A divisible organ is an organ from which a part can be removed without the donating person dying — typically because the rest of the organ regenerates or remains functionally sufficient.
Concrete examples
Liver lobe — The liver regenerates after partial removal. Living donation of a liver lobe (usually the left lobe) is possible, with a higher donor risk than with the kidney: donor mortality lies at roughly 0.28 percent (vs. 0.03 percent for kidney donation).
Pancreas segment — A segment of the pancreas can also be donated. The donation is typically performed together with a kidney (combined pancreas-kidney transplantation).
Small-intestine segment — Rare, but possible.
Relation to paired and unpaired
The classification “divisible” stands transverse to the paired/unpaired distinction. Some unpaired organs are divisible (liver, pancreas), some are not (heart). The liver is in this respect a special case: anatomically unpaired, but, owing to its regenerative capacity, partly donatable while living.
| Organ | Paired | Divisible | Living donation |
|---|---|---|---|
| Kidney | yes | — | whole organ |
| Lung | yes | — | lobe |
| Liver | no | yes | partial liver (regenerates) |
| Pancreas | no | yes | segment |
| Heart | no | no | impossible |
Ethical assessment
Partial living donation satisfies the Principle of Totality (Pius XII, 1956), provided the functional impairment to the donor is not serious. In partial-liver donation the risk is higher than in paired donation — the operation is more extensive — but the regenerative capacity of the liver preserves function in the long term.
Partial living donation thus opens up, for unpaired organs (liver, pancreas), an alternative to postmortem donation, which for the heart remains structurally excluded — the central reason why DCD heart donation is the sharpest point in the discussion of organ donation after circulatory death.
Ontological classification
Superordinate concept: Donor Organ
Ontological relations:
- permits partial living donation
- concrete examples: liver (regenerates), pancreas segment
- grounds the special case of the liver as unpaired + divisible
Chapter assignment: Chapter 4: What is human personhood? (German)
Sources
Generated by querying the Personhood ontology.
Further sources:
- UNOS: Living Donation Facts. https://unos.org/transplant/living-donation/
- Reese, Peter P.; Boudville, Neil; Garg, Amit X. (2015): Living kidney donation: outcomes, ethics, and uncertainty. The Lancet 385(9981): 2003—2013.
- Cheah, Yee Lee; Simpson, Mary Ann; Pomposelli, James J.; Pomfret, Elizabeth A. (2013): Incidence of death and potentially life-threatening near-miss events in living donor hepatic lobectomy: a world-wide survey. Liver Transplantation 19(5): 499—506.