MINIMUM AGE FOR LIVING DONORS: REVIEW OF LIVING ORGAN DONATION POLICY IN HONG KONG

Background and Aims: A recent Hong Kong incident of an under-18 year adolescent being prohibited from donating part of her liver to save her mother has aroused public controversy on the minimum legal age for living organ donors. This review was carried out with the aim to review the criteria and rationale of setting the legal age limit for living organ donation, their compatibility within the Hong Kong local context, and to examine the appropriateness of setting age 18 as the minimum legal age for living donors in Hong Kong. Methods: A policy literature review was conducted, which included a comprehensive search of five electronic databases for literature on living organ donation using specific searching keywords. Literature selection was conducted by screening the titles and abstracts of all identified literature and assessing their relevance. Full text publications of all potentially relevant articles were retrieved and assessed against the pre-defined inclusion and exclusion criteria. Relevant information and data were extracted, summarized, and interpreted. Results: From the identified literature, the 2 main rationales behind setting up a minimum age for living donors were capacity and voluntariness. Literature from the perspectives of developmental science and cultural studies was reviewed to study their impact relevant to age. There was inconclusive evidence suggesting cognitive maturity and voluntariness for age below 18 years. Attitudes amongstakeholders were not favorable regarding lowering the current minimum age of 18. Conclusions: There was no scientific evidence or society need to lower the minimum living donor age in the current Hong Kong situation. To solve the issue regarding lack of suitable organ supply, alternatives should be explored whilst maintaining the current minimum living donor age.