Charlotte Begley explores an unlikely avenue of medical researchWritten by Charlotte Begley on 2nd April 2019
Kidney Donors Swap Their Kidneys For Transplant Vouchers
Sci & Tech online editor Ellen Heimpel reports on the new kidney voucher scheme initiated by Howard Boardman allowing kidney donors to donate now in return for a loved one being given priority for a donation later
One third of people who require a kidney transplant are unable to accept a kidney from a friend or relative who is willing to donate because the kidney is biologically incompatible and therefore would be rejected by their cells. Finding a suitable match for a patient is a long process, made more difficult by a shortage of people willing to donate a kidney to a complete stranger.
In 2014 a former judge in California, Howard Broadman, approached UCLA with a proposition. He wanted to donate his kidney to his four-year-old grandson who had chronic kidney disease and was likely to need a transplant within the next ten to fifteen years. However, by this time Howard would be over sixty-five and therefore, by law, unable to donate his kidney. He wanted to receive some kind of insurance that if he donated his kidney now, his grandson would be more likely to receive one in the future. Surgeon Jeffrey Veale agreed and the first voucher system was developed.
“The scheme allows you to donate a kidney ahead of when a friend or family member needs it
The scheme allows you to donate a kidney ahead of when a friend or family member needs it. This kidney will then be given to a stranger in dialysis. In return, your desired recipient will be given a voucher that gives them priority to be matched with an kidney donor when they need a transplant. Howard donated his kidney to a stranger at Ronald Reagan medical centre and gave the voucher to his grandson.
In the US there are currently 93,000 people waiting for a kidney and about twelve die every day. To address this widespread issue, the voucher system was utilised as a way of increasing the number of kidney donors. A new UCLA study published this September revealed that the first three voucher cases led to twenty-five life-saving kidney transplants across the US.
“The first three voucher cases led to twenty-five life-saving kidney transplants across the US
It already appears that this system is encouraging people to donate kidneys who otherwise would not consider doing so and is therefore saving more lives. However, there are some ethical issues to consider: is it fair that someone with a voucher could receive priority for a kidney donation over another person who has been waiting longer? This would be especially concerning if it resulted in the death of a patient who failed to receive a kidney as a result of this. This is an altogether different case compared to a patient receiving a kidney from a family member who would not otherwise donate. Here, voucher-holders receive preferential treatment and are able to take priority for a transplant over someone who has been waiting longer and possibly needs a donor more desperately.
Currently, around thirty hospitals around the US participate in this voucher scheme. According to the National Kidney registry, twenty-one kidneys have been donated in exchange for vouchers. At the moment this scheme only takes place in the US but with its increasing popularity and the promising results of this new study, it might not be long before the voucher scheme spreads to the UK.