It's time to explore 'regulated paid provision' for live kidneys

It is time to explore how to pay for live kidneys in the UK under strict rules that guarantee access and equity, argues Sue Rabbitt Roff from Dundee University in a personal view article published on bmj.com.

Roff is advocating a system where the standards of pre and post operative care would be as good as they are now for kidney donors in the UK, and where the standard payment would be equivalent to the average UK annual income of around £28,000.

This "would be an incentive across most income levels for those who wanted to do a kind deed and make enough money to, for instance, pay off university loans," she says.

With three people on the kidney transplant list dying in the UK every day and thousands more attending dialysis units, Roff says there needs to a public debate on `regulated paid provision' for live kidneys.

She explains that a regulated system would not resemble the illegal market that currently exists in several countries where poor people are exploited.

"With the number of people with diabetes and high blood pressure on the rise, the demand for kidney transplantation is set to increase," says Roff.

However, she adds that "The level of donation of both deceased and living kidneys has never kept pace with the need, and is plateaued at around 2000 a year in the UK."

Roff concludes that "We need to extend our thinking beyond opt in and opt out to looking at how we can make it possible for those who wish to do so can express their autonomy in the same way as current donors are encouraged to do by making available a healthy kidney for a fee that is not exploitative."