When the market rules, things can get a little haywire. It has been claimed, 17 Americans die each day waiting for a kidney: link, but given the state of health service delivery in the US, it is debatable how many of these 17 would get an organ if it could be purchased on the open market. The first consideration is cost. How much does the owner of the kidney get? and by owner, I mean the actual donor, not his agent, nor his broker, etc. Does the purchase price include the risk to the donor? It has been known for a donor to lose the other kidney – disease, accident, etc. There must be some reason we are born with two. At what stage do the negotiations begin? before, or after , compatibility is established? What controls are necessary? X might be able to afford a dozen kidneys, but is a poor risk for a transplant. Y is a better risk, in fact, is practically guaranteed to live out his threescore and ten, but cannot get because he has no insurance. You have to consider these anomalies. It is not like selling shoes.