Like a kidney donor, I talk a lot about the deadly scale of kidney shortage in the USA. A new paper use a number on the problem: 43,000.

If there were enough kidneys for all those who needed them in the United States, we could save 43,000 lives each year.

This is the conclusion of researchers Frank McCormick, Philip Held and Glenn Chertow, in a editorial published in the Journal of the American Society of Nephrologists.

Their calculations are difficult, but simple. Each year, about 126,000 people are diagnosed with end stage renal failure, the most severe kidney failure that usually requires a transplant. Anyone who has been diagnosed with kidney failure during childbearing would not benefit from a transplant, mainly because some are already so sick and have enough weakened immune systems that their bodies can not handle transplantation. a foreign organ.

But McCormick, Held and Chertow estimate, on the basis of previous researchabout half of those diagnosed (63,000 people a year) would benefit from a transplant. That's way more than the 31,000 people who are added to the kidney waiting list every year; The backlog is so important that many people who have benefited from it are not added. Of the 63,000 beneficiaries of a transplant, only 20,000 get one. Only 6,000 get a living donor kidney, which adds an average of nine to 10 years of life, while the rest receives the kidneys from deceased donors, which helps considerably but last less time.

The 63,000 newly diagnosed people who could benefit from a transplant less than the 20,000 who will get it will leave us with the 43,000: the group of new people who will die prematurely on dialysis because they could not get a new kidney .

43,000 people, that's … a lot of people. McCormick, Held and Chertow note that it equates to 85,747 full board collapsing each year. It's more people than die every year homicide, Parkinson's disease or HIV, which is about the number of deaths by suicide. The kidney shortage kills more people than all gun deaths.

People in good health clearly have the choice to help alleviate this crisis: they can give their kidney. They can give a family member if they suffer, or a stranger, as I did. If you are part of a chain, you can help three, four, or even thirty different people to have kidneys. It's the best thing I've ever done in my life and I encourage all readers who think about it to fill out this form and find out more.

How to end the kidney shortage

But as a society, what should we do to end the scarcity? Many of the people I've talked to about kidneys are looking for kidney transplants using 3D printing or stem cells, but while these technologies are promising, they are not yet clinically available and probably will not be in the near future.

"Until the happy day comes when such [artificial] Organs are readily available, "say McCormick, Held and Chertow," we should be tackling here and now the terrible number of premature deaths caused by kidney shortage with already available and proven technology: compensating donors for their kidneys " .

Compensation is a controversial topic and raises the specter of dark organ markets exploiting the poor. But there are many things to do unless you pay people outright for their kidneys that we can and should try.

An approach, theoretically approved by leading kidney organizations such as the National Kidney Foundation (NKF), consists of: eliminate the deterrents donation by compensating donors for lost wages, child care expenses and travel expenses incurred as a result of the donation. The Trump administration could do a lot to fund the loss of salary with a simple regulatory change, and the support of the NKF – which, according to a spokeswoman, "has not taken a stand on this specific proposal" – and the rest of the kidney world could only help it.

We could then experiment with non-monetary incentives, as proposed by the representative Matt Cartwright (D-PA) in his report. Act on the clarification of the donors of organs, which enjoys bipartisan support in the House. The Cartwright Bill would allow pilot tests of incentives like, say, a life time of free health insurance, or GI Bill type educational benefits, or student loan forgiveness, or life insurance, or retirement savings contributions, instead of pure money.

This approach reduces the operating fears associated with cash compensation while providing extremely valuable incentives that would increase donations and save lives. Cartwright's bill would also make it legal for hospitals and perhaps even for Medicare to reimburse donors for lost wages and other donated expenses, which goes further than the administration allows. Trump with a single rule change.

In the meantime, however, if you are in good health and can afford the expenses, I strongly recommend you to consider make a donation. You will save a life, then you will be part of a wonderful community of living donors trying to find ways to save even more lives in the future.

Editor's note: This article has been updated with NKF's position on a regulatory amendment allowing the National Donor Support Center (NLDAC) to reimburse lost wages and child care costs for living donors .


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