Wednesday, 29 January 2014

Want to Sell Your Kidney?

We read stories about selling kidneys with a lot of distaste.  Usually some person from a very poor country receives a small amount of money (which might seem like a lot to them), them a middle-man receives a much much larger amount, passing it on to a surgeon (or rather passing on the poor person for surgery) and the surgeon makes an even larger amount for carrying out the operation.

We found several such reports back in 2011, although the links to the news items don't seem to work. but the article is still worth reading.

A recent article in the Wall Street Journal looks at the number of people in the US who are on the waiting list for a new kidney and the number who get one, and asks the question is there a case of a market for organs.

The article is by Gary S. Becker and Julio J. Elias.
Mr. Becker is a Nobel Prize-winning professor of economics at the University of Chicago and a senior fellow at the Hoover Institution.
Mr. Elias is an economics professor at the Universidad del CEMA in Argentina

The article says
"Finding a way to increase the supply of organs would reduce wait times and deaths, and it would greatly ease the suffering that many sick individuals now endure while they hope for a transplant. The most effective change, we believe, would be to provide compensation to people who give their organs—that is, we recommend establishing a market for organs."

Then points out that
"For example, people age 45 to 49 live, on average, eight additional years if they remain on dialysis, but they live an additional 23 years if they get a kidney transplant. That is why in 2012, almost 4,500 persons died while waiting for kidney transplants."

It goes on to compare the cost of dialysis over the average waiting time for a transplant (they say it's $350,000) with the cost of a transplant operation (they say it's $150,000).  Clearly it would be cost effective to pay someone, say $100,000 for a kidney and after adding in the cost of the transplant operation, taking the total up to $250,000, compared to the total for the dialysis and the operation - $500,000.  And of course significantly lengthen the life of the recipient, rather than risk them dying before they ever receive a new kidney.

The paper estimates that you could probably find people willing to sell a kidney for around $15,000 although they think the price could be between $5,000 to $25,000. (For $100,000 you could have mine tomorrow, but not for $25,000. Especially if the cost of dialysis over four or five years is $350,000.)

You can legally sell your kidney in some countries, and the article says that in Iran the price is a mere $4,000 and this has eliminated waiting times. Given the incomes in Iran (one quarter of that in the US), this roughly matches their estimate of what it would cost in the US. They suggest that such a scheme could totally eliminate the kidney shortage, as many people would be willing to sell at that sort of price.

They also suggest payments to people who say their organs can be used when they die (any organ). The payment would then go to their relatives (damn I was just about to check what I could go with that money if only it was paid in advance...)

The article points out that the rich can simply go to another country and deal in the underground illegal kidney market, leaving more kidneys for those who would have to wait their turn.

The article finishes by suggesting that this will happen one day, and then people will wonder why it took so long to become acceptable.

Thought proving, isn't it.  Immoral? To be honest, when a donor is paid a fair amount, rather than exploited, it's not that bad.  It's those from poor backgrounds getting a few $100 that is the immoral bit, especially if the surgeon is counting his/her pay in the tens of thousands.  Would altruistic donors continue to just give? Perhaps.  They can still be generous to help those from a poor background, the ones who currently suffer the most.

And finally, have you tried putting kidney for sale in to Google? !

Sunday, 22 December 2013

Billboard Advert - I Need a Kidney

When you need a transplant, things can get a bit desperate after a long wait with no sign of success. so one couple decided to take a bold step and advertise for a donor.

Sharon Nelson, 73, had been on the waiting list for quite some time when she and her husband James decided to rent a billboard on the Interstate 70. After that James went out, climbed up a ladder and painted the problem in rather large letters.

A nurse at their clinic said she knew a Milwaukee man who had found a donor for himself after renting a billboard. So they decided to give it a try.

Hopefully they will find someone. Until the right donor comes through it's just a matter of waiting, so she and husband can move on with their lives, Nelson said.

According to the National Kidney Foundation, over 96,000 people in the United States are waiting for a kidney transplant.

Original article can be seen here.

