Here is a suggestion. When people renew their drivers licenses, they should be given the opportunity to do so at zero fees, IF they check off YES to organ donation.
4
One of the breakthrough in the application of nano science
today is Nano Kicking.i.e transformation of stem cells into bone putty that helps to fill the gap in bone fracture. We hope that soon the medical world would invent an artificial kidney or heart to match the needy to avoid a search for the donor.
When the world makes many with healthy heart and kidney to kick the bucket in the name of terrorism,shooting innocent
children at schools and also in war every day, we are in dire necessity of numerous 'organ- specific nano kicking' today.
1
This article doesn't bother to mention the medical issues that preclude organ donation - HIV, drug abuse, and syphillis for instance. New York attracts and keeps populations that have higher rates of disqualifying diseases. And its only recently that people with HIV could be donors.
2
1. Neither drug abuse nor syphilis preclude organ donation 2. conditions that would preclude donation are excluded from donation rate evaluation
This is a national problem of disrespect for all donors, deceased and living. Consent for organ donation in New York and across the country would improve if federally funded donor compensation was instituted. For more on this topic see here: https://medium.com/@ronparsons_1776/empathy-protection-for-kidney-donors...
3
and what about family living related donors...
3
That's easy--because there are poor people involved.
1
I would rather see an article on 3 d creation of new organs rather than the same old irritation about lack of organ donation.
2
The media is largely at fault. They love to report on the "miracle" cases of "brain dead" patients making miraculous recoveris. On further investigation, it is always found that the diagnosis of "brain death" was misrepresented by the news media, ,the family, and sometimes even the hospital itself. But many now think that donation from a brain dead person will be tantamount to killing any chance of recovery..... of which in real "brain death" there is none.
2
All jews are allowed to donate. The issue is a bit sticky when you get to the issue of brain death, however. Being a donor is not against jewish law but it would usually need to be a situation of non-beating heart death.
1
I work with people on dialysis - independent dialysis (there are 2 options - peritoneal dialysis or independent hemodialysis), often at home and much more than 12 hours per week which is better for one's overall health while waiting for a transplant. Unless there is a medical reason, I wonder why this young woman is doing what we call 'conventional' dialysis which is typically for older and more frail patients....yes it keeps one alive but it doesn't offer nearly the same quality of life as independent dialysis can.
Mr. Alcorn does not mention that kidney failure, need for dialysis and organ transplant is largely due to high blood pressure and diabetes. He does not mention this connection in his article about the need for organ donations. We need more attention to the behaviors that lead to high blood pressure and diabetes as a preventive way to avoid kidney problems altogether.
4
Cultural impediments are hard to overcome. Trying to talk a grieving family who do not see organ donation as a viable act for religious or cultural reasons can legitimately decrease the ability to secure approval.
But then down at the tail end of the article is the clincher - something that can be changed easily. The medical establishment and hospital/ER team can prioritize organ donation higher up the list. This we CAN fix with incentives for the hospital that reduce the cost of prioritizing donation and increase participation. Fund the staff time necessary to make donation viable - create an incentive.
Any hospital focused on profits, or any hospital that cannot afford to pull staff from the next patient in line to address an issue that won't help the last patient in line at all might not see organ donation as something they can afford to do.
While there may be many elements to this quest for organs. There is one element that physicians in the Midwest have observed, but which doesn’t get discussed in the literature. Organ donations increase in the warm months. Why? It’s because young heathy caucasians engage in more dangerous activities then. Motor Cycles are are a major factor. Sadly I’ve heard them refereed to as donor bikes.
7
One can't deny the fact that China has become one of the most preferred nations for organ transplantation, especially for kidney
in the world today.
When my wife suffered renal failure in 2006 we were encouraged to visit hospitals in Philadelphia, and received a transplant two months after our interview. Our kidney doctor here said religious attitudes prevailing among NYC Metro communities of color inhibited donations here, but that attitudes in Philadelphia were entirely different and more accepting. I encourage people to make the trip to Philadelphia and take advantage of that city’s first class transplant establishment. Twelve years later our kidney is still going strong.
7
After my son Daniel jumped to his death at the George Washington Bridge in 2016, LiveonNY contacted me for permission to harvest Danny's organs to which I said yes. I thought that if I cannot have Danny any more, someone could have a part of him that would live on.
