AAP Policy: Denying Organ Transplants to Kids With Disabilities May Be Discrimination

The demand for transplant organs far exceeds the supply of donor organs, and as a result hospital transplant programs carefully evaluate all patients in need of organs to ensure the surgery will be successful. Children with intellectual and developmental disabilities are often not considered for organ transplants. A new AAP policy statement, “Children With Intellectual and Developmental Disabilities as Organ Transplantation Recipients,” in the May 2020 Pediatrics (available online April 20), warns that this exclusion of kids with intellectual and developmental disabilities should end. Children with intellectual and developmental disabilities, which is commonly defined as an IQ of 70 or lower, should be evaluated for organ transplants like their peers without disabilities.  The policy states that denying organ transplants to people with disabilities is unethical and may constitute illegal and unjustified discrimination. The Americans with Disabilities Act and the Rehabilitation Act prohibit disability-based discrimination. While a perceived lower quality of life has been cited as a reason to deny transplants to children with intellectual and developmental disabilities, individuals with disabilities often rate their own quality of life similarly to individuals without disabilities. Furthermore, as children with disabilities can be organ donors, the policy states it would be unfair to categorically exclude them as recipients of organ transplants. The statement recommends that transplant teams should consider both the cognitive and adaptive skills of the patient when determining if a transplant could be of benefit, but children without disabilities have no more claim to organ transplants than do children with disabilities.

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.