The prohibition of kidney sales and organ markets should remain.
OBJECTIVE
There is an ongoing vigorous debate regarding the wisdom of the current prohibition of organ sales in the United States. We argue that this prohibition must remain in place. We discuss the current international realities regarding organ vending in order to show that even a so-called 'regulated' market brings with it danger to the welfare of transplant donors, their recipients, and potential recipients of nonrenal organs. We counter the specific arguments made in favor of organ sales while recommending multiple measures that can serve to remove disincentives to noncommercial organ donation. We encourage the investment in innovative healthy transplant practice for the benefit of all.


RESULTS
In 'natural experiments' performed in developing countries the outcome for kidney vendors, in terms of both their medical and psychosocial health, has been shown to be poor. A high incidence of serious infections has been reported in recipients of vended organs.


CONCLUSIONS
Commercialization of living kidney donation does not serve the interests of the donors, endangers the health of recipients, and undermines the healthy development of the international transplant endeavor.
Danovitch
Gabriel M
GM
Kidney and Pancreas Transplant Program, David Geffen School of Medicine at UCLA, Los Angeles, California, USA. gdanovitch@mednet.ucla.edu
Delmonico
Francis L
FL
D000533:Altruism; D003362:Cost-Benefit Analysis; D003415:Crime / Q000517:prevention & control; D005381:Financing, Organized / Q000331:legislation & jurisprudence* / Q000458:organization & administration; D037921:Gift Giving; D033161:Government Regulation; D017048:Health Care Costs; D006291:Health Policy / Q000191:economics*; D006297:Health Services Accessibility / Q000191:economics / Q000331:legislation & jurisprudence; D006301:Health Services Needs and Demand / Q000191:economics / Q000331:legislation & jurisprudence; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects / Q000191:economics* / Q000331:legislation & jurisprudence; D019520:Living Donors / Q000331:legislation & jurisprudence* / Q000600:supply & distribution; D009042:Motivation; D009937:Organizational Objectives; D011639:Public Opinion; D006435:Renal Dialysis / Q000191:economics; D018570:Risk Assessment; D009927:Tissue and Organ Procurement / Q000191:economics* / Q000331:legislation & jurisprudence / Q000458:organization & administration; D014481:United States; D014850:Waiting Lists