The Daily Pennsylvanian is a student-run nonprofit.

Please support us by disabling your ad blocker on our site.

Imagine paying off student loans by selling a kidney.

Matthew Allen, a student at the Perelman School of Medicine, and Peter Reese, an assistant professor of medicine at Penn, are calling for a reassessment of the National Organ Transplant Act of 1984, which prohibits the buying and selling of human organs for transplantation. In a recent editorial in the Clinical Journal of the American Society of Nephrology, Allen and Reese suggest that a “limited, real-world trial” of payment for kidney donations should be allowed so that researchers can assess the effects of such a policy.

Related: Patients with liver cancer more likely to be on transplant waitlist

The National Kidney Foundation estimates that in the United States, 13 people die each day while waiting for a kidney transplant. Because humans are born with two kidneys but can function normally with only one, kidneys are one of the only organs that can be given by live donors via a procedure with some health risks.

This is lifesaving for the estimated 96,645 people in the United States currently awaiting kidney transplants, according to the National Kidney Foundation. Unfortunately, the number of people who need kidneys far outstrips the number of people willing to donate them, leaving many to undergo dialysis, the only alternative treatment.

Reese and Allen cite a study by Lianne Barnieh, a postdoctoral fellow at the University of Calgary, which suggests that paying $10,000 for a kidney led to a 5 percent increase in live kidney donation.

Related: Penn doctors perform double hand transplant

The study also found that a kidney donation costs $340 less than dialysis.

“A kidney transplant is actually cost saving,” Reese said, stating that dialysis can cost around $75,000 a year and continue indefinitely. According to the United Network for Organ Sharing, the estimated total cost of a transplant, including post transplant immunosuppressant drugs, costs $262,900.

However, immunosuppressants often need to be taken for several years after the transplant, which can incur significant unexpected costs for the patient. Complications from the transplant sometimes can result in costs equal to those associated with dialysis.

Even if incentivizing kidney donation makes economic sense, there are significant ethical concerns around paying people for organs. According to Reese and Allen, many argue that paying for kidneys “commodifies” the body by making it an object, which goes against certain religious or moral views.

Related: Bioengineers use 3-D printer to create human organs

Reese pointed out that the commodification argument deals with the question of “people’s autonomy to do what they want with their bodies.” He argued that if it is ethical to sell eggs and undergo plastic surgery, it would be also be ethical to sell a kidney.

Govind Persad, a visiting scholar in Philosophy at Penn, takes a different view. He points out that “an option can come with benefits but also can come with costs. If you’re a person who doesn’t want to sell their organs, you’re now worse off.” Persad suggested that if selling kidneys is legalized, loaning institutions could require people to put up their kidneys as collateral, or welfare-to-work programs could require someone to sell their kidneys before they could receive assistance.

Related: Transplant house embraces location

Another major objection to paying for kidneys is that it could increase the inequality between the poor and the rich, since the poor could disproportionately sell their organs to the rich. Anne Barnhill, a professor of medical ethics and health policy at the medical school, suggests that one way to mitigate this issue would be for a policy where “some public body pays people for organs and recipients don’t.” Reese also notes that a recent study by Scott Halpern, a professor at the medical school, found that even a $100,000 payment would not influence poorer or richer people in their decision to donate their kidneys.

Persad believes that the Barnieh study “is a little short-sighted” because it did not explore other important economic issues involving paying for kidneys, such as whether public funds should be used for “saving lives right now, versus spending money on public health … to extend other people’s lives for many more years.”

Comments powered by Disqus

Please note All comments are eligible for publication in The Daily Pennsylvanian.