LiveonNY reported back that none of Danny's organs can be harvested because of the hospital's resuscitative efforts after his jump. So this meant that Danny should have been forced to die for his organs to live on? Is that the state of organ donation today?
Why would the hospital employ means to resuscitate Danny that would jeopardize his organs? None of this made any sense at the time and still bedevils me today. Now I have a brother-in-law dying of kidney failure and his doctor is killing time with office visits as no donor can be found and death is at his doorstep.
Can this problem with organ donation be fixed?
8
One thing I’ve heard is that non-white communities are more resistant to organ donations because of a history of ethical lapses in medical situations (Tuskegee syphilis experiments and Henrietta Lacks to name two.) New York is one of the most diverse cities in the US. Could this cultural resistance explain some of the low numbers?
13
This article failed to mention the role of the Organ Procurement and Transplantation Network (OPTN)as well as the United Network for Organ Sharing (UNOS). The OPTN is run by the HHS and I believe UNOS is non- profit private organization that works with the OPTN. The OPTN breaks up the country into regions. UNOS helps to match recipients with donors. When a donor becomes available, UNOS will speak first with hospital transplant coordinators in the donor’s region. If there are no matches they go out of the region until they find a match for all organs: heart, lungs, liver, kidneys etc. Transplant surgeons from all over come to harvest their individual organ. Sometimes they are from the same region and sometimes not. There are time limits to how viable an organ will be once it has been harvested to implantation. So the thinking is that a regional donor would result in the best outcome. Science is changing and there have been some developments in extending the ischemia time of an organ.
Individual states can opt out of the OPTN/UNOS and use their own private organization to allocate local donors with recipients. UNOS has recently changed the way organs are allocated because of the dire need in New York. The organs will be allocated based on need first, regardless of region. I believe it will take effect later this year.
In Florida, UNOS is used as well as a private company called Translife. There might be more factors at play in New York as to why there is a scarcity of donors.
2
There’s some misinformation in this comment. Translife in FL like LiveOnNY in NY is one of 58 federally designated organ procurement organizations in the US, all work with UNOS Look up the National Organ Transplant Act NOTA, the web site for your local OPO and/or the UNOS web site to understand more about how the system works / e.g. the role OPOs vs role of UNOS in the system.
Ethics aside, I wonder if there would be more organ donors if it was conditional in order to receive an organ.
5
My brother got a liver 19 years ago. We wanted to meet the donor family to thank them. Our wish was not granted but we were told by the transplant team manager that the donation was authorized by the donor's husband and that they had a two children, ages one and three. My sister-in-law, a very good writer, did get to compose a letter of thanks that was given to that wonderful man. I often think of him and his children who by now would be young adults. I hope their lives have been and will be as good as they could be under the circumstances.
Jaime, I do not know what your job is in the transplant center but I wonder about something. Have you considered that in your position you may not be privy to what are intensely personal feelings of a combination of gratitude and sympathy on behalf of the donee's family towards the donor and their family. Remember this is occuring at the same time they are experiencing joy and relief because their loved one is getting a new organ. I am pretty sure there were workers at Georgetown Hospital who weren't around when we were expressing our desire to meet and thank that wonderful man.
1
My brother got a liver 19 years ago. We wanted to meet the donor family to thank them. Our wish was not granted but we were told by the transplant team manager that the donation was authorized by the donor's husband and that they had a two children, ages one and three. My sister-in-law, a very good writer, did get to compose a letter of thanks that was given to that wonderful man. I often think of him and his children who by now would be young adults. I hope their lives have been and will be as good as they could be under the circumstances.
Jaime, I do not know what your job is in the transplant center but I wonder about something. Have you considered that in your position you may not be privy to what are intensely personal feelings of a combination of gratitude and sympathy on behalf of the donee's family towards the donor and their family. Remember this is occuring at the same time they are experiencing joy and relief because their loved one is getting a new organ. I am pretty sure there were workers at Georgetown Hospital who weren't around when we were expressing our desire to meet and thank that wonderful man.
