Paying living donors to donate their kidneys to patients undergoing dialysis could be cost-effective, say researchers. Barnieh et al. report that if paying CAN$10,000 per kidney increased the number of living donors by 5%, the incremental cost saving and gain in quality-adjusted life years (QALYs) per recipient would be $340 and 0.11, respectively. If the number of donors increased by 20%, a cost saving of $4,030 and gain in QALYs of 0.39 per recipient could be achieved.