Kidneys - should they be available to buy?

By Dr Andy Stein, Consultant Renal Physician

The crisis in organ donation could be helped by paying people to donate, Aridy Stein told the NKF conference. Aware that he was advocating an extreme measure, Dr Stein, now a consultant at the Walsgrave Hospital in Coventry, said you had to break eggs to make omelettes.

We live in a capitalist society where things have a price, he said.

There is a precedent in GPs receiving incentives. If the Government organised a scheme properly, the worst excesses of exploitation of poor people by the rich could be avoided. At the very least, the donor's family could be given £1,000 to pay for the funeal, or to give to a charity, preferably the National Kidney Federation.

But when Newcastle transplant surgeon, Ross Taylor said it would inevitably lead to the sale of lumps of liver, lobes of lungs and corneas, Dr Stein agreed that it would not work.

There is a clear majority of the British public against it, he said. A show of hands among the audience showed a 50-50 split. Dr Stein said that pressing for a change in the law to allow sales should not be the NKF's highest priority. Instead it should put its weight behind getting a national co-ordinating body for transplantation.

He also agreed with Mrs Gemma Benoliel that it would be a good idea to compensate living related donors for time off work and to set up a pool of living donors, since her kidneys did not match her husband.

Dr Stein had some less controversial suggestions for improving the transplant rate:

  • There should be a single national body supervising transplants;
  • He called on Evan Harris MP, who chairs the All Party Kidney Group, to get the law clarified over elective ventilation, so that doctors would feel safe carrying it out. 'You don't need an intensive care bed, just a ventilator and somebody who knows how to work it,' he said.
  • Make more use of asystolic or non-beating heart donors. Only two units in the country, Leicester and Newcastle, systematically use this system, whereby organs are taken from people who have a cardiac arrest in casualty.
  • Have a fully trained transplant co-ordinator in every hospital in the country. 'Above all, we need to change our way of thinking about transplantation from a secret non-business into an open business' he said.