June 18, 2004
Buying and selling organs is illegal in the United States, so transplant surgeons and economists are trying to create a "moneyless market" for exchanging kidneys.
Doctors and transplant recipients are increasingly turning to living donors, usually relatives, since kidneys taken from live donors are less likely to be rejected. In about a third of all would-be family pairs, blood types are incompatible. But transplant centers have begun organizing exchanges involving three or more participants; for instance, a father donates to a teenager with blood type A, while the teenager's sister donates to the man's daughter, who has blood type B.
The swapping process has the potential to shorten waiting lists:
- Johns Hopkins transplant surgeon Robert Montgomery estimates that 2,000 or more people could get transplants if there were a national database of donors willing to donate an organ if someone would reciprocate for a relative.
- A real-life example of 45 pairs in which the would-be donor couldn't give a kidney to his related recipient showed that all 45 recipients had to wait for an organ.
- With swaps involving two kidneys, eight transplants would be possible; if swaps involving three kidneys were possible, 11 transplants could go forward.
Lawyers and ethicists have decided that such swaps are acceptable if all participants agree on certain rules: the donor must travel to the recipient's hospital, identities may be kept confidential, and all operations in a swap must begin simultaneously to avoid anyone backing out.
Source: David Wessel, "Easing the Kidney Shortage," Wall Street Journal, June 17, 2004.
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