A Cost-Benefit Analysis of Government Compensation of Kidney Donors

The latest issue of the American Journal of Transplantation has an excellent and comprehensive cost-benefit analysis of paying kidney donors by Held, McCormick, Ojo, and Roberts.

最新一期【译注:即2015年第十期】的《美国移植杂志》刊登了一篇由Held, McCormick, Ojo, 与 Roberts合著的文章,出色且全面地描述了关于支付捐肾者报酬的成本效益分析。

Earlier, Becker and Elias estimated that a payment of $15,000 per living donor would be sufficient to eliminate the US waiting list. The authors adopt a larger figure of $45,000 for living donors and $10,000 for deceased donors and find that even at these rates paying donors generates benefits far in excess of costs.

早些时候,Becker与 Elias就估算过,如果向每位活体捐赠者支付15,000美元,就会有足够的捐赠者来满足全美的肾脏移植需求。上述论文的作者们在分析中采用了更高的补贴数额,给予活体捐献者45,000美元,遗体捐献者10,000美元。结果显示,即使以这样的高价格补贴捐献者,其产生的效益也远超过成本。

In particular, a program of government compensation of kidney donors would provide the following benefits (quoting from the article):


  • Transplant kidneys would be readily available to all patients who had a medical need for them, which would prevent 5000 to 10 000 premature deaths each year and significantly reduce the suffering of 100 000 more receiving dialysis.
  • 所有有医疗需求的患者都能够顺利地获得肾脏移植,每年将会挽救5,000至10,000例早逝患者,并为超过100,000名依赖透析的患者极大地减缓病痛。
  • This would be particularly beneficial to patients who are poor and African American because they are considerably overrepresented on the transplant waiting list. Indeed, it would be a boon to poor kidney recipients because it would enable them to reap the great benefits of transplantation at very little expense to themselves.
  • 穷人和非裔病患将尤其从中受益,因为他们在移植等候名单中明显占据了多数。对于贫苦的肾脏移植接受者来说,这的确是一件好事,因为这将使得他们能以非常低的价格享受到肾脏移植的巨大好处。
  • Because transplant candidates would no longer have to spend almost 5 years receiving dialysis while waiting for a transplant kidney, they would be younger and healthier when they receive their transplant, increasing the chances of a successful transplantation.
  • 因为移植接受者将不必再依赖透析等待近5年,他们接受移植的时候也会更加年轻与健康,移植的成功率将会得到提高。
  • With a large number of transplant kidneys available, it would be much easier to ensure the medical compatibility of donors and recipients, which would increase the success rate of transplantation.
  • 由于有大量的肾脏可供移植,捐献者与受移植者在医学上的相容性会更容易得到保障,这也会提高移植的成功率。
  • Taxpayers would save about $12 billion each year. Dialysis is not only an inferior therapy for end-stage renal disease (ESRD), it is also almost 4 times as expensive per quality-adjusted life-year (QALY) gained as a transplant.
  • 纳锐人将因此每年节省大约120亿美元。对末期肾衰竭(ESRD)患者来说,肾透析不仅是一种次等的治疗方法,而且延长每个经质量调整寿命年(QALY)的花费,几乎是肾移植的四倍。【译注:QALY是一种经调整的期望寿命,其计算方式是将实际年数乘上该健康状态下的效用价值。如果在效用价值为5的健康状态持续3年,QALY就等于1.5,相当于保持1.5年的完美健康状态。】



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