thanks again
Bob Aronson

Living donation is not without risk. However, Ms. Satel’s and public/media perception is that relinquishing a major organ is akin to donating a pint of blood. First off, the medical/transplant community has never bothered to track LDs so they have virtually NO idea of the long-term consequences of donation. Secondly, a quick review of the medical literature reveals a variety of possible complications including bleeding, blood clots, hernias, reduced adrenal gland function, hypertension, depression, anxiety and PTSD-like symptoms (just to name a few).

Regardless of the ‘theoretical’ savings to insurance companies by compensating donors instead of paying for dialysis, they are for-profit entities and will not do such a thing unless persuaded by federal mandate. Remember, these are the same corporations that had to be FORCED to allow a woman to stay in the hospital for 48 hours after giving birth. Some recipients receive their transplant before going on dialysis – where is the savings to the insurance company then?

TRANSPLANTS ARE NOT CURES. Most recipients will require re-transplantation within their lifetime. Some transplants fail within days or weeks. This ‘compensation’ will not be a one-time expense.

At one time, the U.S. believed that compensating blood donors would reduce the blood shortage, yet the experiment failed miserably (see Eastlund T. Transfusion 1998 38:874). There is no reason to believe the outcome would be any different for the controlled sale of organs. In fact, recent studies indicate many detrimental consequences to LDs who receive compensation.

Diabetes is the major kidney killer in the U.S. and many forms of diabetes are preventable or treatable. Why are we, as a nation, not emphasizing the prevention of end-stage renal failure? Is it so much more politically correct to create a whole new class of patients by inducing otherwise healthy people to undergo major surgery and lose a vital organ?

Many communities in the U.S. are protected by volunteer fire departments. Not only are we not experiencing a shortage of volunteers, most of the VFDs have extensive waiting lists. If Ms. Satel would actually take the time to have a conversation with a living donor or firefighter, she might discover that money is not the be-all, end-all motivator. She might actually learn some real ways to combat this issue.