Effective Altruism Forum
EA Forum

Hide table of contents
by Rasool
3 min read 2

29

Kidney donation
Frontpage

TL;DR: for a kidney donation to a stranger, the health requirement for the donor is relatively high. The timescale for the whole process is on the order of months

Rigor: I didn't take detailed notes during the process, so am reconstructing this based on call/email logs and memories of conversations. I'm >80% sure I've hit all the major points, though the process may have changed recently. Happy to make edits if anyone has more up to date info.

Edit: A more thorough and up to date post on this topic can be found here

Introduction

In the UK, the process of donating your kidney to a stranger is known as a 'non-directed altruistic donation'. There is some information online, certainly more than when I applied in 2020 but I thought I'd share my personal experience.

Non-directed altruistic donations are used in 'chains', where your donation would facilitate 3+ transplants.

You cannot legally sell your kidney in the UK, only donate.

Process

The process is roughly as follows:

  1. You send an email registering your interest. You can see which hospitals offer kidney donations and then apply to the one most convenient to you. In London there were 4 options (I chose the Royal Free Hospital in Hampstead)
  2. You receive a ~30 minute screening call from a nurse. This is basically to ensure that you understand what you've registered for and aren't acting rashly or being coerced.
  3. A 1-2 hour in-person/video call with a psychologist. Among other things they want to check your motivations for donating, for example that you aren't doing it in response to a recent trauma. There were also some questions about how you would feel if you were unable to donate, the fact that you don't get to pick who gets your kidney, and about the fact that there is little recognition or kudos after the surgery is complete.
  4. Blood and urine tests, blood pressure tests, and chat with a nurse about the surgery/recovery etc. Probably a total of 1-2 hours in the hospital.
  5. Meeting with a renal doctor to discuss test results and the surgery/recovery etc. Around 1 hour in the hospital.
  6. Full day of tests to check your kidney function. It involves ingesting something with a radioactive trace in the morning, then making you do a bunch of stuff, and seeing how it gets processed.
  7. Your application gets submitted to some kind of review board which meets quarterly. At this stage apparently they consider your application closely to make sure that you aren't being coerced or paid.
  8. You wait for a match...

My journey

I personally did not make it past step 5. I was a reasonably fit and healthy 30 year old, but with a family history of cardiovascular disease and diabetes which meant I was too high-risk for a non-directed altruistic donation, but would have still been allowed to donate to a friend or family member.

Why they didn't screen for this earlier on in the process I don't know.

Practicalities

  • Communication was pretty disorganised, a lot of stuff was arranged over the phone only, with no follow up email/text, and no way of contacting anyone to confirm/rearrange/cancel.

  • Things took a long time to progress from one step to the next. I initially applied in August 2020, but did not speak to the psychologist until April 2021, with my final meeting with the renal doctor in July 2021.

  • I was told that the NHS would reimburse travel expenses but I didn't enquire into this.

  • Most availability for these steps are at the same time each week (eg. the slots for you to go to the hospital for tests are only Thursday afternoons). As you can imagine these are during work hours Monday-Friday.

P.S. My motivation

Lots has been written about kidney donation through the lens of effective altruism (there's even a forum tag on the topic!), including a recent post which is what spurred me to write this post.

While I did like Alexander Berger's point of view, what resonated with me more was Dylan Matthew's argument, that while it may be more efficient for an individual to donate to charity (the time spent recovering from kidney surgery I could have instead worked and donated the money for more QALYs saved), donating a kidney could serve as a symbol and a talking point to influence those around me to create a kind of multiplier effect.

29

0
0

Reactions

0
0

More posts like this

Comments2


Sorted by
New & upvoted
Click to highlight new comments since:
Heye Groß1
0
0

If anyone from Germany is wondering, just found out that it's not possible to donate a kidney "altruistically" in Germany. You have to be a direct relative or a spouse.

Reply
Rasool1
0
0

I just came across an interesting (and not too long) article on this point. Quoting the juicy parts:

In 1996, Dr. Jochem Hoyer, a well-known German surgeon and head of a transplantation unit at a university hospital was told by a colleague, “It is easy for you as a transplant surgeon to praise living donors as long as it is NOT you who has to donate, but someone else.”3 Hoyer then voluntarily donated a kidney to an unknown recipient on the Munich waiting list4 with the idea that this would make a “very strong statement.”5

His action led to proposals in Germany for nondirected donation. However, the German Transplantation Act of 1997 prohibited nondirected transplants from living donors.6 Opponents of nondirected transplants feared that this would produce a market in which donors would expect financial compensation. Some surgeons did think that if organs from living donors were to go to someone to whom the donor felt connected, donations might increase.7

One change that might be attributed to Dr. Hoyer’s donation was a substantial increase in the percent of living kidney donations in Germany, jumping from 4% to 20% of all renal transplants.8 The 1997 Transplantation Act was legally challenged, but the German Constitutional Court upheld it.9 In 2012, regulations permitted only first- and second-degree relatives, spouses, and registered life partners to receive a kidney from a living donor. No nondirected donations were allowed.10 This was reaffirmed in 2018: “Altruistic or anonymous [kidney] donation is legally not allowed.”11

Dr. Hoyer stated that it is “…incomprehensible that legislation…disapproves of a consistently lived Christian charity by refusal of an altruistic nondirected donation.”12 Dr. Hoyer was fired from the institution in which he had worked for thirty years.

