Rational solution to debate over compensation for kidney donation

The debate over ethical concerns of financial compensation for kidney donation continues to spark controversy, but a discussion in the latest issue of American Journal of Transplantation proposes a practical solution.

“Live persons who donate kidneys assume real financial and health risks that are not well understood,” says Robert S. Gaston, M.D., lead author of the article. “I believe that it may be possible to find a middle-ground in the debate and propose a package of benefits for donors designed to minimize these risks.”

The National Organ Transplant Act of 1984 expressly forbids the offer of “valuable consideration” for a human organ. The package proposed by Dr. Gaston and his colleagues would cost the government an estimated $23,525 to $32,800 per donor. The expenses involved, however, would be more than offset by savings from decreased use of long-term dialysis as well as related hospital expenses.

As many as 40 percent of potential kidney donors ultimately decide against donation due to financial concerns while the waiting list for transplants continues to increase, sometimes lasting from 5 to 10 years. Additionally, the mortality rate of those on the waiting list has increased by nearly 25% over the last four years.

Dr. Gaston and his colleagues understand the polarizing nature of a debate that seems to place financial value on an organ, but believe that a rational solution to the problem can be achieved. By assessing the true risk to donors, all parties can benefit and lives can begin to be saved immediately.

Robert S. Gaston, M.D. is a professor of Medicine/Surgery as well as the Medical Director, Kidney and Pancreas Transplantation at the University of Alabama at Birmingham Division of Nephrology.

The American Journal of Transplantation serves as a forum for debate and re-assessment and is a major new platform for promoting understanding, improving results and advancing science in this dynamic field. Published monthly, the journal provides an essential resource for researchers and clinicians around the world.