Waiting lists: Transplant experts have ruled out making legal in Ireland the sale of organs for transplant to meet rising demand for donors. David Labanyi reports.
The proposal, published in the latest edition of the journal Kidney International, recommends a regulated market in organs from live donors and says such a system would also curb the growing international black market for organ trading.
Dr Liam Plant, consultant renal physician in Cork University Hospital, said organ trading was strongly debated because the proportion of people with kidney failure was increasing worldwide.
"If you live in the developed world, you have dialysis as an alternative. If you live in many developing countries even dialysis as an alternative does not exist."
This divide is one of the most contentious aspects, with growing evidence of western Europeans and Americans travelling to countries such as Pakistan, India and China to purchase organs. At present, only Iran has a regulated system for organ sales but this is limited to Iranian citizens.
Elsewhere, the activity "happens on the margins of legality", Dr Plant says. As donors are usually poor, the main issue is "one of informed consent".
"For people to properly give informed consent they need to be free from external coercion. Poverty would generally be viewed as an external coercion," he said.
Eli Friedman and Amy Friedman, authors of the Kidney International article, argue that individuals have full control of their bodies and therefore can decide to sell a part.
They suggest the purchase of such organs should be regulated by government agencies and propose a fee of $40,000 (€33,000) per organ.
Mark Murphy, chief executive of the Irish Kidney Association, admits black-market trading of organs takes place but said "no one in Ireland is suggesting using that direction".
He said there was no evidence "of Irish people going to places where they can avail of organs but a number of British people have gone to India or Pakistan to purchase organs. The odd one has died and others have had problems with post-transplant care."
Mr Murphy said he found it "disgusting that rich Europeans were going to countries like India to plunder their poor". He said the vast majority of people on the waiting list for a kidney transplant in Ireland could receive organs if the live donor programme were fully funded.
"We have 1,400 patients on dialysis and about 420 of those are on the waiting list. You could say 650 will have an expectation to be transplanted but only 130 a year are being transplanted. Living transplants could potentially double that," Dr Plant said.