It should be noted that the sorry state of New York's organ donation/procurement results in unnecessary deaths not only for patients on the waitlist, but also for some of those who go on to receive transplants. When patients are forced to wait way too long for a donor organ their bodies become weak and fragile. This inflicts extreme strain on all the organs (not just the one in need of transplant) and puts patients at risk for complications and increased mortality after transplant (and is not a good use of precious donor organs). In addition, with the scarcity of donated organs in New York, its transplant centers are perhaps more likely to accept offers of sub-bar organs—again, giving post-transplant patients a poor prognosis from the start. There has to be a better way. And there is—outside of New York.
4
The best way to increase the donor pool is to change the donation laws. Right now donors have to opt in to be a donor. If everyone was deemed to be a donor unless they or their next of kin opted out we would have many more donors. I know because that law changed has occurred in most off Western Europe and they have a short or non existent waiting period. Here over 8,000 people die every year waiting for a kidney
5
Not true. The UK and Germany don’t. France instituted a form of opt-out last year and donation rates actually declined. Sweden has low donations rates despite decades of some form of opt-out. Spain legally has opt-out but in reality they consult the family. But they’re still the most successful because they also have a well funded national program to encourage and process donations.
Only countries like Singapore have a hard opt-out. If you’re not in their database of opt-outs, they just immediately rip your body apart. It does increase organ availability, but you’re living in an authoritarian state where things like press freedom and political opposition are repressed.
1
Your facts are off. Scotland has increased donations; Spain has increased donations; Wales has remained the same. NO ONE is suggesting a hard opt-in with no chance to change. The European systems permit the deceased, her next of kin and/or medical proxy to opt out. Whatever political problems you have with Singapore I suspect go well beyond organ donation.
2
Just to clarify, England and Scotland do not have opt-out. Scotland considered it, but nothing has passed yet. Yes, Wales has opt-out.
I acknowledged Spain was most successful, but it’s from factors beyond opt-out. They have a national program with well trained workers to carefully engage families. It’s the people that make it successful.
4
there is a common sense solution,though I don't know if it's legal.simply pass a blank box law. if
the dead person left the organ donor box on his
license or state ID empty, just take the organs ,
whatever the survivors think. many families raise
religious objections or are just uninformed.
take the decision away from them and save lives.
4
New York City doesn't have many white protestant christians, and those people are the biggest organ donors.
The state doesn't help itself by making it harder and harder to access bodies of dead people, under the influence of religious groups with an overblown sense of religious sanctity of the body.
Religious superstition and wailing about disadvantage or privilege cannot stand in the way of using useful organs to save human life.
15
This may be dependent on the times-but when I first got my drivers license in Massachusetts, I was asked directly if I wanted to be an organ donor and responded yes. In both NYC and CT when I renewed my license, I was not asked if I wanted to be an organ donor, and after waiting in a very long line, I forgot to ask them about it. Posters at the DMV and a requirement to ask would increase the number of donors.
9
After UCLA bumped yakuza boss Tadamasa Goto to the front of the line for a liver transplant, in a year when hundreds died waiting for donor's livers, I decided to stop being an organ donor. When vice president Dick Cheney jumped to the front of the line for a heart transplant at age 71, that reinforced my opinion -- I would rather accept nature's unjust lottery, that gives and takes from every social class in equal measure than participate in a system that harvests and funnels donor organs up to the social elite.
21
You think “nature’s unjust lottery gives and takes from every social class in equal measure?” How about all of the other income-related health disparities? Maybe you don’t want to be an organ donor; fine, your choice. But don’t make it like you are correcting some social injustice by doing so. Most likely, the person who dies waiting for an organ as a result of this mentality will be some regular Joe, whose family and friends would have appreciated more years with him.
9
The doctors for the patients waiting for transplants aren’t allowed to have any contact with the families of potential donors or the donors or involvement in their care or treatment decisions. Stop spreading lies.
8
Your decision is personal and legitimate, but it's not based in the truth. Please check your facts. The only way to move to the front of the line is to be very, very sick - there is no "jumping," as these patients are so sick they can barely walk a few steps. In fact, in heart transplant, patients who move to the top of the waiting list generally have a two-week life expectancy. Dick Cheney - like him or not - heart was in such utter failure, he had to have a device implanted to keep it beating—these devices are given to the sickest patients to bridge them to transplant, and they have grave risks. He waited like everyone else - for years - and then got a heart. Want to see how transplant waiting lists really work - check this out: https://optn.transplant.hrsa.gov/learn/about-transplantation/how-organ-a...
