As more patients than ever desperately wait for a donor...
would YOU donate a kidney if the NHS paid you £35,000? By Daniel Rodger and Angela Epstein Published: 01:25, 27 August 2024 | Updated: 01:46, 27 August 2024 e-mail View comments More patients than ever are waiting desperately for a new kidney. There are 10 per cent more people on the waiting list for a transplant than a year ago, according to the latest figures. About six people a week in the UK die waiting for a kidney transplant – often after spending several years on dialysis .
But the real number might be higher, as hundreds more are removed from the list annually because their declining health makes them unsuitable. The reason is simple: a chronic shortage of kidneys from living or deceased donors. As a result, demand vastly outstrips supply.
This is made worse by spiralling obesity levels in the UK. Over the next decade, hundreds of thousands more patients will have kidney disease as a result. More patients than ever are waiting desperately for a new kidney.
There are 10 per cent more people on the waiting list for a transplant than a year ago, latest figures reveal (stock image) Read More Kidney donor reveals how an extraordinary act of altruism saved the life of a fellow mum Being obese [defined as having a BMI of 30 and above] comes with a nearly four-fold risk of end-stage kidney disease compared to those within the normal range. So what's the solution? As a researcher exploring alternative ways to source transplant organs, I have taught and written about xenotransplantation – the use of animal cells, tissue and organs in human patients. This year, in a pioneering operation, a 62-year-old man in the US became the first living person to receive a genetically modified kidney from a pig .
The operation seemed a success. But the patient died in May – so it could be years before we know if this approach is safe and effective. What we do know is that transplanting a human organ is the gold-standard treatment for end-stage kidney disease.
Unlike many other types of organ donation, it's possible to donate a kidney while you're alive because you only need one of the two you have to survive. But how do we make more available? All areas of the UK effectively have a consent opt-out system. Every adult is considered to have agreed to be an organ donor after death unless they've recorded a decision not to donate.
However, there still aren't enough. But we could increase availability by financially compensating those who choose to donate – in other words, paying them. This year, in a pioneering operation, a 62-year-old man in the US became the first living person to receive a genetically modified kidney from a pig.
Pictured: Surgeons at Massachusetts General Hospital in Boston preparing the pig kidney for transplantation in March 2024 Surgeons perform the world's first genetically modified pig kidney transplant into a living human at Massachusetts General Hospital in Boston on March 16, 2024 Read More Diabetes is fuelling kidney disease timebomb with number waiting for a transplant at its highest in a decade and 10 per cent up on a year This is currently illegal in the UK and some will be horrified by a cash-for-kidneys scheme. What I'm proposing isn't some back-street racket, rather a regulated system whereby the NHS would pay living kidney donors. Donating a kidney involves a general anaesthetic, a three to five-day stay in hospital and recuperation of up to three months.
It's fairly safe, although not without risk. Being paid would be a fairer way of compensating donors for the risk they accept, attract more donors and raise awareness of the need for more organs. I suggest a 'monopsony' system – where the NHS is the only 'buyer'.
Living donors could still choose to take payment or not. This would rule out private racketeers, as the NHS wouldn't actively be offering to buy kidneys but providing an option for compensation in return for individual and societal good. So how much should we pay? I think £35,000 tax free could be appropriate.
This is just above the 2022 average annual full-time UK income of £33,000 and would reflect the donor's generosity. We DO need to know what public sentiment is first. But one US study found cash incentives increased the probability of people donating – and not just among those needing cash.
About six people a week in the UK die waiting for a kidney transplant – often after spending several years on dialysis. But the real number might be higher, as hundreds more are removed from the list annually because their declining health makes them unsuitable (stock image) The benefits could be huge: reduced waiting times for transplants, pressure eased on dialysis services and fewer deaths among those waiting. It costs the NHS £34,000 per year per patient for kidney dialysis.
With many waiting years for an organ, that's a lot of cash. But does paying devalue the act of donation? No, as compensating people for doing good things and accepting some risk in the process neither diminishes the good nor makes payment immoral. It would remain illegal for an individual to pay someone for their kidney.
The process would be overseen by the Human Tissue Authority, the independent regulator that ensures human tissue is used ethically. Given the organ shortage, I genuinely believe it's time we paid living kidney donors – in one stroke treating the donors more fairly, increasing the number of available organs and helping save more lives. Daniel Rodger is a senior lecturer in operating department practice at the Institute of Health and Social Care, London South Bank University.
AS TOLD TO ANGELA EPSTEIN NHS Share or comment on this article: As more patients than ever desperately wait for a donor...
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