Paying Organ Donors Could Alleviate Shortages, Study Finds

Published February 1, 2008

Allowing financial compensation to kidney donors would allow many patients to avoid dialysis and would save the lives of many who die awaiting transplants, a new study by the Cato Institute reports.

Arthur J. Matas, director of the University of Minnesota Medical School’s renal program in the Department of Surgery, says compensating kidney donors would alleviate organ shortages and save more transplant patients’ lives.

The United States faces an acute shortage of kidney donors. Many patients spend years on dialysis or die while waiting for a suitable organ to become available. According to Matas, removing the ban on compensated donation would help address this problem.

“The economic analysis is straightforward,” said Arnold Kling, a Cato adjunct scholar. “If a consenting adult wants to sell a kidney to save a stranger’s life, then both parties are better off.”

Long Wait

Organ donation is better than dialysis for many reasons, Matas notes.

“Compared with dialysis, a kidney transplant significantly prolongs life and improves quality of life, but kidneys are scarce in large part because federal law prohibits the buying and selling of organs,” Matas writes.

Because the average waiting time for a kidney transplant in the United States approaches five years, and in some parts of the country is closer to 10 years, “over 40 percent of listed candidates may die before ever undergoing a transplant,” Matas concludes.

“The National Organ Transplant Act of 1984 was passed to, among other things, prohibit the sale of organs in the face of apprehension that the growing commercialization of medicine would result in human beings being treated as commodities rather than individuals,” Matas points out in the study.

He argues the best way to increase the supply of kidneys without dramatically changing the existing allocation system is to legalize a regulated system of compensation for living kidney donors. It could be set up using the infrastructure already in place for evaluating deceased donors and allocating their organs.

The only change needed to ease and possibly solve the problem of organ shortage is some kind of payment for the donors, Matas notes. The benefits of a regulated system of compensated donation–chiefly the benefit of increasing the number of donated kidneys–outweigh any risk, he comments.

Dissenting Viewpoint

But Mark Pauly, a health care economist at the University of Pennsylvania’s Wharton business school, says other approaches could work before resorting to lifting the ban.

“I think the supply of kidneys in the U.S. could be increased a lot without having to pay people in cash if the entities involved in organ procurement were better organized, better managed, better marketed, and better funded,” Pauly said. “I would prefer to try these first before worrying about ethically controversial approaches.”

Dr. Sanjit Bagchi ([email protected]) writes from India.

For more information …

“A Gift of Life Deserves Compensation,” by Arthur J. Matas, Cato Institute, November 2007: