We read and hear a great deal about the shortage of organs, incredible stories about “nick-of-time” transplants, multiple transplants and innovations in transplantation but we don’t hear much about the donors who make this all possible.  Being an organ donor is one of the most unselfish, compassionate and noble gestures one can make.  It is particularly noble because in most cases the donor will not be around to hear the praise and thanks.  Paying tribute to donors and their families is one of the most important things we can do.  These mostly anonymous people deserve to be in our thoughts and prayers every minute of every day. 

As you know I am a heart transplant recipient, I only know that my donor was a 30 year old male from South Carolina, nothing more.  I have written to the donor family expressing my gratitude but, like many donor families, they have chosen to remain anonymous.  There are many more, however, who choose to be public about their experience and how we support and honor them is the subject of this blog. 

Prior to my retirement I was honored to have as a client, LifeSource, an organ procurement organization (OPO) that serves Minnesota, the Dakotas and part of Wisconsin.  They were not only a valued client but also became dear, dear friends.  Rebecca (Becky) Ousley is one of the many dedicated people who help to further the LifeSource mission.  Like most OPOs LifeSource does a wonderful job of promoting organ donation and coordinating transplants.  But they are so much more than that, they offer heart felt support to the living, too, especially donor families.  Below is a reprint of their latest blog.  Please read and comment either to this blog or directly to LifeSource at http://www.life-source.org/

From “The Source” by Becky Ousley, LifeSource

One of the things I find remarkable about the work we do at LifeSource is the extent to which we are committed to supporting donor families, both at the time of donation and for years afterward.  Donor families are the cornerstone of the work that we do – without them there would be no transplants.  It is an incredibly generous gift.

I’m always so excited to tell people about this, as many people don’t realize that donor families receive this kind of support in the months and years following donation.  At LifeSource donor families are part of our aftercare program for as long as they wish; we have some families that have been coming to our events for nearly 20 years!   In addition to receiving support and remembering their loved ones, these long time donor families are also able to provide hope and perspective to our families that are more newly bereaved.  That too, is a wonderful gift.

Part of our aftercare program involves facilitating letters between transplant recipients and donor family members.  Either party can write to the other; often, recipients want a chance to say thank you for their gift of life or donor family members may want to share memories about their loved ones.  Donor families and recipients can request to have direct contact with one another and, sometimes, they even meet.  These are often very rewarding relationships.

This was the case today, when I was honored to attend a donor family and recipient meeting with my colleague Jill, whose job it is to support these families.  She connected this pair after some persistent detective work, as the donation and transplant took place more than 40 years ago in 1966!  It was an incredible meeting and I think we were all touched when Steve, the kidney recipient, immediately hugged the donor’s sister and told her he had been waiting for 43 years to give her that hug.

KARE-11 was there to document this wonderful meeting and I encourage you to watch the story by clicking here.

Bob Aronson.  Please visit and join my Facebook site, Organ Transplant Patients, Families and Friends at  http://tinyurl.com/225cfh OR — my Facebook home page  http://www.facebook.com/home.php 

Too many people talk the talk but don’t walk the walk.  What do I mean?  You’ve heard me say that over 90 percent of Americans approve of organ donation but barely 35 percent bother to become donors.  This blog is a challenge.

Hey liberals who make so much of helping those in need, who support large governmental humanitarian relief programs and who urge everyone to perform some kind of community service, why don’t you practice what you preach and become organ donors.  If you don’t become organ donors and urge — no, help everyone you know to do the same, you are nothing but a bunch of hypocrites.

And you compassionate conservatives who so believe in encouraging private citizens to get more involved and to depend on government less, why aren’t you promoting organ donation and becoming donors yourselves?   You seem to encourage faith based and community based activism, but you, like the liberals, are sitting on your hands while thousands die due to a lack of transplantable organs.

And then there are the religious groups who preach the sanctity of life and that you should love your neighbor as you love yourself, why aren’t you doing more to promote organ donation?  You’ve got to do more than pray.  You’ve got to take some action.  Maybe God is answering your prayers by telling you to do something instead of depending on him to solve all the problems.

All of the above groups fall into a very large group of hypocrites.  If you don’t like this blog, don’t complain to me.  Go forth and save lives by encouraging organ donation and when someone tells you, “You are right I’m going to become a donor,” don’t stand by and accept that.  Offer to help them, drive them to the driver’s license office right away or get on line with them to register with Donate Life America.

You should all be as disgusted as I am that only 35 percent of Americans are organ donors.  If you believe in organ donation, why the hell aren’t you doing something about it?

Please visit and join my Facebook site, Organ Transplant Patients, Families and Friends at  http://tinyurl.com/225cfh OR — my Facebook home page  http://www.facebook.com/home.php

For those of you who don’t know, I received a heart transplant at the Mayo Clinic in Jacksonville, Florida almost two and a half years ago.  My new heart came from a 35 year old stranger.  Without it I would have died within a few months. 

As of this writing there are 105,000 people on the national organ waiting list.  82,000 of them are waiting for kidneys (http://optn.transplant.hrsa.gov/).  A new name is added to the organ waiting list every 11 minutes.  A million more people suffer from blindness, medical conditions or devastating injuries that can be successfully treated with donated corneas or tissue.  

You would think that with 300 plus million people in this country there would be more than enough organs and tissue to save or enhance all of those lives. The fact is that while 90 percent of Americans believe in organ donation barely 35 percent take the time to register.  That means that each year more and more people are dying because of a lack of organs, nearly eighteen people die each day while waiting.  These deaths are totally unnecessary.  One organ donor can save or affect the lives of up to sixty people — sixty people!  North Dakota and Minnesota serve as marvelous examples of people getting the message. The donation percentage in Minnesota is 51% and in North Dakota it is 65%. 

Good intentions are not enough.  If you want to pay more than lip service to the issue, go to http://www.donatelife.net/ and you will immediately discover how you can register.  Donate Life America (DLA) is a part of the United Network for Organ Sharing (UNOS), which keeps the waiting lists and coordinates donation and transplantation throughout the United States.  If you are not a computer person either write to Donate Life America 700 N. Fourth Street Richmond, Virginia 23219 or you can call them at phone: 804-782-4920 and they will be happy to help you.  Whether you are a registered donor or not, talk to everyone you know about organ and tissue donation, there is no act that is nobler.

There are a multitude of questions about organ donation but here are the answers to just a few:

1. What can be donated?  Organs: Heart, lungs, kidneys, pancreas, liver and intestines.  Tissue: Corneas, skin, veins, tendons, bone, heart valves and connective tissue.
2. Should age or health affect my decision to be a donor?  No. Almost everyone can save lives through donation!
3. Will my family have to pay for the cost of my organ and/or tissue donation?  There is no cost to the donor family for donation. All expenses related to organ and tissue donation are paid by LifeSource and passed on to the transplant recipients and their health insurers.
4. Does my religion support organ and tissue donation?  All major religions support organ and tissue donation as one of the highest forms of loving, giving and caring.
5. If I am a registered donor and I am admitted to a hospital, will they let me die so they can recover my organs?  Absolutely not.  Organ and tissue donation is an option only after all life-saving measures have failed.
6. Can the rich and famous jump the list based on their celebrity status?  No.  Organs are fairly allocated based on medical criteria, genetic matching, and length of time on the waiting list.

There are many more questions and the answers can be found by calling LifeSource or visiting their website.

I am alive because of the generosity of a total stranger but there are so many just like me who will probably die waiting.  If every person who became a donor would convince just one other person to do the same there would be no shortage and we could stop the dying.  Please act today; it’s a matter of life and death.

Please visit and join my Facebook site, Organ Transplant Patients, Families and Friends at  http://tinyurl.com/225cfh  OR — my Facebook home page  http://www.facebook.com/home.php

If you are over age 64 and you  want the H1N1 flu vaccine (swine flu) forget it!  Even if you meet the criteria set forth by the Centers for Disease Control (CDC) you will not be allowed to get the vaccine.   I know, today I was refused a shot.   This development has great significance for everyone over 64 and especially transplant patients with compromised immune systems. 

