Abstract
In developed countries, the use of living unrelated donors is restricted to purely altruistic donors who have a close and emotional relationship with the recipients. By law, commercial transplantation is illegal. Increasing shortness of donors, the excellent results of kidney transplants from spousal and living unrelated donors as well as the very low risk for the donor has been used as an argument for paid organ donation. Arguments in favour are the relief of donor-organ shortage, short waiting times for renal transplantation, economic benefits for the donor as well as the economic benefits for society by reducing the costs of dialysis by more transplants. Major arguments against are exploitation of the donor, coercion, and a growing black market. Despite the fact that different societies have different norms or reproaches that we are failing our patients and accept the death of thousands, kidney trade has created an environment of corruption and commercialisation, which brings even the cadaver transplant program into disrepute. However, denying the existence of paid organ donation does not contribute to solve the problem. A public discussion about consequences of changing ethics and human rights, rather than pragmatic solutions, is needed.
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References
Guild WR, Harrison JH, Merrill JP, Murray J (1955) Successful homotransplantation of the kidney in an identical twin. Trans Am Clin Climatol Assoc 67:167–173
Terasaki PI, Cecka JM, Gjertson DW, Takemoto S (1995) High survival rates of kidney transplants from spousal and living unrelated donors. N Engl J Med 333:333–336
Cecka JM (2000) Kidney transplantation from living unrelated donors. Annu Rev Med 51:393–406
Kranenburg LW, Visak T, Weimar W, Zuidema W, de Klerk M, Hilhorst M, Passchier J, Ijzermans JN, Busschbach JJ (2004) Starting a crossover kidney transplantation program in the Netherlands: ethical and psychological considerations. Transplantation 78:194–197
Kevorkian J (1989) Marketing of human organs and tissues is justified and necessary. Med Law 7:557–565
Reddy KC (1993) Should paid organ donation be banned in India? To buy or let die! Natl Med J India 6:137–139
The Transplantation of Human Organs Act, 1994 (1995) An Act (No. 42 of 1994) to provide for the regulation of removal, storage and transplantation of human organs for therapeutic purposes and for the prevention of commercial dealings in human organs and for matters connected therewith or incidental thereto. Date of Assent by the President: 8 July 1994. Int Dig Health Legis 46:34–38
The Human Organ Transplants Act, dated March 1993 (1996) An act (chapter 3) to prohibit commercial dealings in human organs intended for transplanting; to prohibit the transplanting of such organs between persons who are not genetically related; and for connected purposes. Int Dig Health Legis 47:169–170
Mansy H, Khalil A, Aly TF, Filobbos P, Al-Dusari S, Al-Shareef Z, Shlash S (1996) Outcome of commercial renal transplantation: two years follow-up. Nephron 74:613–616
The Living Non-Related Renal Transplant Study Group (1997) Commercially motivated renal transplantation: results in 540 patients transplanted in India. Clin Transplant 11:536–544
Dunstan GR (1997) The ethics of organ donation. Br Med Bull 53:921–939
Cosimi B (1998) Position of the Transplantation Society on paid organ donation. Clin Transplant 344–345
Daar AS (1998) Paid organ donation – the grey basket concept. J Med Ethics 24:365–368
Miller RB (1999) Ethics of paid organ donation and the use of executed prisoners as donors: a dialectic with professors Cameron and Hoffenberg. Kidney Int 55:733–737
Naqvi A, Rizvi A (2001) Against paid organ donation. Transplant Proc 33:2628
Phadke KD, Anandh U (2002) Ethics of paid organ donation. Pediatr Nephrol 17:309–311
Drukker A (2003) Payment for organ donation: unacceptable or a possible solution? Pediatr Nephrol 18:198–199
EU legislation (2000) Guidelines: evaluation and selection of donors. Nephrol Dial Transplant 15(Suppl):39–51
Friedlaender MM (2002) The right to sell or buy a kidney: are we failing our patients? Lancet 359:971–973
Schlitt HJ (2002) Paid non-related living organ donation: Horn of Plenty or Pandora’s box? Lancet 359:906–907
Kennedy SE, Shen Y, Charlesworth JA, Mackie JD, Mahony JD, Kelly JJ, Pussell BA (2005) Outcome of overseas commercial kidney transplantation: an Australian perspective. Med J Aust 182:224–227
Sever MS, Kazancioglu R, Yildiz A, Turkmen A, Ecder T, Kayacan SM, Celik V, Sahin S, Aydin AE, Eldegez U, Ark E (2001) Outcome of living unrelated (commercial) renal transplantation. Kidney Int 60:1477–1483
Ram V (2002) Ethical and moral considerations. India's National Magazine 19 (Issue 07)
Israni AK, Halpern SD, Zink S, Sidhwani SA, Caplan A (2005) Incentive models to increase living kidney donation: encouraging without coercing. Am J Transplant 5:15–20
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The content of this article was presented at the 39th Annual Meeting of the European Society for Paediatric Nephrology, Istanbul, September 10–13, 2005
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Hoyer, P.F. Commercial living non-related organ transplantation: a viewpoint from a developed country. Pediatr Nephrol 21, 1364–1368 (2006). https://doi.org/10.1007/s00467-006-0169-4
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DOI: https://doi.org/10.1007/s00467-006-0169-4