There should be a clear and transparent process for providing information about risks to the donor, ensuring that the donor understands the operation and its risks and obtaining donor consent.
There should be a thorough donor screening evaluation using defined (and widely available) protocols. There should be well-defined and transparent criteria for donor acceptance.
There should be a fixed “incentive” to the donor so that all donors (in any one country) receive equal value. The package of incentives may vary from one geographic region to another but should be designed to improve the life of the donor. Even within the same region, it may be possible to have a choice of benefits recognizing that some incentives may be of value to some donors but not others.
The program (donors and recipients) should be limited to citizens and legal residents. This will allow long-term donor medical care and follow-up.
The donation should remain anonymous and there should be no contact between donor and recipient.
The donor should understand the need for long-term follow-up and should consent to follow-up.
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There should be a well-defined and transparent method to follow incentivized donors and study outcomes. There should be:
Studies of the impact of incentivized donation on the number of deceased and living donors, the number of transplants (covering all organs), the wait list and waiting time for a deceased donor transplant;
Comparisons of short- and long-term outcomes (including quality-of-life) of incentivized versus nonincentivized donors;
Studies of whether the incentive had an impact on the donor’s life.
