The donor's decision in renal transplantation: a cost-benefit analysis.

We previously suggested that a fully informed competent potential donor be allowed to donate his/her kidney as long as society will not suffer from the proposed transplant, even if there is added risk for the donor. To help make this sometimes difficult determination, we have constructed a benefit equation that calculates the benefit to society (either positive or negative) of any proposed living-related transplant. We believe that as long as the benefit calculated is positive, the prospective donor should generally be allowed to donate his kidney, since society will not be injured. It is emphasized that the benefit equation should be viewed as a guide to be used in difficult situations where the donor may be at added risk of renal death, and is not meant to supplant the entire complex decision-making process regarding living-related kidney donation.