title: Debating Organ Procurement Policy Without Illusions.
abstract: In this perspective, I review and critique claims that the transplant waiting list overstates the demand for kidneys and correct a few mischaracterizations of some structural barriers to increasing rates of transplantation. The solutions to the shortage of organs proffered by opponents of financial incentives fail to account for a panoply of clinical, regulatory, and financial realities of transplantation centers in the United States in ways that undermine the thesis that a trial of financial incentives for organ procurement is not warranted at this time. I conclude with some personal pessimistic reflections on the progress of this debate.
authors.affiliation: Metrolina Nephrology Associates, PA, and The Carolinas Medical Center, Charlotte, NC. Electronic address: bhippen@metrolinanephrology.com.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Hippen
mesh_terms: D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D017048:Health Care Costs; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000601:surgery; D016030:Kidney Transplantation / Q000191:economics* / Q000941:ethics / Q000379:methods*; D019520:Living Donors / Q000706:statistics & numerical data*; D008297:Male; D011050:Policy Making; D018570:Risk Assessment; D009927:Tissue and Organ Procurement / Q000458:organization & administration*; D014481:United States; D014850:Waiting Lists
keywords: Kidney transplantation; altruistic organ donation; end-stage renal disease (ESRD); financial incentives; living donors; medical ethics; organ procurement; transplant waiting list