NCPA - National Center for Policy Analysis

Divergent Views on Donor Kidney Market

March 29, 2011

Should you be paid to part with a kidney?  It's an unseemly question, but it's one that medical professionals have been grappling with as the waiting list for kidneys gets longer, supply of the organs stagnates and other solutions fall short, says the Los Angeles Times.

  • In 1999, just over 40,000 Americans were on the waiting list for a kidney, according to the Scientific Registry of Transplant Recipients, a record that's overseen by the government.
  • By 2009, the list had grown to nearly 83,000 people, the National Kidney Foundation says.
  • That same year, just 16,500 people received a transplant.

To help increase supply of the organs, some transplant professionals have suggested establishing a market for kidneys so that donors could receive cash or other incentives -- such as health or life insurance -- in exchange for their healthy organ.  (Donors can live a healthy life with only a single kidney.)

Those who are against the idea worry that it could exploit the poor and encourage unethical medical practices.  Those in favor counter that without a market, people on the waiting list for a kidney will die unnecessarily.

According to Dr. Benjamin Hippen, a transplant nephrologist at the Carolinas Medical Center in Charlotte, N.C., the most compelling reason for setting up a market for organs is that there really isn't any other plausible solution to the growing disparity between the demand for and supply of organs.  Even if we were to maximize organ procurement from deceased donors, we still couldn't meet the demand.  Moreover, the unregulated, underground black market in organs in developing countries has been catastrophic for both donors and recipients, says Hippen.

In contrast, Dr. Francis Delmonico, the director of renal transplantation at Massachusetts General Hospital and a professor of surgery at Harvard Medical School, says that despite the good intentions of those who would suggest that an organ market could be regulated, it's impossible to do so.  A market for organ sales enables brokers and extra payments, and in a global society, the market could not be restricted to the United States, says Delmonico.

Source: Jessica Pauline Ogilvie, "The Consequences of a Donor Kidney Market," Los Angeles Times, March 28, 2011.

For text:,0,4492170.story


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