Friedman E A, Friedman A L
Division of Renal Diseases, Department of Medicine, Downstate Medical Center, State University of New York, Brooklyn, New York 11203, USA.
Kidney Int. 2006 Mar;69(6):960-2. doi: 10.1038/sj.ki.5000262.
Continuous growth of the end stage renal disease population treated by dialysis, outpaces deceased donor kidneys available, lengthens the waiting time for a deceased donor transplant. As estimated by the United States Department of Health & Human Services: '17 people die each day waiting for transplants that can't take place because of the shortage of donated organs.' Strategies to expand the donor pool--public relations campaigns and Drivers' license designation--have been mainly unsuccessful. Although illegal in most nations, and viewed as unethical by professional medical organizations, the voluntary sale of purchased donor kidneys now accounts for thousands of black market transplants. The case for legalizing kidney purchase hinges on the key premise that individuals are entitled to control of their body parts even to the point of inducing risk of life. One approach to expanding the pool of kidney donors is to legalize payment of a fair market price of about 40,000 dollars to donors. Establishing a federal agency to manage marketing and purchase of donor kidneys in collaboration with the United Network for Organ Sharing might be financially self-sustaining as reduction in costs of dialysis balances the expense of payment to donors.
接受透析治疗的终末期肾病患者人数持续增长，超过了可用的已故捐赠者肾脏数量，延长了等待已故捐赠者肾脏移植的时间。据美国卫生与公众服务部估计：“每天有17人在等待移植的过程中死亡，原因是捐赠器官短缺，移植无法进行。”扩大捐赠者群体的策略——公关活动和驾照指定——基本上都没有成功。尽管在大多数国家，购买捐赠肾脏是非法的，并且被专业医学组织视为不道德行为，但现在自愿出售购买的捐赠肾脏占了数千例黑市移植手术。肾脏购买合法化主张的关键前提是，个人有权控制自己的身体器官，甚至到了危及生命的程度。扩大肾脏捐赠者群体的一种方法是将向捐赠者支付约4万美元的公平市场价格合法化。与器官共享联合网络合作设立一个联邦机构来管理捐赠肾脏的营销和采购，可能在财务上实现自我维持，因为透析成本的降低平衡了向捐赠者支付的费用。
