Following up on my SHS post from earlier today that disagreed with Sally Satel’s push to legalize a market in live kidney donation to ease the organ shortage, I did a little digging on the risks. Although the surgery is generally considered quite safe, and donors appear to live as long as non donors after the surgery is over, it still carries very grave risks. For example, there is arterial bleeding, which as one study laid out pretty starkly, sometimes leads to death, morbidity, or serious complications. From the study:
In 213 surveys returned (24%), 66 and 39 episodes of arterial and venous hemorrhage were reported, respectively. Among arterial control problems, 2 resulted in donor death and 2 resulted in renal failure; 19 episodes required transfusion. Open conversions in laparoscopic nephrectomy or late reoperations for hemorrhage were reported for 29 cases. Locking and standard clips applied to the renal artery were associated with the greatest risks.It may be one thing for someone to choose to risk these complications in order to give someone a kidney because they are a relative or simply out of the pure goodness of their hearts. But it is quite another to seduce sellers into such a market—who would mostly be the poor or the desperate—and persuade them into risking life and health for money, or a mortgage down payment, or health insurance—some of Satel’s suggested enticements. There is a word for that, and I am afraid it is exploitation.
Conclusions:
Significant hemorrhagic complications occur with living kidney donation in both open and laparoscopic approaches. Loss of arterial control jeopardizes donor life and health, especially when it occurs in the postoperative period.
