This team of Israelis campaigns for a regulated system of organ sales and outlines its possible structure. Officially, organ sales are banned by the Ministry of Health today though it is not technically illegal. Unofficially, it is an “open secret” amongst the end stage renal disease community that kidneys can be bought and transplanted in developing countries with post-transplant follow-up provided by the Israeli government. Under the proposed system, kidney sales would be sanctioned by law and coordinated by Israel Transplant. Suitable donors would undergo the same workup already in place for cadaveric donors. Donor fee would be standardized by the Ministry of Health and paid post-operative by Israel Transplant, which would also be responsible for long-term donor follow-up. Any commercial transplantation outside this framework would be made illegal. Establishing a regulated system for organ sales could reduce overall cost of kidney disease patient management while ensuring better care for donors and recipients.