For a patient with kidney failure, a successful transplant, compared with dialysis, provides longer life and better quality of life. Significant improvement in transplant outcomes has led to expansion of candidacy criteria and a marked increase in the number of patients eligible for transplant. In the past 2 decades, numerous attempts have been made to increase the number of both living donors (eg, nondirected donors, paired exchange) and deceased donors (eg, donation after circulatory death), yet there has been little change in the number of donated kidneys. With increasing need but limited supply, the waiting list for a transplant has grown and waiting times have increased, with substantial negative consequences for patients in the US. In the last 20 years, more than 89 000 candidates in the US died while waiting for a kidney. An additional 54 838 were removed from the waiting list because of becoming too sick to undergo a transplant.1
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Matas AJ. A Regulated System of Incentives for Kidney Donation—Time for a Trial! JAMA Surg. Published online June 02, 2021. doi:10.1001/jamasurg.2021.1435
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