Why We Should Develop a Regulated System of Kidney Sales: A Call for Action!

[摘要] The main argument in favor of a regulated system of payment to living kidney sellers is simple: Financial incentives will increase donation, so fewer of our wait-listed transplant candidates will die while waiting. Wait-list deaths are a relatively new and increasingly severe problem for patients with ESRD. As recently as the early 1980s, the average wait for a deceased donor (DD) kidney transplant was <1 yr; currently, it is >5 yr. Despite decades of effort, there has been little increase in DD organ donation, and that increase has come from the use of expanded-criteria donor (ECD) kidneys (which are associated with decreased patient and graft survival rates and would have been rejected routinely 20 yr ago). In addition, Sheehy et al. (1) reported that even if every potential donor in the United States became an actual donor, there still would be a shortage of kidneys, yet the reality is that in countries such as Spain, which has maximized donation, only 75% of potentially available kidneys are recovered.

[学科分类] 泌尿医学

[关键词] Bone marrow necrosis;Sickle cell disease;Hyperhemolysis syndrome