Transplant process should be more open

History was made on Oct. 20 at Presbyterian/St. Luke’s Medical Center in Denver. One of Robert Smitty’s kidneys was transplanted into Bob Hickey. It wasn’t the transplant itself that was unusual, nor was it that the kidney came from a living donor; such surgeries are becoming commonplace. The unusual part of this particular surgery was the way the kidney’s donor and recipient got together.

Smitty discovered Hickey needed a kidney from a Web site, MatchingDonors.com, a for-profit site that matches donors and recipients. It is the first time an organ donor and recipient have been matched on a commercial Web site. And that’s where some people see a problem.

It’s illegal to buy and sell organs, whether from live or deceased donors. Officials at St. Luke’s postponed Hickey’s transplant for two days while they investigated the possibility of such an arrangement between Hickey and Smitty. It turns out the only money that passed between the two was for Smitty’s travel expenses and lost wages due to the surgery, allowable under present law. Hickey also paid a fee to the Web site to post his request.

Some in the medical community question the propriety of those needing transplants advertising to the general public. We disagree with them. In fact, we’d like to see more openness in the transplant process.

It’s not that we think there might be something fishy going on; we just think more people could benefit if there were a market-based system for organ donors. We’re not talking about buying and selling organs, with only the highest bidders getting transplants; instead, we envision some type of stipend or cash gift for donors or families of deceased donors. This could provide an incentive for donors and families to provide organs for the thousands of patients currently needing transplants to live better, fuller lives.

The national transplant waiting list currently contains more than 87,000 names. Those people must wait for someone to donate an organ from a deceased loved one or, in the case of those needing a kidney or liver, an altruistic living donor. Providing donors with an incentive could encourage those who are undecided about providing needed organs.

That might encourage some bereaved families to reach out to help others in their time of personal sorrow. While the expenses related to harvesting organs are not charged to the donor’s family, there are other hospital costs that must be paid. In the case of living donors, a bit of cash might provide the nudge needed to push a hesitant donor in the direction of donation.

It might sound crass to some to inject money into what has been a system that relies on the good side of human nature, the part of people to want to help others with no thought of reward. That sounds nice, but those 87,000 people waiting for organs don’t all have time to rely on the good nature of their fellow man. And let’s be honest, there’s already a lot of money changing hands, so why shortchange the one person without whom such life-saving surgeries would be impossible?

The Internet is a relatively new tool folks can use to broker such deals, and although paying for organs, no matter the amount involved, raises questions of ethics and fairness, it seems the time has come for serious discussions of all factors involved in the life-saving surgeries. We owe it to those 87,000 looking for a second chance.