Organ Donation

Organ donation has always been a pet project of mine. I was the president of the Organ Donation Interest Group at my medical school. I also worked on the Decision for Life project, which was geared toward education minorities about organ donation and encouraging organ donation. Organ donation is one of the most generous gestures a person or family can make. It has a profound impact on many lives.

There was an Op-Ed published in the New York Times a few days ago, titled Death's Waiting List . In it, Sally Satel talked about what it was like to wait for an organ (she received a kidney transplant) and put forth some suggestions as to what the government could do to improve the situation. She is one of the lucky ones because she got her kidney after being on the list for only a year. She does make some interesting arguments.

First, she points out that the Institute of Medicine issued a report titled "Organ Donation: Opportunities for Action" in which they only suggest one new initiative. They recommended expanding eligibility beyond brain death to people who die from cardiac arrest. Since there are a much larger number of people who die from cardiac arrest, this could potentially include more organs to the system. I think this is a great idea. This doesn't mean all of the people would actually qualify to donate or that their organs would be viable - but it still increases numbers.

Secondly she discusses some other options that she felt the NIM should have discussed. The European system is interesting. In contrast to the system in this country, where you need to expressly state your desire to donate and (in many states) tell your family of your intentions, in Europe they have "presumed consent." This means that it is assumed you wish to donate your organs unless you sign an "opt-out" card. This is an interesting idea. It would certainly increase the number of available organs. But I do find the idea of "presumed consent" slightly discomforting. There are some cultures that view organ donation as a desecration of the body, and if the way to opt out is not well publicized, it is possible for someone who does not wish to donate to become a donor by default.

Another option she discussed was offering incentives to donate, giving things in life to people who are willing to donate after death. Traditionally, this has not been discussed much because it is perceived as being "organs for sale." I think that the sale of organs should be banned. However, I think that if someone makes the choice to donate their organs deserves something. I know that in some states, living donors can have their medical expenses related to the donation covered by the state. I think that this is a good idea.

And there are options to donate while living. Living kidney transplants are being performed all the time. Live liver donor transplants are also being performed. There is a long list of people waiting for bone marrow transplants.

Last week I had the privilege to provide anesthesia to a living kidney donor. He was giving his kidney to his father. It also meant that there were TV cameras in the OR, because a local news program was doing a feature story on them. I admire the son. He's in his twenties and decided to give a kidney to his father. This puts him at risk of kidney problems in the future simply because he has one less kidney. Then there was the risk of the surgical procedure and the anesthetic. Essentially, we were performing surgery on a person who doesn't need it.

Think about being a donor. Talk to your family about it and make sure they know your wished. Check out the National Donor Marrow Program . Donate life.