Intended for healthcare professionals

Analysis And Comment Controversy

Payment for living organ donation should be legalised

BMJ 2006; 333 doi: https://doi.org/10.1136/bmj.38961.475718.68 (Published 05 October 2006) Cite this as: BMJ 2006;333:746

Payment for organs: a careful approach needed

Professor Friedman's brave effort is highly appreciable and we agree
with her on this important issue. It can potentially provide more and
superior organs for transplantation. However there is a clear risk of
commercialisation. We know this is happening in the developing world and
that the poor donors are being exploited. On the other hand, robust
government bodies in the developed countries such as NHS [National Health
Service] in UK can run the administration and implementation of paid
living donation in a professional manner. We think it is a way forward and
official bodies such as NHS, UKT [U K Transplant] and BTS [British
Transplant Society] should jointly consider this seriously.

Although we agree with the author on this issue, in our opinion other
key areas that should take precedence are: 1] to utilise currently
existing cadaveric organ resources maximally & 2] to improve long term
transplant survival rates.

There is a worldwide need to improve cadaveric donation programmes by
amending current regulations [for example The Human Tissue Act 2004 in
UK]. And secondly, there is a pressing need to improve long-term outcomes
in renal transplantation as we are loosing considerable number of renal
transplants every year after transplantation. Some of these patients are
re-listed on the waiting list. This late allograft loss rate has not
changed much in last 10 years in spite of improvements in
immunosuppression and patient care as such.

We hope to see improved cadaveric and living organ donation by
ethically acceptable means and better long-term outcomes in future of
solid organ transplantation.

Competing interests:
None declared

Competing interests: No competing interests

11 October 2006
Chandrashekhar Kubal
Clinical Research Fellow
Chandra S Bhati
University Hospital Birmingham, Birmingham B15 2TH