know about them..

 Thanks...

---

Clarification of Answer by cynthia-ga on 13 Dec 2005 02:19 PST

Thank you for asking for clarification of my answer! I'd much rather
search a bit more and have fully satisfied clients. Often times a
slight change in searching will yeild more results, as in your case. I
changed my search string and got more results for you:

CONSENSUS STATEMENT ON THE LIVE ORGAN DONOR

..."Donating a Second Organ

The conference participants considered it ethically acceptable for a
person to donate more than one organ simultaneously or serially (eg,
the left lobe of a liver and a kidney), if the medical and
psychosocial requirements for each organ donation were fulfilled.
Obviously the risks to the donor could be increased by a simultaneous
donation, so sound judgment is necessary to maintain the medical
dictum of first do no harm.

A potential donor may wish to donate a solitary kidney (having donated
a kidney previously), while realizing that such a donation would
render that individual anephric. The donation from a person who has
only one kidney was considered unacceptable by most conference
participants because physicians should not perform a procedure that
knowingly sacrifices one person's health (resulting in the necessity
of chronic dialysis) for another's.13..."


The above would lead me to believe that there is no medical regulation
against donating more than one organ, as described.


Medical regulations aside, there is no LAW against it, because it DOES
happen in rare occasions, here's one such case:

Ethical Dilemmas in Live-Donor Transplants
By Earl Strum, M.D., Associate Editor and Assistant Secretary, and
Wayne Kaufman, M.D., Director, District 3
http://www.csahq.org/pdf/bulletin/issue_10/Strum_Kaufman.pdf
..."The Universal Donor
A 24-year-old male was going to donate a lobe of his liver to a child
who had liver failure due to hepatitis C. The patient?s family had
advertised for a donor, and the recipient and donor had no previous
contact. The concern that was raised the day of surgery was that the
donor had made a previous donation of a kidney, also to an unknown
recipient, several years prior.

Volunteering to make a second organ donation, again to someone unknown, is an
extremely rare event?rare enough to prompt a discussion between the
anesthesiologist and surgeon to determine if something other than
altruism might have motivated the act of donation. Prior to each
donation, the donor had a psychiatric evaluation. In both evaluations,
there was no evidence of mental illness and he was deemed a suitable
candidate able to consent to donation. In addition, his family members
and friends seemed to be supportive of his decision to donate.

Donors who donate multiple organs to unknown recipients do raise concerns as to
motivation and their suitability to donate. Although it is not optimum
to be discussing issues such as this on the day of surgery, it is
important that those concerns are raised and addressed. The decision
reached was to proceed with the surgery, and that was based on the
overall psychiatric evaluation and the fact that psychiatry found him
to be a suitable candidate. The outcome of the operation was
successful, and both donor and recipient are doing well.."


These are exceptional web sites:

Living Donors Online!
http://www.livingdonorsonline.org/
I searched the forums for "multiple organs" and came up empty. This
would be a good place for you to ask questions.

Living Organ Donor Online
http://www.livingorgandonor.org/

I found that link here:
http://www.livingorgandonor.org/resources.htm


This is informative:

Transplant News - Message from the Executive Director - 2005
http://www.iaod.org/Transplant%20News_V5.pdf


You are still free to ask for another clarification... I live about 10
minutes from the clinic below, and after I get some sleep, IF YOU
REQUEST ME TO, I'll call them and ask directly about medical
regulations governing a living donor donating multiple organs:

The Organ Transplant Program at Swedish Medical Center, Seattle
http://www.swedish.org/body.cfm?id=147
(It will be late afternoon, possibly 24 hours from now before I will
post any feedback I get --real life interferences, I do this
part-time.)


~~Cynthia


New search strings used at Google:
"living donor" "donate multiple organs"
"living organ donor"
"living organ donor" "more than one organ"
"live donor" "donate more than one organ"

Thank you very much for the answer, Now i find it very informative and
well organized. All what i needed to know.. Please accept my (modest
tip), I wud have given more if my internet E-Com Visa card has any
more balance :)

Wow!  Thanks so much for the kind words, the 5 stars and the generous tip!