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ContextMany countries have a shortage of kidneys available for transplantation. Paying people to donate kidneys is often proposed or justified as a way to benefit recipients by increasing the supply of organs and to benefit donors by improving their economic status. However, whether individuals who sell their kidneys actually benefit from the sale is controversial.ObjectiveTo determine the economic and health effects of selling a kidney.Design, Setting, and ParticipantsCross-sectional survey conducted in February 2001 among 305 individuals who had sold a kidney in Chennai, India, an average of 6 years before the survey.Main Outcome MeasuresReasons for selling kidney, amount received from sale, how money was spent, change in economic status, change in health status, advice for others contemplating selling a kidney.ResultsNinety-six percent of participants sold their kidneys to pay off debts. The average …