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This paper addresses ethical, legal and psychosocial aspects of Global Kidney Exchange (GKE). Concerns have been raised that GKE violates the non-payment principle, exploits donors in low and middle-income countries, and detracts from the aim of self-sufficiency. We review the arguments for and against GKE. We argue that while some concerns about GKE are justified based on the available evidence, others are speculative and do not apply exclusively to GKE but to living donation more generally. We posit that concerns can be mitigated by imp
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