Reply
More from Rasool
104
Kurzgesagt video on factory farming
Rasool
· · 1m read
4
4
138
GiveWell raised less than its 10th percentile forecast in 2023
Rasool
· · 1m read
10
10
40
UK to cut its international aid budget 40% from 2027
Rasool
· · 1m read
5
5
View more
Curated and popular this week
 ·  · 4m read
 · 
Forethought[1] is a new AI macrostrategy research group cofounded by Max Dalton, Will MacAskill, Tom Davidson, and Amrit Sidhu-Brar. We are trying to figure out how to navigate the (potentially rapid) transition to a world with superintelligent AI systems. We aim to tackle the most important questions we can find, unrestricted by the current Overton window. More details on our website. Why we exist We think that AGI might come soon (say, modal timelines to mostly-automated AI R&D in the next 2-8 years), and might significantly accelerate technological progress, leading to many different challenges. We don’t yet have a good understanding of what this change might look like or how to navigate it. Society is not prepared. Moreover, we want the world to not just avoid catastrophe: we want to reach a really great future. We think about what this might be like (incorporating moral uncertainty), and what we can do, now, to build towards a good future. Like all projects, this started out with a plethora of Google docs. We ran a series of seminars to explore the ideas further, and that cascaded into an organization. This area of work feels to us like the early days of EA: we’re exploring unusual, neglected ideas, and finding research progress surprisingly tractable. And while we start out with (literally) galaxy-brained schemes, they often ground out into fairly specific and concrete ideas about what should happen next. Of course, we’re bringing principles like scope sensitivity, impartiality, etc to our thinking, and we think that these issues urgently need more morally dedicated and thoughtful people working on them. Research Research agendas We are currently pursuing the following perspectives: * Preparing for the intelligence explosion: If AI drives explosive growth there will be an enormous number of challenges we have to face. In addition to misalignment risk and biorisk, this potentially includes: how to govern the development of new weapons of mass destr
jackva
 ·  · 3m read
 · 
 [Edits on March 10th for clarity, two sub-sections added] Watching what is happening in the world -- with lots of renegotiation of institutional norms within Western democracies and a parallel fracturing of the post-WW2 institutional order -- I do think we, as a community, should more seriously question our priors on the relative value of surgical/targeted and broad system-level interventions. Speaking somewhat roughly, with EA as a movement coming of age in an era where democratic institutions and the rule-based international order were not fundamentally questioned, it seems easy to underestimate how much the world is currently changing and how much riskier a world of stronger institutional and democratic backsliding and weakened international norms might be. Of course, working on these issues might be intractable and possibly there's nothing highly effective for EAs to do on the margin given much attention to these issues from society at large. So, I am not here to confidently state we should be working on these issues more. But I do think in a situation of more downside risk with regards to broad system-level changes and significantly more fluidity, it seems at least worth rigorously asking whether we should shift more attention to work that is less surgical (working on specific risks) and more systemic (working on institutional quality, indirect risk factors, etc.). While there have been many posts along those lines over the past months and there are of course some EA organizations working on these issues, it stil appears like a niche focus in the community and none of the major EA and EA-adjacent orgs (including the one I work for, though I am writing this in a personal capacity) seem to have taken it up as a serious focus and I worry it might be due to baked-in assumptions about the relative value of such work that are outdated in a time where the importance of systemic work has changed in the face of greater threat and fluidity. When the world seems to
Sam Anschell
 ·  · 6m read
 · 
*Disclaimer* I am writing this post in a personal capacity; the opinions I express are my own and do not represent my employer. I think that more people and orgs (especially nonprofits) should consider negotiating the cost of sizable expenses. In my experience, there is usually nothing to lose by respectfully asking to pay less, and doing so can sometimes save thousands or tens of thousands of dollars per hour. This is because negotiating doesn’t take very much time[1], savings can persist across multiple years, and counterparties can be surprisingly generous with discounts. Here are a few examples of expenses that may be negotiable: For organizations * Software or news subscriptions * Of 35 corporate software and news providers I’ve negotiated with, 30 have been willing to provide discounts. These discounts range from 10% to 80%, with an average of around 40%. * Leases * A friend was able to negotiate a 22% reduction in the price per square foot on a corporate lease and secured a couple months of free rent. This led to >$480,000 in savings for their nonprofit. Other negotiable parameters include: * Square footage counted towards rent costs * Lease length * A tenant improvement allowance * Certain physical goods (e.g., smart TVs) * Buying in bulk can be a great lever for negotiating smaller items like covid tests, and can reduce costs by 50% or more. * Event/retreat venues (both venue price and smaller items like food and AV) * Hotel blocks * A quick email with the rates of comparable but more affordable hotel blocks can often save ~10%. * Professional service contracts with large for-profit firms (e.g., IT contracts, office internet coverage) * Insurance premiums (though I am less confident that this is negotiable) For many products and services, a nonprofit can qualify for a discount simply by providing their IRS determination letter or getting verified on platforms like TechSoup. In my experience, most vendors and companies
Relevant opportunities
162
Forethought: A new AI macrostrategy group
5 authors
· · 4m read
5
5
8
EA Organization Updates: March 2025
2 authors
· · 10m read
0
0
22
Kairos is hiring a Head of Operations/Founding Generalist
2 authors
· · 6m read
0
0
View more