According to the CDC website (http://www.cdc.gov/h1n1flu/highrisk.htm) these are the criteria for getting an H1N1 shot:

1. People at High Risk for Developing Flu-Related Complications

• Children younger than 5, but especially children younger than 2 years old
• Adults 65 years of age and older
• Pregnant women

2. People who have medical conditions including:

• Asthma
• Neurological and neurodevelopmental conditions [including disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy, epilepsy (seizure disorders), stroke, intellectual disability (mental retardation), moderate to severe developmental delay, muscular dystrophy, or spinal cord injury].  
• Chronic  lung disease   (such as chronic obstructive pulmonary disease  [COPD] and cystic fibrosis)
• Heart disease (such as congenital heart disease, congestive heart failure and coronary artery disease)  
• Blood disorders (such as sickle cell disease)
• Endocrine disorders (such as diabetes mellitus)
• Kidney disorders
• Liver disorders
• Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)
• Weakened immune system due to disease or medication (such as people with HIV or AIDS, or cancer, or those on chronic steroids) 

I fit into three of the criteria.  I have asthma, COPD (chronic obstructive pulmonary disease) I am over 65 and because of my heart transplant two years ago I have a suppressed immune system.  My transplant cardiologists strongly recommend that people like me should get the H1N1 shot yet when I showed up at the clinic today I was told by the nurse that I couldn’t have the shot because I was over 64.  I double and triple checked to see if that is true and it is.  The government doesn’t care if your health is at great risk from H1N1 if you are over 64.  What I infer from this regulation is that CDC has determined that people my age don’t have much time left anyway so lets not waste vaccine on them even if they meet other criteria.

I would immediately agree that children and pregnant women should get the vaccine ahead of all others.  That only seems fair and fairness is all I ask.  Never before in my life have I been told I was too old for something.  This smacks of governmental age discrimination.

If you agree that this situation is unfair and discriminatory let your congressional delegation know.  Call them, email them or stop them on the street.  CDC should not be allowed to say one thing in public and then introduce restrictions in private.

Please visit and join my Facebook site, Organ Transplant Patients, Families and Friends at  http://tinyurl.com/225cfh  OR — my Facebook home page  http://www.facebook.com/home.php

I’ve taken time off from blogging for the last few months because I was taking care of myself with my own self styled mental/emotional therapy.  For fifty years my parents ran a “Mom and Pop” side street grocery store in my home town of Chisholm, Minnesota.  To honor and remember them I have built from memory and a pitiful few photographs, a scale model replica of the store and the attached house.  The project took the better part of two years and was completed yesterday Sunday November 1, 2009.  When I get some pictures taken I will post them. 

As to blogging, there is something that has bothered me for quite some time and that is the fact that there seems to be a great number of people using disabled parking illegally.  As you know I had a heart transplant a little over two years ago.  My new heart is working extremely well and if anything I have more energy than ever before.  Unfortunately I have COPD (chronic oppressive pulmonary disease) which makes it extremely difficult for me to breathe.  Almost any exertion leaves me out of breath so I have a disabled parking permit and use the spaces often.  They are a Godsend when you can’t walk very far.

What disturbs me is the number of people who think the rules don’t apply to them and when it comes to disabled parking they fall into two categories, 1) those without permits that ignore the signs and 2) those that have permits that belong to someone else. 

The first group is easy to deal with.  If you see a vehicle in a disabled space that has neither special license plates nor a permit hanging from the rear view mirror, notify the authorities.  In most cases there is at least a $250 fine for this deliberate violation of the law and of the rights of the disabled.

The second group is more difficult to deal with.  I fully recognized that not every disabled person is in a wheelchair, I’m not so in many cases when I see people hang the tag on the mirror and walk to the store I ignore it.  People deserve the benefit of the doubt.  But, when I see people park, display the permit and then sprint across the lot into a store I get angry.  Too many able bodied people use permits issued to friends or family members.  I know of some people who are using permits that were owned by deceased relatives.  How disrespectful can you be?

Many people who are awaiting transplants but are ambulatory need those spaces.   They are not reserved for lazy people but rather for those who genuinely need to be close because they can’t walk very far.  Many other people who are not transplant candidates also have very serious disabilities that require them to park as near to their destination as possible.  Without disabled parking many people would be forced to either stay at home or face the danger of having to walk farther than they are physically capable of doing.

I was at an art show with my wife recently and I parked in one of the few disabled spaces that were available.  Two burly guys in a pickup truck pulled in next to me in the space reserved for Vans for the disabled and began to sprint away.  I rolled down the window and told them it was not a parking space and that they should move.  They got quite belligerent and after several profanities and hand gestures they grudgingly moved — a half block away.  I’ll bet the walk absolutely exhausted them.