7
It is interesting that there is an assertion that Orthodox and Hassidic Jews, along with other groups, will not donate. I believe that is incorrect. My father was in need of a kidney transplant (no one in the family was a match) and spent 3 years on dialysis. A physician in NJ suggested reaching out to nonprofits in the region (in addition to being listed in NY, NJ and other areas, though my father declined to be listed outside the region). One such nonprofit, Renewal, is run by ultra-Orthodox Jews who facilitate kidney donation from living donors as a form of mitzvah. Alas, perhaps instead of assuming a particular group- be it very religious Jews, people of color, etc- is unwilling to donate, we should work on cultural awareness to identify potential barriers and develop methods to approach donors and families in a respectful way that will allow them to feel comfortable with the decision to donate organs.
13
Alas, I cannot donate my organs because of arthritis medicine that I take. However, it is heartwarming to know that my tax dollars are paying into the 'Caid for the poor
2
I had a liver transplant in 2015. I left my home in NY and travelled to New Orleans because of the horrendous wait times in NY.
Have you seen the offices at LiveOnNY? Fancy shmancy full floor in Manhattan with tons of space and custom finishes. When I applied to be a volunteer, they NEVER followed up with me. Evidently there is no follow up for anyone who volunteers. Frankly, I am disgusted with them.
They should be removed as the organ procurment agency for New York.
30
What you’re saying is simply incorrect. The doctor quoted in the article about preserving the opportunity for donation knows what he’s talking about.
Everyone has to die at some time. People do not have a right to other people's organs. The hospitals have made transplantation a big business. The harvesting teams swoop in like vultures badgering family to donate the organs of a loved one. Even though the harvesters and those who care for the victims are different, there is no way there is no pressure to "pull the plug", but only figuratively. They want the donors alive so they can cannibalize them better. Some people seem comforted giving away organs but that doesn't mean everyone does.
It makes me sick when I hear people say they are waiting for an organ. No! Essentially, they are saying they hope someone, preferably young, dies soon in an accident that damages their brain but not the organs they want. The liver or kidney didn't suddenly become available. Someone else died. You do not have a right to their organs.
19
This is simply not true. You do not need to be dead to donate a kidney, nor to donate part of your liver. My brother donated a kidney to me in 2001, and we are both still very much alive and well. You can live fine with single kidney, as he and I both do now.
This article does not explore the fact that many MORE people are alive and well these days due to laparoscopic nephrectomy, which harvests the kidney from a living donor in a minimally invasive way, and leaves just a small scar for the donor, reducing recovery time immensely.
Prior to this technology, all donors were opened up like a fish being fileted, then had their bottom two ribs removed, and then the kidney was extracted. This left a scar like a helix around one’s torso.
Living donation is what has been revolutionizing organ transplantation for the past 17 years, not cadaver parts.
And people are going outside the registration system to do so, helping each other out, and donating to strangers who they are a match for in return for a stranger donating to a loved one. The article should have focused on the option of living organ donation in equal measure.
10
I imagine the problem is a combination of religious quackery (i.e., that removing organs from someone that's already cold and dead is somehow 'immoral' or 'sacreligious'), bureaucracy (confusing forms to fill out, no clear information on what constitutes a formal declaration that one is willing to donate their own organs, where such a declaration should be filed and/or with whom), superstition/ignorance, and a simple lack of sufficient press on this huge void in the NYC area.
NYC needs to run an effective advertising campaign within the MTA system.
3
Yes. Agreed. And also the Ask matters: the way in which the grieving family is approached, ideally by a well-trained, compassionate, capable person on staff at the hospital (or someone from LiveOnNy). I know a donor mother who said No when she was approached in a gruff, haphazard way by a random hospital staff member while her daughter lay braindead from meningitis. It was only later, when she felt goosebumps (that she perceived as her daughter trying to tell her DONATE DONATE) that she changed her mind. The Ask matters - a lot.
