Thursday, November 26, 2015

Solutions for dealing with kidney shortage

In previous posts I have mentioned about growing number of patients waiting for kidney and the large number of patients who die waiting for a kidney.  Here is a promising solution:


  1. Public Advocacy: This is the low hanging fruit. We can increase donor organ awareness.  More number of people can sign up to become organ donors via their driver's license or otherwise.  Over a 100 million people have signed up to become donors and we can probably get more signed up here at organdonor.gov.  There is also a site which I like a lot which has become a resource for donor advocacy (waitlistzero.org). This site helps donors with lost wages, travel as well as with paired kidney. But to put it bluntly, is clear that eligible donors are not dying at rate fast enough to make up for the kidney shortage. 
  2. Science: Here is a 4 minute audio blurb on NPR about scientists trying to grow kidneys from your own stem cell (link to npr site with audio and text description). One of the benefits of this is that recipient will not need any immuno-suppressants and that will a big deal. 
  3. Market Economics: Perhaps the most controversial, but this involves creating some form of regulated marketplace for organ sales. In past postings I have talked about this happening in Iran (where there is no waitlist for organ donors). There are number of prominent economists (including Nobel Prize winners) who have given this some thought, Becker/Posner. Becker, Posner think the market price is around $15,000 while some others think a price of around $50,000. Along the same lines is another thought from Rohit Dhar where he suggest that instead of a marketplace, Medicare buys organs and provides it to recipients. This is not such an outrageous thought because Medicare spends 100,000s of dollars on patients with kidney failures. This would be more cost efficient, alleviate shortage problem, and provide public oversight.  This is a complex topic (from a policy standpoint) but to most economists this is not a problem that cannot be solved. 

I have enumerated them in the order of realistic outcomes. On 1), Clearly, it is up to each one of us to become organ donors (if we have not signed up).  So if you are reading this (and have not registered), then consider registering.  We can also do to support option 2) by ensuring that we support public funding (NIH, etc), oppose legislation that bans stem cells research. On 3), I think we are far from having a non-academic discussion which is what we need to make progress on this. But think about it, our own lives or lives of our loved ones may depend on this.....

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