You should do the same.  Challenge people who park illegally, notify the authorities.  The space they occupy may be the one you or a loved one will need someday.

Also, please visit and join my Facebook site, Organ Transplant Patients, Families and Friends at  http://tinyurl.com/225cfh  OR — my Facebook home page  http://www.facebook.com/home.php

Each year thousands of people die because of a lack of organs for transplantation.  Current efforts to increase the supply of organs are woefully inadequate.  The altruistic method (becoming a donor out of the goodness of ones heart) simply doesn’t work well enough.  Fewer than fifty percent of Americans are organ donors.  It does not look like the altruistic approach is going to change any time soon so we must explore every possibility. 

One way of increasing the supply of organs for transplant is to reduce the demand and that can be done in part by changing lifestyles.  Some of the causes of organ failure are preventable.  This blog will focus on two contributors to the rising need for organs; obesity and diabetes.  Both could be far better controlled than they are currently simply by eating properly and exercising regularly.

Let’s talk obesity, the second leading cause of unnecessary death in America.   According to the American Obesity Association (AOA).  http://obesity1.tempdomainname.com/subs/fastfacts/obesity_what2.shtml   Approximately 127 million adults in the U.S. are overweight, 60 million obese, and 9 million severely obese   Obesity is a disease that affects nearly one-third of the adult American population (approximately 60 million). The number of overweight and obese Americans has continued to increase since 1960, a trend that is not slowing down. Today, 64.5 percent of adult Americans (about 127 million) are categorized as being overweight or obese. Each year, obesity causes at least 300,000 excess deaths in the U.S., and healthcare costs of American adults with obesity amount to approximately $100 billion.  

Fox news quoted a Web MD report  http://www.foxnews.com/story/0,2933,215604,00.html that says nine out of ten obese people develop type 2 diabetes and while obesity does not cause diabetes, research shows the two are closely related.                      

Net Wellness (http://www.netwellness.org/healthtopics/diabetes/faq3.cfm) defines diabetes as the inability of glucose to enter the cells. The result is that the bloodstream has a high amount of glucose and cells are not able to produce energy for the body. When diabetes is not carefully managed by keeping the amount of sugar in the blood at the right level, the resulting high glucose amounts wreak havoc on nearly every organ system in the body.  The report goes on to say that as many as 65% of people diagnosed with diabetes will eventually die of a heart attack or a stroke and nearly 1 in 3 diabetics will experience kidney failure. For more information on diabetes visit the National Diabetes Education Program Website at: http://www.diabetes.niddk.nih.gov/dm/pubs/type1and2/what.htm

The American Diabetes Association (ADA) offers comprehensive information on diabetes prevention and the value of proper nutrition and exercise along with symptoms of disease http://www.diabetes.org/diabetes-prevention/how-to-prevent-diabetes.jsp

While I will continue to work to develop other methods of increasing the supply of transplantable organs, all of us should take every measure to prevent diseases that can affect our organs.  As in most cases prevention is the best cure for organ failure. 

LifeSource is an Organ Procurement Organization (OPO) in St. Paul, Minnesota.  I know the people there quite well and was so impressed by their latest posting in “The Source” I decided to reprint it so others could benefit from it as well.  I am often asked, “What can I do to promote organ donation besides becoming a donor myself?”  Well, there are many answers but this blog offers a couple of excellent examples. 

The Source

by Jeff Richert

http://donatelife.wordpress.com/

We have many exceptional, creative and energetic volunteers. I want to focus on just two of them and what they are doing to celebrate National Donate Life Month in April.

Judy is a long time LifeSource volunteer from Fergus Falls, MN. She lost her daughter, Jenny, in May of 1993.  Judy’s activities for April included a radio interview about donation and drunk driving that she has done for many years. She also coordinates a unique program with her beautician.

In addition to providing space for a display and information table, her friend who owns the “ExSalonce” has a special promotion during April. She gives a 20% discount to customers who either show that they have “Donor” on their license or to those who sign up as donors for the first time! What a unique and fun way to communicate our message during April!

Suzanne Ruff is a LifeSource volunteer who knows too well the ravages of Polycystic Kidney Disease (PKD). For several generations, her family has suffered from this often fatal genetic disorder. For National Donate Life Month and for National Donor Sabbath for at least two years, Suzanne has communicated with the Archbishop of St Paul and Minneapolis to convey information to him about donation and transplantation.

