The high cost of organ transplant commercialism.

[Clark]

http://www.ncbi.nlm.nih.gov/pubmed/24284519

The high cost of organ transplant commercialism.
Danovitch GM
Kidney Int. 2014 Feb;85(2):248-50. doi: 10.1038/ki.2013.466. Epub 2013 Nov 27.

Abstract
The Declaration of Istanbul defines organ transplant commercialism as '…a policy or practice in which an organ is treated as a commodity, including by being bought or sold or used for material gain.' It is this treatment of the organ that inevitably leads to its financial value being placed before the welfare of either its donor or its recipient or others in need of organ transplantation. International experience over the past two decades has proven this point and outcomes of commercial donation for both organ donors and their recipients have been poor. Commercial organ donation also comes at the expense of, not in addition to, unpaid, 'altruistic' donation. Other consequences of commercial donation are discussed in addition to a review of measures taken by the international community to put an end to the exploitation of vulnerable organ donors and the provision of ethically acceptable options for those in need of organ transplantation.

Reply: The high cost of organ transplant commercialism
Arthur J Matas and Robert S Gaston
http://www.nature.com/ki/journal/v86/n4/full/ki2014184a.html

Abstract
To the Editor: The shortage of kidneys for transplantation has now achieved crisis proportions; numerous efforts over the past decade to increase donation in the United States have had zero net impact. One potential solution is a regulated system of incentives to increase living kidney donation...

Reply: Kidney International Web Focus on Transplantation
P Toby Coates, Michael Ross and Detlef Schlöndorff
http://www.nature.com/ki/journal/v85/n2/full/ki2013550a.html

Abstract
In 2014 we celebrate the 60th anniversary of the first successful renal transplantations in humans as one of the big success stories of modern medicine. Thanks to improvements in techniques and, especially, newer immunosuppressant medication during those past 60 years, kidney transplantation has developed into the best treatment option for end-stage kidney failure worldwide...

The author replies:
Gabriel M Danovitch
http://www.nature.com/ki/journal/v86/n4/full/ki2014185a.html
I share the concern of Matas and Gaston1 for the excess morbidity and mortality of those who remain on dialysis for years awaiting a transplant: many of them are my own patients. But introducing ‘incentives’—a hygienic code word for ‘cash for kidneys’2—will not prevent me from ‘failing’ them: to the contrary.