Payment for donor kidneys: Pros and cons

• Published in: Kidney international Vol. 69; no. 6; pp. 960 - 962
• Main Authors: Friedman, E.A., Friedman, A.L.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2006; Elsevier Limited
• Subjects: advanced glycation end-product; albuminuria; chronic renal failure; diabetic nephropathy; hemodialysis; Humans; Kidney Failure, Chronic - surgery; Kidney Failure, Chronic - therapy; Kidney Transplantation - economics; Kidney Transplantation - ethics; Kidney Transplantation - legislation & jurisprudence; Living Donors - ethics; Living Donors - legislation & jurisprudence; Renal Dialysis - economics; Risk; Tissue and Organ Procurement - economics; Tissue and Organ Procurement - ethics; Tissue and Organ Procurement - legislation & jurisprudence; Tissue Donors - legislation & jurisprudence; Tissue Donors - statistics & numerical data; Tissue Donors - supply & distribution; Waiting Lists; hemodialysis; albuminuria; chronic renal failure; diabetic nephropathy; advanced glycation end-product
• ISSN: 0085-2538; 1523-1755
• DOI: 10.1038/sj.ki.5000262

Continuous growth of the end stage renal disease population treated by dialysis, outpaces deceased donor kidneys available, lengthens the waiting time for a deceased donor transplant. As estimated by the United States Department of Health & Human Services: ‘17 people die each day waiting for transplants that can’t take place because of the shortage of donated organs.’ Strategies to expand the donor pool – public relations campaigns and Drivers’ license designation – have been mainly unsuccessful. Although illegal in most nations, and viewed as unethical by professional medical organizations, the voluntary sale of purchased donor kidneys now accounts for thousands of black market transplants. The case for legalizing kidney purchase hinges on the key premise that individuals are entitled to control of their body parts even to the point of inducing risk of life. One approach to expanding the pool of kidney donors is to legalize payment of a fair market price of about $40 000 to donors. Establishing a federal agency to manage marketing and purchase of donor kidneys in collaboration with the United Network for Organ Sharing might be financially self-sustaining as reduction in costs of dialysis balances the expense of payment to donors.