Encouraging Living Kidney Donations

Every year, 126,000 people in the United States are diagnosed with end-stage renal disease (ESRD), which requires dialysis or a kidney transplant as treatment. About 43,000 of these patients will die prematurely because they cannot get a transplant. Dialysis typically gives an ESRD patient only five more years of life, but a transplant from a living donor generally increases life expectancy by 12 to 20 years. Although kidney transplants could benefit 50 percent of patients diagnosed with ESRD—extending the lives of 63,000 people per year—only about a third of those patients receive new kidneys annually. Experts predict that present numbers of deceased kidney donations will not increase substantially, making expansion of living donor transplants the only practicable solution to ending the kidney shortage. The 1984 National Organ Transplant Act (NOTA) governs living kidney donation at the federal level. This law, along with the U.S. Department of Health and Human Services’s accompanying regulation, created the Organ Procurement and Transplantation Network, which maintains “a national system for the uniform matching of organs with potential recipients.” NOTA bans the trade of “any human organ for valuable consideration,” criminalizing the sale of organs for transplantation. Although some scholars argue that the ban contributes to the kidney shortage, others caution that legalization would lead to exploitation and coercion of donors. Advocates of living donation claim that the relative ease of donating a living kidney warrants revisions to the NOTA ban. These advocates emphasize that a donor’s remaining kidney compensates for the one lost and that donors need only make minor lifestyle changes after the procedure. Most laparoscopic surgeries, the preferred operation for donating kidneys, involve small incisions, require short recovery times, and have less than a 1 percent fatality rate. This week’s Saturday Seminar highlights proposals to encourage living kidney donations. Racial Inequality Kidney Chains and Vouchers Benefits for Donors Direct Compensation for Donor