1
There was a PR campaign a while back in NYC featuring Jerry Orbach and the fact that he donated his eyes. It was the catalyst for my choice to become an organ donor.
4
I think one of the most selfish acts anyone can do is take their body with them once they have left this realm. ( in reality their bodies are but worm food, or ash once cremated )
Aye, there are those that are going to chastise such a comment and possibly decry religion or some such thing, but don't you want to give life to someone while taking your last breath ?
Think about it. (and become a donor)
18
Is there any good reason not to donate organs? It's not as if you need them when you're dead.
As far as kidneys go, shouldn't prospective recipients go to family members first?
9
Yes, transplant teams generally encourage those in need of kidney transplants to seek living donors. However, many times within a family, no one exists. I know because that’s my current situation- I’m an only child, both parents have been disqualified, as well as all related aunts/uncles. I’ve literally considered printing a shirt with my need and blood type and wearing it in Times Square for a few days.
6
My cousin in need of a kidney refused the offer from his entire family. He did not want to jeopardize their health.
2
I am alive today thanks to the generosity of a 38 year old man named Gregory, who was a organ donor.
Because of this, his heart lives on in me!
I am shocked to hear of the organ procurement shortage in New York. Thank goodness I was in Pennsylvania and was under the exemplary organ donor awareness and procurement of The Gift of Life.
I am also shocked to read some of the horrible and negative comments left in the Times. To think NY is a "progressive" city!
To those who think that patients needing a life saving organ transplant somehow brought it on themselves is judgmental in the worst possible way. Many people, including me, inherited their disease, unknowingly passed down the line by way of genetics.
To those who believe this, I say I hope you are happy being openly ignorant and judgmental.
Would you say this if your son, daughter, parent, spouse or other loved one needed a new heart? A new kidney?
Have a heart!
8
Some people don't feel comfortable donating their organs due to cultural or religious reasons/differences and shaming them would not make them more likely to donate. Organ donation is not a political issue, so it is not liberal or conservative to decide to donate an organ. It's a personal choice and I think you should respect that.
5
??? Even if it contributes to more deaths???
Let's also include an exemption from all income & estate taxes; & an NPR tote-bag or mug.
1
Is it a coincidence that the most progressive city in the country is the last generous in this regard or more evidence of the arrogance and hypocrisy of liberals today? Just saying, and I voted for both Clinton and Obama once each, so I'm no right wing nut case.
8
The diverse population contributes to lower donation rates in different ways. Orthodox and Hasidic Jews have long standing religious objections. Blacks have a history of mistreatment by and therefore distrust of the medical community. In China, organs are often procured from executed prisoners, including political prisoners and the falsely accused. Drug, tobacco, and alcohol abuse excludes many young Whites as suitable donors.
Refusing organ donation is not a political statement. Paying more taxes for government services is completely different from allowing yourself or relatives from being hacked apart alive. I went to school with people who went on to become doctors. They were intelligent, greedy, and manipulative. I’m not relying on their determination of supposed brain death.
Increasing organ donations requires building trust. The way the donation system operates does not engender that.
7
"Just saying" is what people say when they don't have facts or logic on their side. And I voted for Clinton and Obama, too. (Obama twice.)
New York progressives are very good at telling others what to do, or demanding that the government do something. New York progressives are not very good at lifting their own fingers to do something good for someone else.
12
Trenton McKinley was declared brain dead. The hospital convinced his family to sign the donation forms. But he wasn’t dead and actually woke up before they could harvest his organs.
The issue comes down to lack of trust in doctors and hospitals. Both in competency and in ethics. Hospital administrator and surgeons are not extremely wealthy because they’re humanitarians. You need only examine the UCLA liver transplant scandal with the preference given to Japanese yakuza members. And remember Dick Cheney’s heart transplant? Transplants like every other aspect of American society are tilted toward the wealthy and powerful. Presumed intent and opt-out only reinforce the fact that we’re just spare parts for the global elite.
This article mentions the most sympathetic patients. But not more controversial cases like Riley Hancey. Perhaps the lower donation rates in New York are because we’re more informed and therefore more cynical about the altruism rhetoric surrounding the organ transplant industry. Who do you think New York’s prestigious hospitals are going to place at the top of the transplant list, the housekeeper or the hedge fund executive? If you think medical criteria only determines list priority, I have a bridge to sell you.
