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Compensating kidney donors

Arthur Matas, M.D. (Photo: Jerry Vincent)

Transplant surgeon Arthur Matas, M.D., has found himself in the middle of an ethical crossfire.

To help alleviate the shortage of donated kidneys for people who need them, Matas, director of renal transplantation in the Medical School’s Department of Surgery, in 2004 proposed a regulated way to pay donors for their spare organ. And the sparks flew.

“I think one of the keys [to increasing the number of living kidney donors] is removing the disincentives for donation in addition to providing compensation for donation. I think you should do both,” Matas says. “But only if it’s done the right way.”

So Matas suggested a regulated system through which the government would compensate healthy people willing to give up a kidney with about $95,000, the cost to Medicare for a year of dialysis. (The money would come from insurers, being that they’d no longer need to cover the costs of dialysis for the patient.) The compensation could include cash and health and life insurance, and the person would get follow-up health care.

People on the waiting list wouldn’t be allowed to “buy” kidneys; instead the kidney would go to first patient on the list, the way kidneys from deceased donors are distributed now.

Matas admits that there are “pluses and minuses” to this approach. But he believes it’s a discussion worth having. Several studies to date have suggested that living kidney donors are just as healthy as nondonors long term (see adjacent story), and Matas says he feels obligated to find more options for people facing kidney failure.

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