How would you approach organ harvesting in an ambulatory patient with ALS who wishes to transition to comfort measures and to be an organ donor?

Data is very limited. If the patient is deemed safe to undergo general anesthesia, it would be reasonable for the patient to be a living donor, either as a direct donation or non-directed/altruistic. There is some theoretical risk of transmission of ALS (based on the potential that some ALS is due to misfolded proteins that may behave in a prion-like manner). As such, informed consent and shared decision-making with the potential recipient would be advisable. A similar recommendation for potenti...