Wednesday, 4 December 2013

FDA Approves Velphoro for Kidney Disease Patients

Velphoro® (sucroferric oxyhydroxide) has received US Food and Drug Administration (FDA) approval for the control of serum phosphorus levels in patients with Chronic Kidney Disease (CKD) on dialysis. Velphoro® will be launched in the US by Fresenius Medical Care North America in 2014.

Velphoro® (previously known as PA21) is an iron-based, calcium-free, chewable phosphate binder. US approval was based on a pivotal Phase III study, which met its primary and secondary endpoints. The study demonstrated that Velphoro®successfully controls hyperphosphatemia with fewer pills than sevelamer carbonate, the current standard of care in patients with CKD on dialysis. The average daily dose to control hyperphosphatemia was 3.3 pills per day after 52 weeks.

Hyperphosphatemia, an abnormal elevation of phosphorus levels in the blood, is a common and serious condition in CKD patients on dialysis. Most dialysis patients are treated with phosphate binders.

Read Vifor Pharma's press release

Viforo Pharma are part of of the Galenica Group, which in turn is part of Fresenius.

Friday, 15 November 2013

Scottish Kidney Project Receives Major Grant!

A EUROPEAN-wide project, being co-ordinated by experts at Dundee University, has received a grant of £2.2 million to investigate new ways of improving kidney dialysis treatment. The European Union’s Marie Curie Partnership and Pathways programme has award £2.2 million to further the project's work. (That's about $3.5 million for our American readers.) A vast number of patients receive hemodialysis three times a week, in sessions lasting three to four hours. The dialysis equipment is connected to their blood supply through an access point grafted in to their body. A Dundee University spokesman explained: “The problem is that these vascular access sites fail in at least half of patients within the first year, leading to increased infections, hospital stays and operations. The ReDVA consortium will examine the problems that occur during long-term haemodialysis and look to improve the performance of vascular access that underpins the life-supporting dialysis techniques. “The academic members of the consortium will work with work with biotechnology experts at the University of Limerick in Ireland, Guerbet, a global imaging contrast company in France and Dundee-based Vascular Flow Technologies to investigate venous access and develop new clinical technologies, methodologies and devices to improve their performance.” He added: “The four-year project will see staff seconded between the universities and the industry partners as well as creating five new research posts.” “New techniques in imaging the vessel with ultrasound and MRI before it blocks, combined with improved surgical technique and vascular devices offers a real prospect of improving the lives of kidney failure patients. The research group offers an unparalleled range of expertise in surgery, imaging, and engineering to tackle this problem.” The grant is to the ReDVA Project. The ReDVA (Development of hemodynamic solutions in Renal Dialysis Venous Access) project is a team of scientists from the Dundee University Medical School, Birmingham's Queen Elizabeth Hospital and developers from industry. There are a few more details in the story published in

Wednesday, 13 November 2013

Overnight Dialysis Boosts Heart and Kidney Health

Regular dialysis can really wear you out! Three days a week in a clinic for hours on end certainly takes its toll. Overnight dialysis is less tiring, taking place while you sleep, but recent research suggests it gives you more than just a rest! Have a read of the research paper in the Canadian Journal of Cardiology

Nocturnal home hemodialysis (NHD) could soon become a popular way to be treated. And it can be quite straightforward as well. After examining 17 patients responses to NHD, the spokesman for the group of medical scientists from Toronto, cardiologist Dr. Christopher Overgaard, said that "Longer dialysis, done while patients are sleeping, may improve the health of arteries and could lower the risk of developing heart disease."

While they are sleep, the patients are clearing their systems of more waste, and in a less disruptive manner, than they would be by going to their normal clinic several times a week.

And the heart benefit? The scientists found that coronary endothelial responsiveness — or how well the layer of cells along the inner lining of blood vessels functions — was partially improved with overnight dialysis. This finding is crucial for patients with impaired endothelial function, which is linked to accelerated atherosclerosis — or the hardening of arteries leading to the heart—in kidney disease patients.

Just imagine - a simple change in how the treatment is given and the patient's health improves. And it is less stressful than the standard hemodialysis treatment too!