Bidding wars in the organ trade

Bidding wars in the organ trade

Jason Mountney
May 8, 2008

The campaign by Canberra nephrologist Gavin Carney to legalise the sale of kidneys between consenting adults will have many people looking at their insides in a new light.

Can their left kidney (the one that is usually removed) be traded for a new pool, a deposit on an investment property or a couple of years at private school for the children?

While the debate has involved medical experts and ethicists, no one has asked the opinion of an economist - maybe they can't find one who has donated a kidney - on how the laws of supply and demand would affect the organ trade.

As someone who went through the surgical procedure nearly two years ago (as an act of love for a family member, rather than for money) my advice to those looking to cash in on their innards in a legalised organ-trading market would be to get in early, before the price falls.

In 2005 my brother discovered he was suffering the early stages of renal failure. Late that year my father and I were asked to take a blood test to determine if either of us could save him from a life of dialysis. My blood group was the one, triggering seven months of medical and psychological testing, requiring a visit to hospital once every week or two.

The tests ensure the operation won't harm the donor physically, and that they haven't been coerced into the operation. Any threat to their health and the whole thing is off. Furthermore, if a patient confesses they have been forced by family members or employers into donating against their will, a medical obstacle to the procedure will be "discovered" and the operation cancelled.

The reward for passing the tests was a trip on a gurney into an operating theatre in early July 2006. I was home from hospital after a three-night stay.

My remarkably short turnaround was thanks to keyhole surgery. Known as laparoscopic nephrectomy, the procedure has dramatically reduced the amount of time kidney donors spend in hospital, the amount of pain they go through and the scarring their bodies endure.

Four small holes are made in the abdomen to give access to a camera and surgical instruments. The kidney is cut free and placed into a bag that has been inserted into the body via a small incision just above the patient's pubic area. The kidney is removed via the same incision and taken to another operating theatre, where it is placed into the recipient via a much more invasive procedure.

Several hours later, I woke up in severe pain that slowly eased in the next day or so to a dull ache. On my first day home I could walk around my local park and visit a nearby cafe. Within a week I was visiting friends, drinking alcohol with dinner and getting out of bed without doubling over in discomfort. Within a fortnight I was working from home and going to the pub and after a month I was back to work in the city. If I were in urgent financial straits, I'd have returned to work faster.

Twenty-two months on, my brother has been spared a life on dialysis and I am all but completely unaffected by the operation. My remaining kidney has "taken up the slack" and operates at about 80 per cent of the capacity of two healthy organs. The scars on my belly are almost unnoticeable and my diet and alcohol intake unaffected. I play futsal and indoor hockey without the need for additional padding.

Of course, there are drawbacks. Any operation that involves a general anaesthetic carries with it the risk of death, and hospitals are dirty places full of sick people and "superbugs" that sometimes have catastrophic effects on patients.

Full-contact sportsmen need not apply. A heavy blow on the right side of my back and I don't have another kidney to fall back on. But modern surgical techniques have transformed what was once a groundbreaking surgical procedure into the relatively mundane.

Having been through the procedure, if I were in severe financial difficulties and had a spare organ, the operation would be well worth $50,000. But once word got out that people could earn substantial money for a relatively risk-free operation that involves minimal discomfort and not too much time off work, we could well see renal patients holding the upper hand for once as potential donors begin undercutting each others' prices.

This story was found at: http://www.smh.com.au/articles/2008/05/07/1210131061931.html