'Cash for Kidneys' idea controversial but gaining support

Some say paying for kidney donations would adversely affect the poor


SAN ANTONIO – It's been a lifelong battle for Denise Martinez.

At just 7 years old, she was diagnosed with Type 1 diabetes. Later, it was renal failure.

"I just wanted to live," Martinez said.

She desperately needed a kidney to survive.

"For a person who is waiting for an organ transplant, that's all they can think about, day and night," Martinez said.

Time is not a kidney transplant patient's friend. That's why professors Gary Becker and Julio J. Elias are calling for change.

They think the U.S. should create a compensation system for live donors.

"With a market system in which you will have competition that will assure quality, I think that the quality will increase," Elias, a Stanford professor, said.

Many in the medical community disagree, or at least acknowledge it's a very controversial proposal.

Dr. Neema Stephens is a transplant Nephrologist with the University of Texas Health Science Center in San Antonio.

"I think it gets very challenging when we enter into the realm of making it a for-profit endeavor," Stephens said.

The development of new drugs in the 1970s made kidney transplants more successful, and that has increased the number of patients needing an organ.

The life expectancy for a person on dialysis is an additional 8 years.

After a kidney transplant, life expectancy increases 23 years.

The need for more organs is there, and Dr. Stephens says she supports some compensation for donors.

"There are costs that are accrued in terms of travels, costs to the transplant center, the medical cost of the evaluation lodging," Stephens said. "There is recovery, time for recovery from surgery."  

But paying for organs could mean too many people simply donate for the money.

"So do you want to have an endeavor that targets the poorest of the poor to provide organs for all of society. That's something that medical ethicists consider unjust," Stephens said.

Another consideration is whether someone just donating for the cash would be truthful about their medical and recreational background if it meant they might not be allowed to donate.

Some argue that people are allowed to donate plasma and sperm, for example, in exchange for cash, and they question how organ donation is any different. But Stephens said the risks of donating a solid organ are completely different, with different risks and benefits.

Becker and Elias say cash for kidneys would help those in need.

"You will have a wide pool of people to choose," Elias said. "Now you have a narrow pool."

The World Health Organization currently has what's called a "Declaration of Istanbul," which opposes the cash trade for organs and using the human body as a commodity.

The declaration was so named because it was crafted during a World Health Summit in Istanbul in 2008.

As for Denise, she received her kidney in 2009 and is now healthy.

She thinks cash for kidneys is something that needs to be considered.

"It's always an option," Martinez said. "It would be nice if people who do have the money and are able to afford it make it easy for someone to donate an organ for them ... to be allowed to do it legally."

In Texas, over 10,000 people are waiting for a kidney transplant. Locally, at University Hospital, there are 805 people on the kidney waiting list.

To find out more about University Hospital's Organ Transplant program, click here.