Transplantation in the Treatment of Kidney Failure

Kidney Donation

Embryonic Stem Cells Transplantation

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Nearly 93,000 people are currently waiting for kidney transplants in the U.S. Last year 11,043 lucky patients got organs from deceased donors, while another 5,771 received kidneys from living donors. At that rate, the waiting list will be down to zero in just under nine years -- if, of course, nobody else comes down with kidney failure. In the real world, the waits are getting longer and longer. Last year, 4,701 people left the list because they died, while another 2,466 became too sick for a transplant. The waits are particularly lengthy in some states.

Dialysis, which is covered by Medicare regardless of patient age, keeps kidney patients alive, but their health tends to decline. Regularly tethered to a machine, they also find it hard to work or otherwise maintain an active life. Every transplant from a living, unrelated donor saves a almost $100,000 compared to dialysis payments, estimates a careful 2004 study in the American Journal of Transplantation by transplant surgeon Arthur Matas and economist Mark Schnitzler. That doesn’t take into consideration the economic value of patients’ ability to resume normal employment, not to mention their happiness.

In other words, paying, say, $50,000 a kidney would not only save lives. It would actually save Medicare money.

Instead of forbidding compensation, driving it underground (or abroad) and keeping most kidney patients waiting, the law should regularize it. Allow the same insurers, public and private, who cover all the other costs of transplant surgery to also pay fixed fees to organ donors selected and screened by transplant centers. The payment could be cash, perhaps paid over time to discourage impulsive or desperate decisions. Or it could be payments of student loans, contributions to retirement accounts or other more-specific compensation.

Otherwise, the waiting list will continue to grow, as will the opportunity for black market organ dealers.

By Virginia Postrel Jul 16, 2012 9:38 AM PT

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