People typically come with two healthy kidneys. We only need one in order to survive, and therefore, the second one can be donated without much risk to the donor. In general, the procedure to donate a kidney is no more dangerous than any other surgery, although — being a surgical procedure — is not without risk. And as Virginia Postrel noted as an aside in the Atlantic, while blunt trauma or cancer can cause a healthy kidney to fail, kidneys typically fail in tandem in other situations. Therefore, leaving yourself with only one kidney isn’t as risky as many would believe.

But due to moral and practical concerns (which are subjects for other publications), selling one’s kidney is illegal in most of the world. In the United States, for example, in 2011, a New Jersey man was sentenced to two and a half years in prison for brokering kidney sales. Given the political and legal restraints upon transactions regarding kidneys and other organs, there are many creative solutions which are brought to bear. For example, a recent pair of Nobel laureates in Economics earned the award for their work in “matching theory” — which, as the New York Times noted, has practical applications for those in need of kidney donations.

And where there is room for a Nobel Prize, there’s probably room for its polar opposite: reality TV. As mental_floss notes (item #7), a Dutch television producer came up with a shocking concept: a show where three patients, each in need of a kidney, make their case to the audience. Waiting in the wings is a terminally ill patient with a kidney, ready for donation upon her death, to be given to whomever the viewers at home deem the most worthy. The 2007 show, called De Grote Donorshow, was, to say the least, controversial. There were attempts to censor it; the Dutch Kidney Foundation asked the show to remove their logo from the show’s logo (note the kidney as the letter “O,” pictured above); and many officials decried the show as reflecting poorly on the Netherlands.

But the outrage was, it turns out, unwarranted. De Grote Donorshow was a sham. It was designed to raise awareness of the lack of available kidneys in the Netherlands and the country’s low rate of organ donor registration. The terminally ill patient was a model/actress; there was no kidney to be donated. The three patients in renal failure did, in fact, need kidneys, but they were in on the ruse. The deception worked: per the Dutch news portal NU.nl, just days after the finale aired, over 40,000 donor forms were downloaded off the national donor registry’s website, and within a month or so, over 7,000 new donors registered.

Bonus fact : According to the Wall Street Journal, “only one country [. . .] has eliminated the shortage of transplant organs.” That country? Iran. How? Via “a working and legal payment system for organ donation.” Iranian donors can get in excess of $5,000 for a kidney, part from the government and the rest from a non-profit organization designed to facilitate donations. (For perspective’s sake, the per capita GDP of the United States is about $48,000; Iran’s is about $6,000.)

From the Archives: Choosing Dialysis Patients: When there are more patients than facilities available, what do you do?

Related: A human kidney for the low, low price of $69, plus shipping. Kind of.