In an article published online today by the British Medical Journal, Dr Sue Rabbitt Roff, of Dundee University, called on the health service to offer financial rewards to individuals willing to give up a kidney as a means of speeding up the rate of transplants and reducing the cost of treatments and dialysis to the NHS.
But her comments divided the medical community amid concerns the payments would encourage people to risk their health for money. The British Medical Association said it would not support money being offered in exchange for kidneys.
Dr Calum McKellar, director of the Scottish Council on Human Bioethics said: “A legal, regulated market in human body parts would end up exploiting those who have very restrictive financial means, such as many students and foreigners.”
The majority of kidneys used for transplant in the UK come from the recently deceased, with a smaller number donated by relatives to family members suffering from renal failure. However, some people donate a kidney to the NHS altruistically, with no idea who the recipient will be and only their expenses covered.
Dr Roff, a senior research fellow at Dundee’s department of medical sociology, believes it is a “small step” to move towards paid-for kidney donation. She said: “It’s a very small step from where we are now to where I’m suggesting we go.
“We already allow strangers to donate kidneys out of the goodness of their hearts. They get their costs covered, they don’t know who the recipient is, there’s no publicity, no public acknowledgement of what they do.
“We’ve moved away from the notion it has to be a family member or a close associate who can give you a kidney. We’ve already moved into the zone of allowing the general public to make good-hearted donations.
“What I’m suggesting is, why don’t we add money to this equation in order to increase the amount of provision which is there, because we’re behind the eight ball in terms of the number of kidneys that are needed in the community.”
There are currently 725 people in Scotland waiting for a new kidney but the number coming up for transplant has plateaued at around 200 in recent years.
Dr Roff said she had calculated her suggested fee of £28,000 based on average incomes, compensation and the cost-benefit analysis to the health service of a successful transplant.
She said: “The parameters have already been set by our compensation authorities in relation to criminal injuries, and also in relation to military service compensation. If a person lost a kidney in a criminal injury event, they would be eligible for compensation of £22,500 for a lost kidney.
“I came to this figure of £28,000 because that’s the average national income in Britain at the moment, so it seems a fair price across all the social strata. It’s also a great deal cheaper than it costs the NHS to treat someone on dialysis for a year, apart from all the social advantages of helping someone regain quality of life or even avert dying from renal failure. Everything I’m saying is just an extension of what exists. We’ve already got systems in place for men to donate sperm and women to donate eggs -- that’s paid-for donation.
“The special thing about kidneys is that we have two of them. Most of us can get by on one. The other thing is that live kidney donation is better than any deceased kidney donation. It’s medically stronger and it’s going to do more for the recipient than anything that comes from a dead person.
She said donors could be paid from a pool of money set aside by the NHS, preventing a black market trade in organs. A similar system could be applied to liver and blood donation, she added.