Dr. Avci is currently a Post-Doctoral Fellow at the Grefenstette Center for Science, Technology, and Law at Duquesne University. He has an MA in Political Sciences from Hacettepe University (Turkey), an MS in Healthcare Administration from the University of New Haven (CT, USA), and a Ph.D. in Healthcare Ethics from Duquesne University (PA, USA). He worked for the Ministry of Health in Turkey as a Health Inspector for over 20 years. As an adjunct faculty, he has also taught ethics and health-related courses at different universities, including Chatham University and Carlow University. Dr. Avci has several peer-reviewed articles and book chapters on a wide range of topics in the bioethics field. Dr. Avci’s research interests lie in several sub-areas of bioethics, including ethics education, clinical ethics, public health ethics, end-of-life ethics, religious ethics, global health ethics, and AI ethics.
The need for rethinking about kidney donation systems
Ercan Avci1.
1Duquesne University, Pittsburgh, PA, United States
According to the World Health Organization’s (WHO) Global Observatory on Donation and Transplantation (GODT) data, in 2022, 26,310 kidney transplants (20,446 from deceased donors and 5,864 from living donors) were performed in the United States. In the same period, in Turkiye, 3,621 (281 from deceased donors and 3,340 from living donors) and globally, 102,149 (62,505 from deceased donors and 39,644 from living donors) kidney transplants were performed.1 The numbers demonstrate that the rate of kidney transplants from deceased donors was 61.19% globally, 77.71% in the United States, and 7.76% in Turkiye.
Turkiye's low deceased donation rate may be explained through several religious, cultural, and social factors.2 However, neither globally nor in the United States can the current total donation and transplant rates reduce the number of people on kidney transplant waiting lists.3
The GODT data also indicates that in two decades (between 2000 and 2022), deceased kidney donations remarkably increased in the United States and globally but did not show significant changes in Turkiye. On the other hand, living kidney donation numbers have stayed stable in the United States, fluctuated globally, and increased in Turkiye in that period.4
Despite the increasing need for kidney transplants, stable numbers or slight changes in living kidney donation should urge the public, authorities, and scholars to rethink organ donation systems. At that point, this presentation aims to highlight the need for organ donation and propose an incentivized model to increase kidney donation from living donors. The model suggests lifetime health insurance, exemptions from copayments/contribution shares, priorities for receiving an organ and getting a job, income tax exemptions for salaried employees, and free or discounted public utilities for living donors. The model can promote donors’ altruistic acts and solidarity and loyalty among members of a society without violating ethical values and internationally accepted principles.5
References:
1- Global Observatory on Donation and Transplantation (GODT). https://www.transplant-observatory.org/summary/.
2- Avci, Ercan. "Should We Formulate an Incentivized Model Facilitating Kidney Donation from Living Donors? A Focus on Turkey's Current System." Developing World Bioethics 18, no. 3 (2018): 279-290.
3- Cheng, Xingxing S. et al. "Trends in Cost Attributable to Kidney Transplantation Evaluation and Waiting List Management in the United States, 2012-2017." JAMA network open 5, no. 3 (2022): e221847-e221847.
- Wu, Diana A. et al. "Global trends and challenges in deceased donor kidney allocation." Kidney International 91, no. 6 (2017): 1287-1299.
4- Global Observatory on Donation and Transplantation (GODT). https://www.transplant-observatory.org/summary/.
5- Avci, Ercan. "Should We Formulate an Incentivized Model Facilitating Kidney Donation from Living Donors? A Focus on Turkey's Current System." Developing World Bioethics 18, no. 3 (2018): 279-290.
