Economic and Health Consequences of Selling a Kidney in India

 Madhav Goyal, MD, MPH; Ravindra L. Mehta,MBBS, MD; Lawrence J. Schneiderman, MD; Ashwini R. Sehgal, MD

Context  Many countries have a shortage ofkidneys available for transplantation. Paying people to donate kidneys is oftenproposed or justified as a way to benefit recipients by increasing the supplyof organs and to benefit donors by improving their economic status. However,whether individuals who sell their kidneys actually benefit from the sale iscontroversial.

Objective  To determine the economic and healtheffects of selling a kidney.

Design, Setting, andParticipants  Cross-sectional survey conducted in February 2001 among 305 individualswho had sold a kidney in Chennai, India, an average of 6 years before thesurvey.

Main OutcomeMeasures  Reasonsfor selling kidney, amount received from sale, how money was spent, change ineconomic status, change in health status, advice for others contemplatingselling a kidney.

Results  Ninety-six percent of participantssold their kidneys to pay off debts. The average amount received was $1070.Most of the money received was spent on debts, food, and clothing. Averagefamily income declined by one third after nephrectomy (P<.001), andthe number of participants living below the poverty line increased. Threefourths of participants were still in debt at the time of the survey. About 86%of participants reported a deterioration in their health status afternephrectomy. Seventy-nine percent would not recommend that others sell akidney.

Conclusions  Among paid donors in India, sellinga kidney does not lead to a long-term economic benefit and may be associatedwith a decline in health. Physicians and policy makers should reexamine thevalue of using financial incentives to increase the supply of organs fortransplantation.