Global kidney exchange : opportunity or exploitation? An ELPAT/ESOT appraisal

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Abstract

This paper addresses ethical, legal, and psychosocial aspects of Global Kidney Exchange (GKE). Concerns have been raised that GKE violates the nonpayment principle, exploits donors in low‐ and middle‐income countries, and detracts from the aim of self‐sufficiency. We review the arguments for and against GKE. We argue that while some concerns about GKE are justified based on the available evidence, others are speculative and do not apply exclusively to GKE but to living donation more generally. We posit that concerns can be mitigated by implementing safeguards, by developing minimum quality criteria and by establishing an international committee that independently monitors and evaluates GKE’s procedures and outcomes. Several questions remain however that warrant further clarification. What are the experiences and views of recipients and donors participating in GKE? Who manages the escrow funds that have been put in place for donor and recipients? What procedures and safeguards have been put in place to prevent corruption of these funds? What are the inclusion criteria for participating GKE centers? GKE provides opportunity to promote access to donation and transplantation but can only be conducted with the appropriate safeguards. Patients’ and donors’ voices are missing in this debate.

Item Type: Journal Article
Subjects: H Social Sciences > HV Social pathology. Social and public welfare
Q Science > QP Physiology
R Medicine > R Medicine (General)
R Medicine > RC Internal medicine
R Medicine > RD Surgery
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH)
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Chronic renal failure, Kidneys -- Diseases, Kidneys -- Transplantation, Kidneys -- Transplantation -- Moral and ethical aspects, Kidneys -- Transplantation -- Patients, Transplantation of organs, tissues, etc. -- Moral and ethical aspects, Medical ethics, Living related donor transplantation, Organ trafficking
Journal or Publication Title: Transplant International
Publisher: Wiley-Blackwell Publishing Ltd.
ISSN: 0934-0874
Official Date: September 2020
Dates:
Date
Event
September 2020
Published
29 April 2020
Available
24 April 2020
Accepted
Volume: 33
Number: 9
Page Range: pp. 989-998
DOI: 10.1111/tri.13630
Status: Peer Reviewed
Publication Status: Published
Re-use Statement: ** Article version: VoR ** From Crossref via Jisc Publications Router ** History: epub 20-05-2020; issued 20-05-2020. ** Licence for VoR version of this article starting on 20-05-2020: http://creativecommons.org/licenses/by-nc-nd/4.0/
Access rights to Published version: Open Access (Creative Commons open licence)
Date of first compliant deposit: 4 June 2020
Date of first compliant Open Access: 5 June 2020
Related URLs:
URI: https://wrap.warwick.ac.uk/137280/

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