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U. S. Ethics surrounding kidney donations result in needless deaths

The Kidney Sellers: A Journey of Discovery in Iran

By Sigrid Fry-Revere, J.D., Ph.D. 
Published by Carolina Academic Press

Copyright March 10, 2014

Genre:  Creative non-fiction, non-fiction adventure (adult and young adult)

ISBN 978-1-61163-512-6


According to Sigrid Fry-Revere, ethics consultant for the Washington Regional Transplant Community’s Organ and Tissue Advisory Committee, there were more than 100,000 people on the waiting list for a kidney transplant in the United States at the end of 2013 and about 400,000 people on dialysis.

The sad truth, she says, is that many of them will die because there are not enough cadaver kidneys to meet their needs and those on dialysis usually only survive for approximately four years.

“Every year only about 15% of those on the active waiting list get transplants,” she writes. “Most will die waiting. Another 7–8% die or drop off the list (because they are too sick for an operation) without getting a kidney. This translates to approximately 20-25 American dialysis patients dying needlessly every day.”

Why is this happening in such a progressive country? Fry-Revere says it is because Congress passed the National Organ Transplant Act (NOTA) in 1984 that prohibited anyone from paying for organs. On top of that, doing so could result in a fine of $50,000 and up to five years in jail.

Based on the ethics that body organs should not be up for sale, this system is why those wealthy enough sometimes turn to purchasing a kidney on the black market. Fry-Revere notes “ a thousand or more Americans purchase illegal organs (mostly abroad) every year.” However, the black market is totally unregulated leaving patients open to contracting such diseases as “HIV, hepatitis and even cancer from improperly screened donors.” And she adds, “Donors are lied to, cheated, and left without sufficient post-operative care.”

The wealthy can also afford to get an operation as well as take the needed time off work. Thus the poorer folks are the ones more likely to die. Fry-Revere, who is also project director of the Center for Ethical Solution’s SOS (Solving the Organ Shortage) project, views this situation as unacceptable, especially when she learns that a much smaller country - Iran – has solved the problem of kidney shortages.
“The United States should be ashamed to be outdone by a country like Iran,” she notes.

Fry-Revere spent two months in Iran interviewing physicians, nurses, kidney sellers and patients, as well as administrators of non-governmental, non- profits called Anjomans that arrange kidney sales in that country. She became the first person ever to document interviews on film and what she learned about the Iranian’s legal compensation system has proved invaluable.

One cannot read this book without feeling deep sympathy for not just the kidney patients who die each year in the U.S. but also for the families who are forced to watch them slowly dwindle away on dialysis. For Fry-Revere it also strikes close to home because her own son was diagnosed with kidney cancer when he was just 10 months old.

For this writer living in Canada brings the same restrictions as the U.S. I could only helplessly watch as a good friend and former co-worker on dialysis slide toward death’s door. According to Organ Donation and Transplantation in Canada, kidney donations have not increased over the past 10 years and ironically it is believed that copying the U.S. would provide the solution.

This book is a work of creative non-fiction. As such Fry-Revere, who is also president of Stop Organ Trafficking Now, uses not just her own knowledge of the situation but also relates the stories of others both in the U.S. and Iran in a way that is informative, interesting, easily readable and most importantly, heartfelt. Travel along with this courageous woman, who took her chances filming interviews without government permission. Find out why the 25-year-old Iranian system works and what problems still exist. Learn how donors are compensated and kidney patients are helped. Also discover how administrators, donors and patients deal with the ethical problems that have caused the U.S. to refuse to institute a similar system. Most importantly, learn what life on dialysis is really like. It will surely break your heart.

Aside from compelling personal stories, Fry-Revere also gives us a glimpse of life in current-day Iran that is far different than what the media and the U.S. government have led us to believe. This book is definitely worth five stars and a must-read that is hard to put down.


To pick up a copy of The Kidney Sellers: A Journey of Discovery in Iran, go to

Amazon link:


All author royalties go to support the SOS, Solving the Organ Shortage, project



To view photos that Sigrid Fry-Revere took while in Iran, go to  For a discussion of the center’s Solving the Organ Shortage project and other related issues, go to:


Author’s site:

Facebook page:

Other sources: Organ Donation and Transplantation in Canada

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