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To Pay or Not To Pay for a Kidney – What Do Patients Think?

N. Kessaris, M. Lim, A. Vowler, T. Masher, A. Greenberg, P. Thiruchelvam, V. Papalois, E. Kingdon, M. Phanish, N. Mamode, B. Fernando, I. MacPhee, S. Heap

Guy's Transplant Unit, Guy's Hospital, London, United Kingdom
Renal Unit, St George's Hospital, London, United Kingdom
West London Renal &
Transplant Centre, Hammersmith Hospital, London, United Kingdom
Sussex Kidney Unit, Royal Sussex County Hospital, Brighton, United Kingdom
SW Thames Renal &
Transplant Unit, St Helier Hospital, Carshalton, United Kingdom
Renal Unit, Royal Free Hospital, London, United Kingdom

Meeting: 2013 American Transplant Congress

Abstract number: A793

Introduction:

The aim of this study was to review patients' thoughts on financial incentives in kidney transplantation in UK.

Methods:

A questionnaire was sent to patients on the National transplant list asking them what they think about the recipient’s ability to pay in order to be allocated a deceased kidney for transplantation. This was approved by a Research Ethics Committee (Ref:10/H083/61) and sent to all patients awaiting deceased donor kidney transplantation at 6 renal units in UK.

Results:

The response rate was 410/1221 (34%). 18 patients did not want to participate.

The ability to pay for a kidney was an issue that 310 responders (76%) did not think should be part of the National allocation guidelines. 42 (10%) patients felt that payment should be part of the National allocation system and 51 (12%) patients said they didn’t know whether payment should be part of this.

Thirty-six (9%) responders thought that payment for a kidney is part of the current National kidney allocation system. 295 (72%) patients stated that the recipient’s ability to pay was not part of the allocation system. Finally, 79 (19%) said that they didn’t know whether payment is part of the allocation system.

Conclusions:

The majority of patients do not feel that paying to receive a kidney should be allowed. More concerning however is that 9% of patients currently think that the ability to pay influences kidney allocation and that 10% felt that payment should be part of the allocation system.

Patients should be provided with more information about the allocation system before listing for deceased donor kidney transplantation. In addition, patients should be informed that payment is not part of this and made aware of the Declaration of Istanbul (2008), which prohibits organ trafficking and transplant tourism.

Further research is required, possibly in the form of focus groups, to explore deeper some of the patient’s thoughts raised here. Finally, it would be interesting to perform similar questionnaires in other countries for comparison.

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To cite this abstract in AMA style:

Kessaris N, Lim M, Vowler A, Masher T, Greenberg A, Thiruchelvam P, Papalois V, Kingdon E, Phanish M, Mamode N, Fernando B, MacPhee I, Heap S. To Pay or Not To Pay for a Kidney – What Do Patients Think? [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/to-pay-or-not-to-pay-for-a-kidney-what-do-patients-think/. Accessed May 14, 2025.

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