Cato study advocates compensation for kidney donors

Compensating donors would alleviate shortage and save lives

November 7, 2007

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The United States currently suffers from an acute shortage of kidney donors, leaving many patients to spend years on dialysis or die on waiting lists. Removing the ban on compensated donation would be a vital step in alleviating this tragic problem, reports a new study by the Cato Institute.

In “A Gift of Life Deserves Compensation,” Arthur J. Matas, professor of surgery and director of the kidney transplant program at the University of Minnesota, makes the case for financially compensating donors in the existing regulated system. “Compensated donation would increase the number of kidneys available for transplants, thereby shortening waiting time, improving patient survival rates, and minimizing suffering on dialysis,” he writes.

Matas reports that the time Americans spend on waiting lists is expanding. “As recently as 25 years ago, the average wait for a deceased donor kidney in the United States was about 1 year; currently, the average wait is approaching 5 years,” he notes. “Over 40 percent of listed candidates may die before ever undergoing a transplant.”

In addition to improving lives, compensating donors from a federal fund would likely be a fiscal improvement over keeping patients on dialysis. “Each living unrelated donor kidney transplant saves Medicare about $95,000,” says Matas. The improved quality of life for patients would also translate into greater productivity, saving the federal government another $75,000 in other costs and lost income taxes.

Objections to compensated donation generally involve fears of black markets or murky ethical dilemmas, issues that Matas addresses at length in the new study. “The issue of compensated donation is not a hypothetical ethical fine point; it affects the lives of people worldwide,” he concludes. “Once the ban on incentives is lifted, we can initiate pilot trials to determine how best to preserve the rights and improve the lives of both kidney donors and kidney recipients.