Living and Deceased Organ Donation Should Be Financially Neutral Acts

    FL Delmonico, D Martin, B Domínguez-Gil, E Muller, V Jha, A Levin, GM Danovitch, and AM Capron

    AJT logo

    2015; Epub March 31

    The supply of organs—particularly kidneys—donated by living and deceased donors falls short of the number of patients added annually to transplant waiting lists in the United States. To remedy this problem, a number of prominent physicians, ethicists, economists and others have mounted a campaign to suspend the prohibitions in the National Organ Transplant Act of 1984 (NOTA) on the buying and selling of organs. The argument that providing financial benefits would incentivize enough people to part with a kidney (or a portion of a liver) to clear the waiting lists is flawed. This commentary marshals arguments against the claim that the shortage of donor organs would best be overcome by providing financial incentives for donation. We can increase the number of organs available for transplantation by removing all financial disincentives that deter unpaid living or deceased kidney donation. These disincentives include a range of burdens, such as the costs of travel and lodging for medical evaluation and surgery, lost wages, and the expense of dependent care during the period of organ removal and recuperation. Organ donation should remain an act that is financially neutral for donors, neither imposing financial burdens nor enriching them monetarily.

    Read the complete article here at the American Journal of Transplantation(subscription required).

    The Impact of the Israeli Transplantation Law on the Socio-Demographic Profile of Living Kidney Donors

    Boas H, Mor E, Michowitz R, Rozen-Zvi B, and Rahamimov R

    AJT logo

    2015; 15(4):1076-80

    The Israeli transplantation law of 2008 stipulated that organ trading is a criminal offense, and banned the reimbursement of such transplants by insurance companies, thus decreasing dramatically transplant tourism from Israel. We evaluated the law’s impact on the number and the socio-demographic features of 575 consecutive living donors, transplanted in the largest Israeli transplantation center, spanning 5 years prior to 5 years after the law’s implementation. Living kidney donations increased from 3.51.5 donations per month in the pre-law period to 6.12.4 per month post-law (p<0.001). This was mainly due to a rise in intra-familial donations from 2.11.1 per month to 4.62.1 per month (p<0.001). In unrelated donors we found a significant change in their socio-demographic characteristics: mean age increased from 35.47.4 to 39.910.2 (p¼0.001), an increase in the proportion of donors with college level or higher education (31.0% to 63.1%; p<0.001) and donors with white collar occupations (33.3% to 48.3%, p¼0.023). In conclusion, the Israeli legislation that prohibited transplant tourism and organ trading in accordance with Istanbul Declaration, was associated with an increase in local transplantation activity, mainly from related living kidney donors, and a change in the profile of unrelated donors into an older, higher educated, white collar population.

    Read the complete article here at the American Journal of Transplantation (subscription required).

    An Open Letter to HHS Secretary Burwell on Ethically Increasing Organ Donation

    Transplantation Direct

    Volume 1, Issue 1, pp 1-19

    Published Online First March 6, 2015

    Hon. Sylvia Mathews Burwell

    Secretary of Health and Human Services

    Washington, DC

    Dear Madame Secretary:

    In 1984, Congress passed the National Organ Transplant Act (NOTA). That statute not only established the Organ Procurement and Transplantation Network but also enshrined in law a principle that had guided the development of organ transplantation worldwide over the previous 30 years: organs from living and deceased donors are precious gifts, and should not be bought and sold as market commodities.

    Remove the Obstacles to Donation

    The growing demand for transplants currently exceeds the supply of donated organs. In the previous decade, a collaborative effort among the Department of Health and Human Services, organ procurement organizations, physicians, and community groups produced a 25% increase in the number of deceased donor organs. Yet, over the course of the past ten years in the United States, the number of kidney transplants (which account for more than two thirds of all transplants) made possible by living donors has declined by approximately by a thousand...

    Read the complete letter here courtesy of Transplantation Direct.

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