I think it makes sense to be wary of non-directed living donations or deceased donations. Clearly any sort of incentive system is pretty appalling. But what about a directed kidney or liver donation to a immediate family member?

Forcing someone to watch a loved-one die when they could have helped them outside of jail, seems cruel and unnecessary.

There is more time spent investigating potential organ donors but the absolute restrictions are actually much less strict. While blood supplies have been scarce over the last few years, availability of donor organs is extremely limited. And organs must be matched to a recipient in many ways aside from blood type (size for example).

So transplant medicine has gone to great lengths to maximize the potential for organ donations. This includes transplanting from donors who were incarcerated, are Hep C positive, or HIV positive. These risks do require a conversation between the recipient and their doctor, but may make sense in some cases (such as if the potential recipient is also Hep C positive or if it does not appear they would survive long enough to receive another organ offer).

A similar idea applies to tissue donation. People are more likely to die in a way that allows them to be tissue donors (skin, corneas, etc) and the recipient’s health is less critical. So there are stricter eligibility criteria for tissue donation than organ.

But regardless, I think this kind of incentive is a truly bad idea.