Ideally, we should be able to put a stop to the organ shortage through the manufacturing of artificial organs. Research is advancing rapidly in this direction and there have even been successful transplants involving an artificial trachea, windpipe or esophagus. However, when it comes to complex organs, like the heart, kidney, liver or lung, the steps that have been taken so far are encouraging, although their concrete application is still to be expected at an indefinite and hopefully not too distant future time.
In a context in which in the United States alone 30 people die of organ failure every day, the organ shortage cannot be taken lightly. Relying on organ cadavers, though helpful in and of itself, has proven not to be enough for our current demands. It is estimated that even if everybody would register as an organ donor after death, the organ crisis could still not be solved. While waiting for the breakthroughs of artificial organ manufacturing, could there be a way in which we might at least partially improve the current organ situation?
A positive answer with high prospects for success comes from Sigrid Fry-Revere. In The Kidney Sellers, Fry-Revere looks into the way in which Iran has managed to successfully cope with the kidney shortage and also at those practices that set it apart from the American model. Rather than focusing on the harvesting of cadaver organs, Iran has encouraged the compensated living donation. Iranian people are not selling their kidney, but are instead being offered money and other benefits in order to make altruism possible.
Following this reasoning, the petition to introduce and pass the Stop Trafficking in Organ Procurement and Transplant Improvement Act of 2014 (SOTN Act) in Congress is aimed at increasing the penalties for illegal transplant tourism and at removing the barriers to living donation in the US. Here is the Act's detailed proposal:
1) Increase the criminal penalties associated with the brokering of / or sale of organs for transplant.
2) Remove the financial disincentives that hinder living donation by establishing a federal benefit to help donors cover the non-medical expenses inherent in any living organ donation. The federal benefit established by this legislation should only apply to Americans willing to donate to people at the top of the waiting list in their own transplant region. If patients make it to the top of the transplant waiting list, it is pretty clear they have exhausted all other options for getting an organ. No one wants to wait longer than absolutely necessary because the longer patients are on the list, the more the chance that they will develop health problems that disqualify them from getting a transplant. Also, Medicare saves the most money by removing those at the top of the waiting list because those are the patients who are at the highest risk of developing debilitating illnesses that cost Medicare more than providing a transplant.
3) Allow charitable organizations to provide non-medical assistance to donors without fear of violating the National Organ Transplant Act (NOTA). The federal benefit would only go to donors willing to give to someone at the top of the waiting list, but charities could help any donor, for example, a linchpin donor for a chain (domino or paired) donation or someone who wants to donate to a family member or friend before that person even goes on dialysis.
4) Create a living donor registry that allows living donors to move themselves, or one relative, to the front of the transplant waiting list in their region should they at some later date need an organ themselves or for a relative. This provision removes a non-financial disincentive for donation.
It seems that, in the short run, living donation is our safest bet in the attempt to alleviate the organ shortage. Every day matters and every delay, big or small, leads to more lives being lost. If you believe in this cause, you can sign here the petition to remove the financial disincentives that hinder living donation.
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