Misinformation from UNOS after confessed killer gets organ transplant

"A confessed Bronx wife-killer who destroyed his liver in a half-cocked suicide attempt blew past nearly 2,000 New Yorkers on the state's transplant list to get a new organ," reports the New York Post.

The story attempts to explain how this can happen:

Social factors -- such as wealth, fame, arrest or criminal records -- do not figure into the decision on whether to give someone an organ....

"The system is designed to save as many people as possible," said Anne Paschke, spokeswoman for the United Network of Organ Sharing, which is responsible for organ allocation in the United States.

Ms. Paschke's statement is clearly not correct. The organ allocation system is NOT designed to save as many people as possible. If UNOS wanted to save more lives, it would change its organ allocation rules to offer donated organs first to registered organ donors. This would create an incentive for non-donors to become donors. With more donors, more lives would be saved.

UNOS should have two transplant waiting lists: the "A" list for registered organ donors, and the "B" list for those who haven't agreed to donate. UNOS should offer all organs first to donors on the "A" list. Non-donors on the "B" list can have the leftovers, if there are any.

UNOS has the power to make this common-sense change. Instead, UNOS treats registered organ donors no better than it treats people who refuse to donate. Since UNOS is willfully blind to the organ donor status of potential organ recipients, about half of the organs transplanted in the United States are given to people who haven't agreed to donate their own organs when they die.

Americans bury or cremate about 20,000 transplantable organs every year. Most of this tremendous waste would be eliminated if UNOS put organ donors first. Few Americans would refuse to donate their organs after they died if they knew it would reduce their chances of getting a transplant should they need one to live.

In the mean time, if you want to donate your organs to other registered organ donors you can join LifeSharers at http://www.lifesharers.org/.

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The shameful need for live organ donors

A man who agreed to donate part of his liver to help a sick relative died while undergoing the transplant procedure at Lahey Clinic near Boston two weeks ago, according to a report in the Boston Globe.

The generosity of live organ donors is spectacular. Imagine having a piece of your body cut out to save the life of a relative, a friend, or someone you don't even know.

It's shameful that America needs so many live organ donors. We wouldn't need so many of these incredibly brave people if Americans weren't burying or cremating 20,000 transplantable organs every year.

In the United States, about half of the people who can donate their organs after death do donate them. The other half don't. What an awful waste! Every transplantable kidney or liver that is buried or cremated means another person dies or another live donor goes under the knife.

Would people still refuse to donate their organs if affected their ability to receive an organ? Or would more people donate if it increased their chances of getting an organ if they needed one? These questions answer themselves.

The United Network for Organ Sharing, which manages the national transplant waiting list, moves live organ donors up the waiting list if they need a transplant later in life. This is a good thing to do. It's fair, and it increases the number of people who are willing to donate.

UNOS should do the same thing for people who agree to donate their organs after death. It would make the organ allocation system fairer. Currently, about half of the organs transplanted in the United States are given to people who haven't agreed to donate their own organs when they die. More importantly, giving organs first to registered organ donors would increase the number of donated organs. It would save more lives, and it would reduce the need for live organ donors.

UNOS has the ability to make this common-sense change to its organ allocation rules. They should make this change immediately. If they made this change today, they'd save thousands of lives next year, the year after that, and every year after that one.

Americans who want to donate their organs to other organ donors don't have to wait for UNOS to act. They can join LifeSharers. LifeSharers is a non-profit network of organ donors who agree to offer their organs first to other organ donors when they die. Membership is free at www.lifesharers.org or by calling 1-888-ORGAN88. There is no age limit, parents can enroll their minor children, and no one is excluded due to any pre-existing medical condition. LifeSharers has over 13,900 members, including members in all 50 states, the District of Columbia, and Puerto Rico.

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NY presumed consent proposal: all stick no carrot

New York could be the first state that presumes everyone wants to donate their organs unless they specifically say otherwise, according to a story in the Washington Post. If a recently introduced bill becomes law, hospitals in New York will be able to assume you have given consent to organ donation unless you haved previously filled out an official form saying otherwise.

Only about 50% of adult Americans have signed up to donate their organs when they die. Supporters of presumed consent say it will increase the supply of transplantable organs. They say few people will opt out, since about 90% of adult Americans say they support organ donation.

