As more patients than ever desperately wait for a donor… would you donate a kidney if the NHS paid you £35,000?

More patients than ever are desperately waiting for a new kidney.

According to the latest figures, there are 10 percent more people on the waiting list for a transplant than a year ago.

In the UK, around six people a week die while waiting for a kidney transplant, often after years of being on dialysis.

But the real number may be higher. Hundreds more are removed from the list each year because their deteriorating health makes them unfit.

The reason is simple: a chronic shortage of kidneys from living or deceased donors. As a result, demand far exceeds supply.

This is exacerbated by rising obesity levels in the UK, with hundreds of thousands more patients set to develop kidney disease over the next decade as a result.

Obesity (defined as a BMI of 30 and above) carries a nearly fourfold increased risk of end-stage kidney disease compared to people who fall within the normal range. So what’s the solution?

As a researcher investigating alternative means of obtaining organs for transplantation, I have taught and written about xenotransplantation: the use of animal cells, tissues, and organs in human patients.

This year in the US, a 62-year-old man became the first living person to receive a genetically modified kidney from a pig, a groundbreaking operation.

The surgery appeared to be a success. But the patient died in May – so it could be years before we know if this approach is safe and effective.

What we do know is that transplanting a human organ is the best treatment for end-stage renal failure.

Unlike many other forms of organ donation, it is possible to donate a kidney while you are alive, as you only need one of the two kidneys to survive.

But how do we ensure that more is available?

All areas of the UK effectively have a consent opt-out system. Every adult is deemed to have consented to organ donation after death, unless they have recorded a decision not to donate. However, there are still not enough.

But we could increase availability by financially compensating those who choose to donate – in other words, by paying them.

This is currently illegal in the UK and some people will be shocked by a scheme where people are paid for their kidneys.

This year, a 62-year-old man in the US became the first living person to receive a genetically modified pig kidney in a groundbreaking operation. Pictured: Surgeons at Massachusetts General Hospital in Boston prepare the pig kidney for transplant in March 2024

Surgeons perform the world’s first genetically modified pig kidney transplant into a living human on March 16, 2024 at Massachusetts General Hospital in Boston

What I am proposing is not an illegal scam, but a regulated system where the NHS pays living kidney donors.

Donating a kidney requires general anesthesia, a three to five day hospital stay, and a recovery time of up to three months. It is relatively safe, but not without risk.

Getting paid would be a fairer way to compensate donors for the risk they take, attract more donors and raise awareness that more organs are needed.

I propose a ‘monopsony’ system, where the NHS is the only ‘buyer’. Living donors can still choose whether or not they want to receive payment.

This rules out private extortionists as the NHS would not actively offer kidneys but would offer an option for compensation in exchange for the welfare of the individual and society.

So how much should we pay? I think £35,000 tax-free might be appropriate. This is just above the average annual full-time income in the UK of £33,000 in 2022 and would reflect the generosity of the donor.

We NEED to know what public sentiment is FIRST. But a US study found that cash incentives increased the likelihood of people donating – and not just among those who needed money.

The benefits could be enormous: shorter waiting times for transplants, less pressure on dialysis services and fewer deaths among those waiting. It costs the NHS £34,000 a year per patient for kidney dialysis. With many years of waiting for an organ, that’s a lot of money.

Around six people a week die in the UK while waiting for a kidney transplant – often after several years on dialysis. But the true figure could be higher, with hundreds more taken off the list each year because their declining health makes them unfit (stock image)

But does paying reduce the value of donating?

No, because compensating people for doing good things and accepting some risk in doing so does not diminish the good or make payment immoral.

It would remain illegal for an individual to pay someone else for their kidney. The process would be overseen by the Human Tissue Authority, the independent regulator that ensures human tissue is used ethically.

Given the organ shortage, I truly believe it is time to start paying living kidney donors to treat donors more fairly, increase the number of available organs, and help save more lives.

• Daniel Rodger is a Senior Lecturer in Operating Theatre Practice at the Institute of Health and Social Care, London South Bank University.

AS TOLD TO ANGELA EPSTEIN