Saturday, September 21, 2019

Should the US government reforms its laws to allow more kidney transplants?

The waiting list for a kidney transplant is anywhere from 2 to 4 years depending on where you live, your blood type and other factors like compatibility and your size. The list has about 80,000 names on it, and 11 of them die waiting, daily, which represents around 4,000 lives per year that are not saved.

I found an interesting article in a magazine called The Atlantic. Its author, Conor Friedersdorf, suggests that the federal government should reform its laws regarding organ donations based on the fact that more and more Americans are going abroad to find a kidney. One of the popular destinations is Peru. Of course, this is a poor country and who really knows about the quality of the healthcare system. People in those countries are willing to give one of their kidneys in exchange for some money so they have a chance to live a decent life. There are risks to both the recipient and donor when these surgeries are performed in third world countries. Who knows if they really do a good job in looking for compatibility and transmissible disease the donor might have.

Some people are willing to take the risk just because they are tired of living on dialysis (the alternative to kidney transplant). Dialysis has its own risks: catheter and blood infection can all lead to death. Who wants to spend half of his life in a dialysis center anyway?

Like I mentioned earlier, it takes years to get a kidney transplant for most of the people waiting on the list unless they can find a living donor. Under US laws, it is illegal to pay someone for an organ or receive money from organ donation. If transplant centers were allowed to give good money, like $30,000 or more per kidney, to the donor, I do think there would be a lot of people willing to give organs. That could be a way to trim the waiting list pretty quickly.

I am afraid that if this whole process is not done the right way it could lead to some ethical and social problems. One of those is would rich be allowed to bypass poor patients by offering extra incentives? Should only hospitals be allowed to give money to the donors? Would the donor and recipient be paired on a first come first serve basis or the recipient will be able to handpick his kidney? Would there be good or bad reasons to accept a living donor candidate based on the motive?

Those all are questions that a panel would have to answer before moving forward. I don’t think the living donor transplant centers are immediately ready to handle the surplus of work. In a matter of a few months, one could see an increased of several hundred potential donors per hospital. You need staff and infrastructure to process and screen all those kidney donors efficiently and safely. A well-known hospital in the state of Pennsylvania temporarily shut down its living donor program last week because a kidney transplant recipient contracted hepatitis C with the new organ. Last thing we want to do is to harm patients.

Even if the government allows people to get money for their organ, which I would not have a problem with, it will take several months or years to catch up to the list of 80,000 people waiting for a new kidney. You just can’t safely screen and do surgery on that many people overnight. It might be time to start the conversation.

Pierre Luc Charland
Pierre Luc Charland
Aside from being a very experienced transplant coordinator in the Houston area, Pierre is also an amazing content creator for our properties. Pierre plays a key role in driving our mission and offering expert insight to the ever evolving world of transplantation.

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