Earlier this month, Suzanne received a response from the Archbishop’s office saying that he is both supportive of our cause and that he will try, ” … to the best of my ability, to mention it in my Catholic Spirit column.”  Thank you Suzanne for your perseverance and for helping us to communicate to our friends in high places.

Judy and Suzanne’s activities  for April are not big and flashy acts. They don’t involve billboards or spot lights. But ultimately their work will contribute to the many activities of our volunteers that help ensure that thousands of people hear about the life saving miracles of donation and transplantation!

I hope reprinting this blog inspires people to do something special to promote organ donation.  If each of us could convince just one person to become an organ donor we could end the shortage and be able to offer transplants to everyone on the list. 

Also, please visit and join my Facebook site, Organ Transplant Patients, Families and Friends at  http://tinyurl.com/225cfh  OR — my Facebook home page  http://www.facebook.com/home.php   

It is unfortunate but there are some people who seek to take advantage of the misfortune of others.  While I find it hard to believe that anyone would take advantage of people seeking organ transplants, it happens and via this blog I will endeavor to expose as many of these people as I can.

Remember, if it seems too good to be true, it probably is.  Before you make any decisions about potential transplant possibilities in other countries check with your local Organ Procurement Organization (OPO), The United Network for Organ Sharing (UNOS) www.unos.org, or your state’s Attorney General’s office. 

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On March 19, 2009 Sue Weibezahl Porter of the Syracuse NY Post-standard wrote the following story under the headline:  (http://blog.syracuse.com/healthfitness/2009/03/international_organ_transplant.html)

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Organ transplant scam preyed on dying people, ends with capture of Syracuse man

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Federal prosecutors announced this afternoon that Jerome Feldman, 67, was captured in the Philippines and will be extradited to Syracuse on charges he scammed dying people by setting up phony organ transplant surgeries.  Feldman had them wire money — more than $400,000 — to the Chase Bank in DeWitt and also had postal boxes in Fayetteville and DeWitt for more checks, authorities said.

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It’s not the first time he’d been in trouble. His New York State medical license was revoked.  Feldman, who has family ties in Central New York, allegedly trolled Web sites looking for people who needed transplants.  Using phony names, he would promise to set up the surgeries if the people would wire money in advance.  FBI investigators have identified at least five victims, most of whom died after arriving in the Philippines and discovering the doctor who was supposed to perform the life-saving surgery did not exist. Feldman faces up to 20 years in federal prison and fines totaling more than $250,000.

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Authorities are also trying to freeze, then seize, his assets.

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If and as we find more of these frauds who prey on people’s worst fears and infirmities we will expose them.  In the meantime if you are aware of a person or organization that appears to be a scam let us know and we’ll do what we can to get to the truth.

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Please comment in the space provided or email your thoughts to me at bob@baronson.org.  And – please spread the word about the need for more organ donors.  There is nothing you can do that is of greater importance.  If you convince one person to be a donor you may have saved or affected over 50 lives.

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Also, please read and comment on my World Wide Issues blogs on http://blogsbybob.wordpress.com.   I ask, too, that you visit and join my Facebook site, Organ Transplant Patients, Families and Friends at  http://tinyurl.com/225cfh  OR — my Facebook home page  http://www.facebook.com/home.php   

In the March 2009 edition of the Virtual Mentor The American Medical Association Journal of Ethics has published a paper in support of “First Person Consent,” a concept that could increase the number of organs available for transplantation. Now effective in 42 states, “First Person Consent” laws dictate that a documented donation decision like a donor card, drivers license etc, is legally binding and does not require the consent of any other person upon the death of the donor.   That means if a person has documented their decision to be a donor, families have no legal right to overrule it.  You can read the report in its entirety at http://virtualmentor.ama-assn.org/

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I’ll explain the rationale in a moment but in order to make the concept effective two things must be done, 1) more people need to document their wishes.  That means that we should consider enacting laws in every state that require people to make a decision on donation when they renew their drivers license.  2) Medical personnel need to defer to the expertise of Organ Procurement Organizations (OPOs). 

To further quote from the AMA report,”The death of most people who become deceased organ donors is sudden, unexpected, and frequently tragic. The families of these donors are almost never prepared for this unfortunate situation.  “The refusal of families to grant permission is a major impediment to organ donation.  If, despite the law, we must get family consent, several factors have been shown to improve family consent rates:

First, the request for organ donation should be separate—or “decoupled”—from the declaration of brain death. This allows the family time to understand and accept the concept of brain death.  

