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February 12, 2003

Consequences of Selling a Kidney in IndiaConsequences of Selling a Kidney in India

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(6):697. doi:10.1001/jama.289.6.697-a

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