21
I can tell you that many folks in Louisiana with Medicaid are transplanted. Liver transplants are based on how sick a person is or their MELD score and not how much money they have. I can’t speak for the other organ transplants.
3
The UCLA scandal occurred before MELD scoring was introduced. The MELD scoring model has been adjusted over several years to prevent doctors from gaming it with exceptions. But problems with data manipulation can still occur. You just need a doctor to tamper with lab results. There was actually just such a scandal in Germany a few years ago. It contributed to a fall off in organ donations there.
4
If they want them, they can buy them. Medical industry make out like bandits so why shouldn't we at least get fair market value? Can't afford it? Life's tough. World's vastly overpopulated and only getting worse every day. At current rates WWIII will occur before 2050 over resource - primarily water and food - scarcity.
5
It is illegal in the US to buy or sell kidneys.
My question when I see the shortage of kidney donations is where are your families?
Regrettably the answer is simple - In a trend that has lasted more than a decade, 39 percent fewer family members — parents, children, siblings or other blood-related family — are donating one of their kidneys to a relative in need of a transplant.
We are simply less generous and charitable as a nation across all political and social strata.
19
We can't have it both ways. Either we want people to have large families--- so that they potentially have a ready-made social safety net and source of organs--- or we want smaller families because the world is already overpopulated and resources are already scarce.
7
I used to think that donating my organs would be a good thing. Now I think it's just another way for the medical industry to reap huge profits, not only from the expensive surgery but also from the all the drugs required to prvent rejuection of the donated organ. One reason for so many damaged organs are pharmaceutical drugs that destroy livers, kidneys and hearts. Other reasons are GMOs, processed food diets, excess alcohol, smoking and other controllable factors. That is to say that in many cases the organ failures are earned by our own negligence and in some cases the ignorance of doctors. I read about one doctor that was curing people dying from liver failure using intravenous alpha lipoic acid. He incurred the wrath of his boss because the clinic made its money from liver transplants.
I sympathize with people waiting for transplants and it's a difficult issue. But it's one manufactured by the medical industry.
5
Do you sympathize with people waiting for transplants? If so, perhaps not saying things like "in many cases the organ failures are earned by our own negligence" would be a better way to demonstrate that sympathy.
7
What on earth are you talking about? Every transplant center in the country does living kidney donations and talks to patients and their families about it. There is no fear of swamping the system at all.
9
You might be right but still, being an organ donor is an incredibly important contribution to humanity. Think of all the people out there who are ill through no fault of their own, who could benefit from a donation. Think of the lives viable organs can save. It's sickening to think of people suffering and others choosing not to contribute upon their deaths when their own earthly needs have ceased. Often adults who would gladly accept a donation are not donors themselves, and that really is unacceptable.
This is not to say that all reasons, including preventable ones, for the need for transplants shouldn't be explored and addressed. But in the meantime it's hard to make any kind of a case for not being a donor at one's death. It's a colossal waste.
4
Not wanting to be uncivil, but I suppose that if people are not willing to make the appropriate, humane arrangements, the social order will have to require such arrangements for every individual as a matter of law (think Obamacare extended "beyond authority").
https://www.youtube.com/watch?v=Sp-pU8TFsg0
2
"Presumptive Donation" has already been proposed.
1
Five years ago I donated a kidney to my husband in Portland OR. There are excellent programs there which allow donation Iby people who are adequately matched, not perfectly matched to recipients. My husband is doing well, and I am delighted we could have more years together. He is not on any different regimen from a recipient who might have been what’s considered a perfect match.
Many physicians and programs are aware of this possibility. I can only imagine that there is a fear of swamping the system if people become aware of the possibility of donating a kidney to a loved one. I thank the wonderful health care professionals who gave us another chance at a good life.
5
I live in MA where one can be an organ donor by indicating such a desire when obtaining or renewing a driver's license. The license is marked accordingly. Could the fact that many New Yorkers don't drive be part of the problem?
