To the Editor: Dr Goyal and colleagues1 report a deterioration in health status in a surprising
86% of Indian kidney sellers after nephrectomy. This is not the experience
of living kidney donors in the United States, and these poor outcomes may
not necessarily be relevant to the debate about paid donation in western countries.
In his Commentary, Dr Rothman2 recognizes
that people in financial need—not all of them "desperately poor"—
may do things for money that others might avoid. People such as professional
football players also take risks to their health for money. Participating
in or otherwise supporting these practices is not necessarily unethical. Rothman
also notes that kidney selling may not produce sustained financial benefit
for sellers. However, living kidney donation in the United States has never
produced permanently good results either. Even now, 1 in 20 recipients returns
to dialysis within a year; about 25% need dialysis within 7 to 8 years.3
Steiner RW. Consequences of Selling a Kidney in IndiaConsequences of Selling a Kidney in India. JAMA. 2003;289(6):697. doi:10.1001/jama.289.6.697-a
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