Small steps towards a better world

It looks like New Zealand will implement a local version of MatchingDonors The Kidney Exchange as part of a push to improve organ donation and transplant figures. They'll also invest in training specialised ICU nurses to talk with families about donation options.

All of this is for the good. Live kidney transplants are pretty safe; living donors sharing a liver lobe also have pretty good outcomes [discussed here]. But few people would be willing to give a kidney or a liver lobe even to a friend given the reasonably large time commitment involved: frequent flights to Auckland for consultations, recovery time post-op. Compensation to living donors is pretty limited. So Matching Donors, which helps route around donor compatibility issues and increase the potential for altruistic donations, can make a big difference.

Israel experienced a big increase in transplant rates when they paired a Matching Donors system with compensation to living donors - expenses plus up to 40 days' lost wages. New Zealand could improve outcomes further here by making it less costly for donors to give organs.

We could do even better by considering things like Israel's priority law, which complements a binding organ donor registry with priority access to organs for those willing to be organ donors. Or, by requiring that transplant surgeons respect the wishes of members of LifeSharers: organ donors who prefer that first call on their organs goes to other organ donors.

We don't have to go all the way to complete markets in organs to improve outcomes. I'm glad New Zealand's taking a step in the right direction. Other useful steps:

• Compensate cadaveric organ donors with free funerals. It's odd that Otago can cover a cremation subsidy for those leaving their bodies to science, but we can't compensate organ donors for similar donations.
• Encourage LifeSharers as a way of boosting donation rates rather than try to stomp on it [see also here]. 
• Consider the other steps taken by Israel: priority access to donated organs for those signing on as organ donors. See here and here.
• Switching from opt-in to opt-out.

My prior posts on organ donation are on the "Organ markets" tag; some of them are linked above.