31
that is an excellent point. I do not drive, but I have a card that states I am an organ donor and it is noted in all my medical records and in my health care proxy and I have stated the same to all of my relatives. even those with non-driver's drivers licenses can fill out a form. here's just one place you can register: https://dmv.ny.gov/more-info/register-become-organ-eye-or-tissue-donor
8
Kehinde’s story resonates so strongly with me. I too am one of the 8,500 New Yorkers awaiting transplantation. Despite excellent medical care throughout my lifetime, the kidney disease I was born with progressed rapidly 2 years ago. Like Kehinde, no one looking at me would suspect that I share her battle. But, it is a battle that consumes you. You wake up every single day knowing that you will die unless you receive the truly miraculous gift of kidney from a living donor or deceased donor. It is always in the back of your mind and is a consideration in every life decision you make (can I go on vacation? Do I tell my young children? Do I share this with my work? Is it time to take on that new job?). And while I wait, I must manage my anxiety about the future and what tomorrow holds.
Despite what some of the commenters seem to think, I know that organ donation is the greatest gift you can ask of someone, and for me, that has been by far the most difficult aspect of this – knowing that someone needs to be hurt to make me better. Every person who has been tested for me as a potential living donor is a true hero; every family that chooses to donate their loved one’s organs at death is heroic. And I’m convinced that the large team of doctors, coordinators, and nurses who care for us on the transplant list are secretly wearing superhero capes under their white coats.
33
Thank you for your comment. The sheer amount of time and energy that dialysis takes up — and the limits it puts on other aspirations on life — stuck with me as I reported this piece. I hope you get a chance at a donor organ soon.
2
Institute a free funeral system for the donee. That will counter the harvesting for money argument.
32
If karma counts for anything in the afterlife, donating an organ you won’t need seems a good way to rack up some points. Some of us may need help on our credit score.
22
Very interesting article. But also, it underscores the imperatives of preventing the need for transplants.
About 45% of renal failure, for example, is due to diabetes---yet neither the New York City or New York State Departments of Health will pay for the CDC's Prevention program, a multi-session course that reduces by almost 60% the risk those with high blood sugar will actually develop diabetes. And this is but one example where targeted education is a proven intervention to prevent diabetes-related renal failure.
45
Just make organ donation the default, with an opt out option. And give preference to recipients who are on a donation list.
27
"And give preference to recipients who are on a donation list."
So people can opt-out but then opt-in when they need to get on the list? Sounds like the great logic of of the ACA, you don't have to buy insurance until you get cancer...
5
Change the rules so that hospitals that want to do transplants have to clean up their act so that their ERs & ICUs have to help increase the donation rate.
2
What's love got to do with it? Plenty as the folks featured in the article will tell you, that becoming a living donor extends the life of a dialysis patient some 50% longer than a kidney from a cadaver but both are the gift of life, regardless. Need more inspiration? Here it is: http://www.nephtalk.org/nephtalk-magazine/2018/may/an-act-of-love-donati...
4
Spain's ONT (National Transplant Organization) has become a leader in organ donations per capita and transplant operations. They have accomplished this by developing a world class system combining education, coordination between facilities, and an opt out donation process. They are a model for the rest of the world to follow, many of which are getting onboard. http://www.ont.es/Paginas/Home.aspx
16
HRSA funded a small proof of concept trial in NYC headed by Dr. Lewis Goldfrank around 2010. He had to get buy in from the city, state, feds, medical and religious communities, etc. It was based on the Spanish model. It had so many hurdles to pass that the trial ended before they could retrieve their first donation. It is worth revisiting.
3
Maybe this is what Cynthia Nixon should be campaigning on instead of tilting at windmills about ICE. Does she really think a governor can do away with a federal agency?
28
Many, many people, especially some people of color, worry that if they are listed as an organ donor on their drivers license medical personnel will not try to save their lives. They fear that they will be left to die so their organs can be harvested. Far fetched? Medical abuses against Black Americans are well documented. Marion Sims, the Tuskegee experience, forced, uninformed sterilization, etc.
35
The same reasoning keeps a person suffering under a ventilator, force fed via tube, no hope for a recovery, while another person ends their life without unnecessary intervention at greater peace for loved ones, and maybe being of benefit to a stranger. People can make own choices even if the choices do not make sense and cause extra grief to the most important people in the world, your family.
3
No matter how one views the Jahi McMath case, it has almost certainly eroded trust further.
