This blog post is dedicated to the question of whether people with MS can serve as organ donors, which types of organ donations are permissible, and under what conditions.
MS-afflicted father wants to donate kidney to daughter
The following case from clinical practice: He, 59 years old, has been suffering from MS for many years. In the past, he used different immunotherapies but is currently not taking any MS medication. The MS has led to a spastic-atactic paraparesis of the lower extremity, reducing his walking distance and requiring him to use a walker for longer distances. Despite physical limitations, his quality of life is good, he is still working full time, and he enjoys his work. Apart from MS, he is healthy, has no other relevant pre-existing conditions, does not take any medication, is a non-smoker and keeps himself fit through regular exercise, appearing biologically rather younger. Many years ago he separated from his wife, a daughter from this marriage, in her mid-30s, is an important person in his life, she lives in the same city, they support each other.
The daughter has been on dialysis for several years due to kidney failure, which is very distressing for the family. He could not accurately name the cause of his daughter’s kidney disease, possibly a severe hemorrhagic fever with renal syndrome (HFRS) following a hantavirus infection. His question now is whether he can donate one of his kidneys to his daughter, i.e., whether he qualifies as a living organ donor.
The question of to what extent those affected by MS can be considered as organ donors is important and interesting. Just recently, the MS societies in German-speaking countries, in cooperation with the Competence Network Multiple Sclerosis (KKNMS), have issued a very readable statement on this topic, which I would like to refer to here (Organ transplantation, blood donation and stem cell donation in multiple sclerosis – Competence Network Multiple Sclerosis).
Accordingly, people with MS can be considered as donors if the recipient agrees to receive an organ from a donor with a chronic disease. The potential risk must be weighed against the consequences of not performing an organ donation. Therefore, after informing and obtaining the daughter’s consent, a living donation by the father affected by MS would be possible. The current statement correctly points out that the relationship of the organ donor with MS to the recipient is an ethically relevant aspect. Possible role conflicts should be taken into account, the donating person must be fully informed about risks and side effects and must give consent to the organ donation free from any pressure. In the above-described father-daughter relationship, this is certainly a relevant point that must be addressed during counseling.
Living donation despite Multiple Sclerosis
Living donation offers advantages, but also risks. One advantage is that among blood relatives (as in the case reported above), the risk of organ rejection is lower. For the donor, however, a living donation involves some risks, especially if MS is present. As with any major surgery, pain and infections can occur, which can simultaneously worsen pre-existing MS symptoms. An organ donation can be associated with a reduction in performance and, for example, exacerbate MS fatigue. And of course, possible long-term complications regarding the further (medication) therapy of MS must also be kept in mind, even if this point does not play a prominent role in the case reported above.
“The aim is, according to the experts in the current statement, to ensure that the MS disease is stable before an organ donation. This also includes psychological and cognitive symptoms. Due to conceivable long-term complications, people with MS with further accompanying diseases should only undertake an organ donation after very careful medical clarification. This is to ensure that an organ donation, as far as foreseeable and influenceable, does not lead to a significant change in the course of MS or its treatability.”
This post was translated from German to English with the help of AI.