Second, the request for organs should be made by a trained OPO representative along with the hospital staff as a team. It is best that the physician or nurse caring for the patient not discuss organ donation with the family prior to OPO involvement. The hospital staff and OPO donation coordinator can work together to determine the best time to talk to the family.

Third, the request should be made in a private and quiet setting. Higher consent rates have been shown to occur when these 3 procedures are followed [1].(clicking on the number will provide further information).”

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The AMA report continues, “First-person consent removes a burden from family members because they do not have to come to a decision while attempting to cope with the very stressful situation of the death of a relative. First-person consent also avoids the problem of family members’ disagreement, and it may benefit families later on: more than one-third of families who made a decision themselves and declined to donate the organs subsequently regretted their decision [2].”

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The Virtual Mentor also says, “The medical care team must, to the greatest extent possible, remove itself from this conflict resolution process and rely upon the expertise of the organ procurement professionals. It is likely that the procurement coordinator has been in similar situations, has been trained to deal with them, and will be able to adequately resolve most of the issues to the satisfaction of all.

The AMA report is very emphatic, though, on the need for OPOs to develop and maintain a close working relationship with donor families.  “Although the law is on the side of the designated donor, it is critical to procurement organizations, transplant centers, and recipients that the OPO make a concerted effort to establish a cooperative relationship with the family. Legal and public conflicts that could result in fewer donors must be avoided. Willing participation from the family will also enable the procurement coordinator to obtain a thorough medical and social history, and will allow him or her to explain the procedure fully, confirm that donation will not interfere with the funeral, clarify that the OPO will assume hospital costs related to the donation, and convey much other information.

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Perhaps the most compelling reason to establish a positive relationship with the family of a potential donor is the benefit it offers to the future of organ donation. Working cooperatively with the donor family will result in a positive continued relationship. The surviving family members of a donor are known as donor families and, in our mission to increase awareness of the need for more organ donors, donor families remain an unparalleled resource for promoting the message.”

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I am a believer in adopting a system of presumed consent.  One in which people could opt out rather than opt in.  In countries where this has been tried donation rates have increased substantially.  But presumed consent requires a change in the law.  First Person Consent is already the law in all but 8 states.  What needs to be done is to fine-tune the system so we can eliminate the obligation OPOs and hospital officials feel to get donation permission from families.  Under First Person Consent laws no permission is necessary and that could mean a significant increase in available organs.  Perhaps if the AMA suggestions were adopted we might be a step closer to closing the organ donation/transplantation gap.

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Please comment in the space provided or email your thoughts to me at bob@baronson.org.  And – please spread the word about the need for more organ donors.  There is nothing you can do that is of greater importance.  If you convince one person to be a donor you may have saved or affected over 50 lives.

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Please read and comment on my World Wide Issues blogs on http://blogsbybob.wordpress.com.   Also…visit and join my Facebook site, Organ Transplant Patients, Families and Friends at  http://tinyurl.com/225cfh  OR — my Facebook home page  http://www.facebook.com/home.php   

THIS IS NOT AN OFFER TO BUY ORGANS.  ATTEMPTS TO SELL ORGANS HERE WILL NOT BE PUBLISHED.

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Let me begin by quoting Sally Satel M.D., Kidney transplant recipient and Resident Scholar American Enterprise Institute: (Kidney for Sale, Lets Legally Reward the Donor  http://www.aei.org/publications/filter.all,pubID.29515/pub_detail.asp)

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“America faces a desperate organ shortage. Today, more than 78,000 people are waiting for a kidney transplant; only one in four will receive one this year, while twelve die each day waiting for help. Not surprisingly, many patients are driven to desperate measures to circumvent the eight-year waiting list—renting billboards, advertising in newsletters, or even purchasing organs on the global black market. Altruism (the current system where one donates an organ through the goodness of their heart) is an admirable but clearly insufficient motivation for would-be donors.

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According to the International Society of Nephrology, kidney disease affects more than 500 million people worldwide, or 10 per cent of the adult population. With more people developing high blood pressure and diabetes (key risks for kidney disease), the picture will only worsen.

