What We Can Learn from Iran about Organ Donation

The Problem: Millions of people suffer from kidney disease, but in 2007 there were just 64,606 kidney-transplant operations in the entire world. In the U.S. alone, 83,000 people wait on the official kidney-transplant list. But just 16,500 people received a kidney transplant in 2008, while almost 5,000 died waiting for one…

Some Solutions: Singapore is preparing to pay donors as much as 50,000 Singapore dollars (almost US$36,000) for their organs. Iran has eliminated waiting lists for kidneys entirely by paying its citizens to donate. Israel is implementing a “no give, no take” system that puts people who opt out of the donor system at the bottom of the transplant waiting list should they ever need an organ…

The Evidence: The Iranian system and the black market demonstrate one important fact: The organ shortage can be solved by paying living donors. The Iranian system began in 1988 and eliminated the shortage of kidneys by 1999…

A U.S. Proposal: Nobel Laureate economist Gary Becker and Julio Elias estimated that a payment of $15,000 for living donors would alleviate the shortage of kidneys in the U.S. Payment could be made by the federal government… Moreover, this proposal would save the government money since even with a significant payment, transplant is cheaper than the dialysis that is now paid for by Medicare’s End Stage Renal Disease program.

Full report on new programs to boost organ donation.

Comments (10)

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  1. Tom H. says:

    Interesting post.

  2. Stephen C. says:

    There has always been a lot of resistence to paying people for their organs. It is unclear why. In general, economists tend to favor it. Noneconomists do not.

  3. Larry C. says:

    All we need here is elementary price theory. Price controls produce shortages — whether in the housing rental market or in the market for organs.

    At a price of zero, there are too few organs. Raise the price and there will be more.

  4. Linda Gorman says:

    Big question is how one ensures that the trade is voluntary, without outside pressure. Related question: how much is voluntary in Iran? And why should one believe Iranian statistics on anything?

    Another problem is the shifting definition of death, especially in view of the Israeli requirement.

    Finally, how do they know, for sure, that there is no payment for organs in the US? Not, of course, that an open market wouldn’t be bigger.

  5. artk says:

    If you want a free market solution to the donor organ surfeit, why just focus on the supply of organs? Why not focus on the demand side? Encourage insurance plans to eliminate reimbursement for kidney transplants. Even better, you can have patients opt out of transplant eligibility for a cash stipend.

    I would also argue that kidney transplants are more expensive then dialysis. A Kidney transplant costs about $150,000 plus an additional $20,000 a year for immunosuppressive therapy. Dialysis costs about $30,000 a year. The 10 year survival rate for dialysis patients is 20% and but 10 year survival rate for transplant patients is 65%.

    This is only a temporary problem, in 40 or 50 years, embryonic stem cell and cloning technology will sufficiently advance so you’ll be able to grow a new kidney that’s an exact match, no rejection problems. I understand that some people have a moral objection to this. They can always tell their dying relative to refuse the treatment for moral reasons.

  6. Michael Kirsch, M.D. says:

    I’m not prepared to open up a free market organ bazaar. Yet, we need some way to increase donations without crossing ethical boundaries. Folks in need of organs,and their families, understandably would do anything to help their loved ones, but this might violate society’s rights and would also encourage exploitation of the vulnerable. We should devise other incentives, such as Israel as adopted, to save lives. I haven’t regarded Iran to be a worthy model of ethical behavior. http://www.MDWhistleblower.blogspot.com

  7. [...] they do it? They have a kidney matching system and they pay donors.  Singapore plans to pay donors up to 50,000 Singapore Dollars (Almost $36,000 US [...]

  8. Mel says:

    Iran’s system seems to be exploiting the poor. In an underdeveloped nation with a high poverty rate, where donors are paid relatively small sums of money for their organs, which are then sold for much higher prices by the government. Is it not morally wrong to accept organs donated due to economic preasure rather than altruistic choice?

  9. Nick, Wada says:

    Dear Sir:
    I am looking for kidney transplant in Iran but I don’t know detail of the Kidney transplant there however if you have the any information for the kidney transplant in Iran please contact me immediately for the future considration.

    Sincerely your:

    From: Nick

  10. T-nation says:

    I think you have to be an Iranian citizen to donate or receive organs in Iran, but my info is from youtube.