A review of the possibility of adopting financially driven live donor kidney transplantation

ABSTRACT Kidney transplantation for end-stage renal disease remains the preferred solution due to its survival advantage, enhanced quality of life and cost-effectiveness. The main obstacle worldwide with this modality of treatment is the scarcity of organs. The demand has always exceeded the supply resulting in different types of donations. Kidney donation includes pure living related donors, deceased donors, living unrelated donors (altruistic), paired kidney donation and more recently compensated kidney donation. Ethical considerations in live donor kidney transplantation have always created a debate especially when rewarding unrelated donors. In this paper, we examine the problems of financially driven kidney transplantation, the ethical legitimacy of this practice, and propose some innovative methods and policies that could be adopted to ensure a better practice with accepted ethical guidelines.

摘要：针对终末期肾病（end-stage renal disease）的肾移植术，凭借其生存优势、更高的生活质量与成本效益，仍是首选治疗方案。该治疗方式在全球范围内面临的核心障碍为供体器官匮乏。供体需求始终大于供给，由此催生了多种肾脏捐献模式。肾脏捐献类型涵盖纯活体亲属供体、尸体供体、非亲属活体供体（利他型）、配对肾捐献（paired kidney donation），以及近年出现的有偿肾捐献（compensated kidney donation）。活体肾移植中的伦理考量向来引发争议，尤其在对非亲属供体给予报酬的场景下。本文剖析了经济驱动型肾移植面临的诸多问题，论证了该实践模式的伦理正当性，并提出可在公认伦理准则框架下推行的创新方法与政策方案，以推动肾移植领域的良性发展。