Presumed consent is all stick and no carrot. If we're going to presume people are organ donors unless they opt out, we should also give people a reason to NOT opt out. Donated organs should be allocated first to those who haven't opted out. People who opt out of organ donation should go to the back of the transplant waiting list. The United Network for Organ Sharing, which manages the national organ allocation system, has the power to make this simple policy change. No legislative action is required.

Americans who want to donate their organs to other registered organ donors don't have to wait for UNOS to act. They can join LifeSharers, a non-profit network of organ donors who agree to offer their organs first to other organ donors when they die. Membership is free at http://www.lifesharers.org/ or by calling 1-888-ORGAN88. There is no age limit, parents can enroll their minor children, and no one is excluded due to any pre-existing medical condition.

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UK may move registered organ donors up the transplant waiting list

How should organ donation rates be increased in the United Kingdom? The Nuffield Council on Bioethics in London is asking the public what they think about various options. Among the options presented is giving priority for transplants to people who sign up to donate their organs when they die.

Ian Cowie writes about possible solutions to the United Kingdom's organ shortage in the Telegraph:

...offering donors priority status in the event that they may need a transplant in future looks like a reasonable compromise which could ease the current problem. NHS reliance on public altruism has failed. When demand vastly exceeds supply it may be time to consider economics as well as ethics.

Adam Smith was among the first to notice that one motivation you can always rely on is self-interest. In his classic The Wealth of Nations he observed: “It is not from the benevolence of the butcher the brewer, or the baker that we expect our dinner, but from their regard to their own interest.

Registered organ donors in the United States can get preferred access to donated organs by joining LifeSharers. Registered organ donors in New Zealand can do the same thing. In Israel, if you and your family members get preferred access to donated organs if you sign up to donate your organs after you die.

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New Yorkers find organ donation registration "off-putting"

Only 13% of adults in the state of New York are registered organ donors, according to a story in the New York Times. Why is the registration rate so low? According to the story, it's because New Yorkers can't register on the internet and because they have to decide which organs and tissues they want to donate. Having to decide whether to donate your bone and connective tissue, heart with connective tissue, and pancreas with iliac vessels is "off-putting", according to the New York Times.

I wonder how many New York adults would find dying waiting for an organ transplant "off-putting". Probably a whole lot more than 13% of them.

LifeSharers has over 750 members in New York. New Yorkers (and everyone else in the United States) are welcome to join LifeSharers at www.lifesharers.org/enroll.aspx. Members get preferred access to the organs of other members, so they get a chance to help themselves while helping others.

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Organ shortage increase fueled by unwillingness to donate

According to a new survey by Donate Life America 43% of people are undecided, reluctant or do not wish to have their organs and tissue donated after their deaths. Is this because Americans don't know there is an organ shortage? No. The survey also reports that 78% realize there are more people who need organ transplants in the U.S. than the number of donated organs available.

Meanwhile, the number of people who need transplants keeps growing. As of April 1, 2010, there were over 106,700 people on the national transplant waiting list. More than half of these people will die before they get a transplant, while Americans bury or cremate 20,000 transplantable organs every year.

Just about every single one of the 43% of Americans who aren't willing to register as organ donors would accept an organ transplant if they needed one to live. As long as we let non-donors jump to the front of the waiting list when they need transplants we'll always have an organ shortage.

There is a simple way to put a big dent in the organ shortage -- allocate donated organs first to people who have agreed to donate their own organs. UNOS, which manages the national organ allocation system, has the power to make this simple policy change. No legislative action is required.

Americans who want to donate their organs to other registered organ donors don't have to wait for UNOS to act. They can join LifeSharers, a non-profit network of organ donors who agree to offer their organs first to other organ donors when they die. Membership is free at www.lifesharers.org or by calling 1-888-ORGAN88. There is no age limit, parents can enroll their minor children, and no one is excluded due to any pre-existing medical condition.

Giving organs first to organ donors will save more lives by convincing more people to register as organ donors. It will also make the organ allocation system fairer. People who aren't willing to share the gift of life should go to the back of the waiting list as long as there is a shortage of organs.

