Policy analysis on cadaveric kidney donation and transplantation

The increase of successful rate of kidney transplantation has made this treatment as a major preference for patient with end-stage renal disease. As a result, the waiting list for kidney transplantation has been progressively increasing every year. This condition has forced many countries to make policies to increase the supply of kidney. This article discussed three major policies on cadaveric kidney donation. The first policy is opt-in system which requires people to register as a donor before their death (informed consent). The second policy is opt-out system in which every individual is automatically treated as a donor (presumed consent) unless otherwise requested. The third policy is regulated-paid donation in which the donors receive financial incentives for their kidney donation. The purpose of this study is to review these three main strategies including whether or not the policies have an impact to increase kidney donation. It was found that the reviewed policies have less effect on increasing the number of kidney sources. It seems that these policies were not effective without public willingness for renal donation. Furthermore, the transplantation facilities and procedures such as, transplant center hospitals, skilled medical personnel and transplant network also played important roles to increase kidney donation. As conclusion, to increase the supply of kidney, the implemented policy should be supported by good public attitudes and effective transplantation system.