London, June 15 (IANS) A debate on the sale of kidneys has thrown up the idea of a regulated system of compensation, but opponents have slammed it, saying such a system would not hold in poorer countries like India. Writing in the British Medical Journal, Arthur Matas of the University of Minnesota suggested that regulated compensation systems for living donors may be the solution to the growing shortage of kidneys for transplantation.

The current unregulated systems in developing countries, he said, only benefited the rich, and provided no long term donor follow-up, or protection for either the buyer or seller.

A regulated compensation system, he argued, would increase the number of available organs, provide strict control and limit harm by allowing every candidate an opportunity for transplant, full donor evaluation, informed consent, and long-term health follow-up.

The payment gateway could be managed by the government or insurance companies, and all other forms of commercialisation would be banned, he said.

Countering this argument, Jeremy Chapman of the Centre for Transplant and Renal Research in Sydney, said such a system may end up reducing the supply of all organs.

He said the idea of the regulated market is a myth, which could have devastating consequences on the less easily regulated environments of Asia and Africa.

According to Chapman, selling organs does not help lift people out of poverty. In India and Pakistan people sell their kidneys to pay off debts, but they continue to live below the poverty line, and recent data show that 86 percent report deteriorating health after organ removal.

In addition, he asked, which family member would donate if the government is willing to pay for a kidney? Many would prefer a stranger rather than a family member to take the risk.

What’s more, he added, if a kidney is worth money before death, then rather than donating, families may demand money for all sorts of organs after death.

The reality of regulated organ purchase will be a reduction in organ donation, and the destruction of kidney, heart, lung, liver, and pancreas transplantation, he concluded.

Matas, however, has pointed out that Western societies already compensate people for sperm, ova, surrogate motherhood, and loss of body parts in court cases without any loss of dignity or humanity.

He has thus concluded that a trial of compensation for living donation should be allowed to learn if the number of kidneys could be increased while protecting the dignity and humanity of the donors.