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Transplantable kidneys infected with hepatitis C are being wasted

Hundreds of transplantable kidneys from people who have hepatitis C are thrown away every year in the United States, according to a study published in the American Journal of Transplantation. Escience News reports on the study, as does US News & World Report.

Some transplant centers give kidneys from hepatitis C patients to other patients who have hepatitis C. Recipients of these kidneys have a slightly lower survival rates than do patients who receive infection-free kidneys. The difference in 1-year survival is 1%, and the difference in 3-year survival is 2%. But the wait for an infection-free kidney is over a year longer, and the risk of death during that extra year is 10% to 15%. This more than offsets the lower survival rates from infected kidneys.

This is further proof that everyone can sign up to donate their organs when they die. Surgeons are also transplanting organs from people who had cancer and HIV. This is why LifeSharers doesn't exclude anyone from joining. No one will know if your organs are transplantable until you die. The surgeons will figure it out when the time comes. If someone tells you that you can't donate your organs, they are mistaken.

If you haven't already done so, please join LifeSharers. It's free. You can save several lives. One of them might be your own, because your membership gives you preferred access to the organs of other members.

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Should organ allocation follow the "Golden Rule?"

MSNBC.com is running a poll asking if people willing to donate their organs should get preferential treatment if they ever should need an organ.

The results so far:
Yes - 90%
No - 7%
I'm not sure - 3%

Click here to vote and see updated poll results. You can also post a comment and read other comments.

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Experts praise "organs for organ donors" law in Israel

Israel recently enacted a law that gives organs first to registered organ donors. Jacob Lavee, director of the heart transplant unit at Israel's Sheba Medical Center, says the law "will rectify the unfairness of the situation where people who are unwilling to donate wait in the same line as those who are willing."

The same Associated Press story reports other positive reactions to the law:

Writing in the December issue of The Lancet, the British medical journal, Dr. Paolo Bruzzone of Sapienza University in Rome said... "giving holders of donor cards priority in organ allocation sounds more acceptable than the introduction of organ conscription or financial incentives for organ donation."

Luc Noel, coordinator of clinical procedures at the World Health Organization in Geneva, praised the Israeli law for its educational value and for introducing a "community spirit" to the field of organ donations. "The bottom line here is doing to others as you would like others to do to you and that is where the community has a role," he told The Associated Press.

Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, said the Israeli measure was ethically sound — he called it "reciprocal altruism" that would benefit society as a whole.

In the United States, registered organ donors can get preferred access to donated organs by joining LifeSharers.

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Need an organ? Maybe you should move!

Geography plays a large role in allocating donated organs to patients in the United States. Under the allocation rules of the United Network for Organ Sharing, most organs are offered first to local patients. If no local patient needs an organ, it's then made available to patients elsewhere in the donor's geographic regions.

St. Louis University explains why this is important:

Recent studies have found that patients with similar diseases but living in different parts of the country had substantially different waiting times and waitlist mortality rates due to geographical differences in organ supply.

The resulting disparity can mean some patients will not have access to organ donations that could save their lives, says Krista Lentine, M.D., associate professor of internal medicine and lead researcher at Saint Louis University School of Medicine.

"The geographic regions were established prior to the availability of modern systems of organ preservation and without anticipation of the current unevenly distributed organ supply-demand ratios across the country," said Lentine.

Supporters of UNOS allocation rules say that only medical criteria should be used in allocating organs. But if geography was ever a "medical" criterion it isn't any more.

Most people think organs should be given first to the people who need them the most. It's a nice thought, but that's not how the system works. As long as UNOS is going to use non-medical factors in allocating organs, it should use "donor status" as one of them. UNOS already moves live organ donors up the transplant waiting list if they later need a transplant. UNOS should do the same for people who register to donate their organs upon their death.

UNOS should establish two transplant waiting lists: the "A" list for registered donors, and the "B" list for non-donors. All organs should be offered first to donors on the "A" list. Non-donors on the "B" list can have any leftovers. This would save thousands of lives every year by creating an incentive for non-donors to become donors.

Only about 50% of adult Americans are registered organ donors. Americans bury or cremate 20,000 transplantable organs every year. That wouldn't happen if UNOS put organ donors first.

Join LifeSharers if you'd like to donate your organs to other organ donors. Your membership will increase your chances of getting a transplant should you ever need one. It's free. It could save your life.

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