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There are nearly two million new cases of the most serious form of kidney disease–renal failure–each year. Unless patients with renal failure receive a kidney transplant or undergo dialysis–an expensive, lifelong procedure that cleanses the blood of toxins–death is guaranteed within a few weeks”

The argument against paying people for their organs (living donors of kidneys and livers) is that the practice would prey on the poor.  Supposedly only people who are in desperate need of money would sell their organs.  “The rich or reasonably well off,” the argument goes, “Don’t need the money so few of them would become donors under such a system.”  Additionally, wealthy people could buy organs from the poor but the poor could not afford to buy organs if they needed them.  So the question;  “Is it ethical to compensate people for their organs?”  My answer is, probably not – if the exchange is simply cash from the recipient to the donor for a kidney.  But what if there are other considerations?  Dr. Satel offers some interesting options:

“My colleagues and I suggest a system in which compensation is provided by a third party (government, a charity or insurance) with public oversight. Because bidding and private buying would not be permitted, available organs would be distributed to the next in line–not just to the wealthy. Donors would be carefully screened for physical and psychological problems, as is currently done for all volunteer living kidney donors. Moreover, they would be guaranteed follow-up care for any complications.

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Many people are uneasy about offering lump-sum cash payments. A solution is to provide in-kind rewards–such as a down payment on a house, a contribution to a retirement fund, or lifetime health insurance–so the program would not be attractive to people who might otherwise rush to donate on the promise of a large sum of instant cash.   The only way to stop illicit markets is to create legal ones. Indeed, there is no better justification for testing legal modes of exchange than the very depredations of the underground market.”

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Dr. Satel goes on to say that, “Momentum is growing. In the British Medical Journal, a leading British transplant surgeon called for a controlled donor compensation program for unrelated live donors. Within the past year, the Israeli, Saudi and Indian governments have decided to offer incentives ranging from lifelong health insurance for the donor to a cash benefit. In the United States, the American Medical Association has endorsed a draft bill that would make it easier for states to offer non-cash incentives for donation.”

• Dr. Satel and her colleagues call on Congress to reform the 1984 National Organ Transplant Act (NOTA), which makes it a felony to provide material reward for an organ. The authors suggest that:

 • Congress should amend NOTA so that existing criminal penalties for selling and brokering organ sales between individuals do not apply to any economic incentives offered by federal, state, or local governments. Such a revision would not require any such incentives; it would simply allow states and federal agencies to undertake experimental incentive programs.

• Compensation to prospective donors could take the form of health insurance, tax credits,

tuition vouchers, or contributions to tax-free retirement accounts.

• Rigorous protections for the safety of donors would be created.

• Because the compensation would be provided by the government, every patient in need

would benefit, regardless of income.”

The issue of paying for human organs is controversial to say the least but that does not mean it can’t or won’t work.  Iran, which is usually not a good example for much of anything, allows for such a program and the result reportedly is that their waiting list has sharply declined and in some cases it has diminished entirely. 

http://freakonomics.blogs.nytimes.com/2008/04/29/human-organs-for-sale-legally-in-which-country/ 

What we need in the United States is an open dialogue free of emotional outbursts that would allow for a small pilot program to test the concept.  We need universal agreement on the need to elminate organ transplant waiting lists, much like the commitment the National Kidney Foundation made to eliminating the kidney waiting list within ten years.   We must also agree, though, that the altruistic approach that we’ve tried for the last quarter of a century does not work.  Every year the number of people who die while waiting for a transplant grows, yet we continue to cling to the notion that if we work a little harder more people will become donors.  Well, everyone has worked very hard and we are still losing the battle.  As I have written before about the United Network for Organ Sharing (UNOS) which regulates the entire process, “It’s not working and it is time we tried something that will work, we must stop the dying.”  We’ve got to do something new and a pilot program somewhere in the United States would be a great way to start.  What have we got to lose?

Please comment in the space provided or email your thoughts to me at bob@baronson.org.  And – please spread the word about the need for more organ donors.  There is nothing you can do that is of greater importance.  If you convince one person to be a donor you may have saved or affected 50 or more lives.

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Please read and comment on my World Wide Issues blogs on http://blogsbybob.wordpress.com.   Also…visit and join my Facebook site, Organ Transplant Patients, Friends and You at  http://tinyurl.com/225cfh  OR — my Facebook home page  http://www.facebook.com/home.php