In a recent New York Times Opinionator piece, “Fixes: It’s Time to Compensate Kidney Donors” (August 7), the author encourages compensation and incentives for kidney donors. The National Kidney Foundation (NKF) firmly believes that paying for organs isn’t the answer since there are effective, proven methods to increase donation that are currently underutilized.
NKF supports increasing the availability of organs and believes kidney transplantation is the most cost effective treatment in the long term. Accordingly, NKF has worked with Congress consistently for many years to address extending Medicare immunosuppressant transplant medications to cover the life of the transplant.
NKF has consistently advocated for removing financial disincentives and barriers to living donation. These include: expanding paired exchange and donor chains; protecting job security for those who take time off to donate; covering all donation-related expenses, including travel, lost wages and childcare costs; and ensuring the availability of health, disability and life insurance for all living donors.
Paying kidney donors can introduce health risks for the recipient if donors withhold important medical information in order to receive payment. Additionally, international experience has shown that a payment system for kidneys often exploits poverty stricken sellers who can be manipulated or coerced into selling their kidneys for quick money or to repay debts. We are also concerned that paying donors could adversely impact altruistic living donation.
The article references NKF as part of a larger consortium that will be meeting with the federal Health Resources and Services Administration (HRSA) in September to discuss financial compensation for donors. To clarify, the purpose of this meeting is to discuss increasing living donation through education and removing disincentives to organ donation, not to promote payment for kidney donations.
With regards to the Iran waiting list mentioned in the piece, it’s important to note that it hasn’t been proven that the list has actually been eliminated. An article in BMJ investigated claims about the impact of the payment system for kidneys and cites both potential benefits and serious harms.
NKF’s position on payment for organs is consistent with that of the World Health Organization (WHO) and the Institute of Medicine (IOM).