Monday, June 3, 2013

Best post I have read on how to pay donors for kidneys

If you want to start a fight among nephrologists, start talking about paying donors for their kidneys. This may be the most contentious issue in nephrology. I personally am a believer in the concept but trying to imagine a free market for organs makes me nauseous.

Rohin Dhar, at the Priceonomics Blog has put together a brilliant, straight-forward essay describing the problem, showing how current ideas for increasing the organ supply (make donating organs the default after death, paired kidney donation, improved donor-recipient matching) are not working and cannot hope to solve the problem and then goes on to describe a hypothetical organ purchasing system run by medicare. I'm convinced.

When discussing this on twitter, the always interesting Christos Argyropoulos talked a bit about the problem with Greece's implementation of default organ donation:

An open access review of Iran's transplant system can be found here (A non-systemic review from McGuil University? I grow feint.) Here is the Kidney International paper Dr. Argyropoulos was referring to.

Look at how the number of transplantations is growing in Iran:
Mitra Mahdavi-Mazdeh. Kidney International, 2012

While it is flat in the US:


The current system of paired exchanges and campaigns for kidney donors has noble intentions, but it’s not working. People are needlessly dying as a result.

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