2
That's about the most ill informed. incorrect statement I've read today, and given that I've caught up on all the things Trump has said, that impressive.
17
Because I have a relatively high body mass index, no one will accept my organ donations. At least, it was that way five years ago. Does anyone know if this has changed?
2
It's important to distinguish here between living donation and post-death donation. You probably will be denied the ability to make a "living donation," such as giving a kidney or part of your liver, because of potential risks to your health. Living donors usually have to be very healthy. But if you suffered a fatal accident, your own health would not be a consideration. After death, many of your organs could still save others' lives.
11
Millions of New Yorkers donate and fundraise to help cure cancer, AIDs, polio, malaria, MS... things that may never be curable. Yet they will not agree to donate their loved-one's, the surest way to save a life. What a sad indictment of our priorities.
3
This article is a valuable exposé of a critical aspect of health care. Improving the likelihood that people will consent to organ donation is a complex process that needs to be further studies and improved. Many of the people involved in this process are no doubt aware of this. Improving public awareness about the importance of organ donation can help. But the way each of us views donating our organs or those of a loved one is highly impacted by our religious, cultural and socio-economic backgrounds.
As is always the case, those with the least financial resources get the worst health care. The inequities need to lessened but as a country, we are sadly going in the opposite direction.
3
"He and a team of other clinicians spent an hour resuscitating the patient’s heart so that it would continue circulating blood to the other organs and they could be donated, the kind of intensive intervention that trainees might assume only a living patient merited."
This is not only unethical, but medically uncalled for as no organ hypoperfused or that long will be a viable transplant - at least not one that any rational patient and surgeon would accept. .
3
New Yorkers may be more aware of the economic divide between the rich and everyone else than the rest of the US. That knowledge informs them doctors are as greedy as NYC real estate developers, and will declare someone dead in order to harvest their organs for the sick family members of the very wealthy. Potential NYC organ donors should suspect the transplant industry of conspiring to use them as commodities to service the rich who can afford transplant surgery, and provide the transplant industry with above median wage revenues. The transplant industry cannot be trusted to perform their skill for the public good, and potential donors should reject the appeal to allow their organs to be used to earn revenues for the elitists of the medical class, who treat donors as a surplus to be exploited.
6
Wow sorry but that's just crazy. Have you ever heard of the Hippocratic oath? This sort of ridiculous paranoia is not something you should go around telling people.
8
This thinking is flat out wrong and certainly contributes to the deplorable organ shortage in NYC. Medicare covers all transplant costs for patients who can't afford the procedure. At the transplant center where I was transplanted, University Hospitals in Cleveland, over 60% of organ recipients are covered by Medicare. Transplant surgeons are not in business to pad their salaries. In my experience, they are dedicated to making a difference in peoples lives.
I pray that this baseless sort of attitude is not common in NYC. Lord help you if it is.
42
Doesn't matter if they do. Cryogenically frozen means an ice cold corpse. Freezing breaks cell walls and there will never be a way to revive a body that's been frozen.
My father in law recently died waiting for a lung transplant. Though he was a New Yorker he had to go on the list in Pittsburgh at UPMC because it was more likely that he would get a lung there. But the commute back and forth was too much for him and when he went for a routine check up last January, he lost the ability to breathe shortly after arriving and died.
New Yorkers are often too wrapped up in the considerable daily difficulties and challenges of life in this city to dwell on their own mortality, let alone that of others. But I agree that an effective PR campaign would help.
6
In Delaware we have many motor vehicle accidents which involve motorcyclists who ride without helmets - hence become prime candidates for organ donation. In Maryland we have excellent helicopter triage for motor vehicle accident victims who are delivered to Baltimore within an hour. Like it or not, New York's mass transit and highway congestion reduce per capita the chances of harvesting organs for donation. So If you're waiting for a transplant the chances are so much better in PA, MD and DE.
23
I think all Americans should be thought of as organ donors unless they carry a card, obtainable online or with your driver's license or with your voter's registration or when you join the military, designating that they are opting out of that program. It would then be not something discussed with next of kin in those moments when someone is dying-'do you want to donate your next of kin's organs?' but would be a given that any organs seen to be fit for donation would be taken. And over the course of time a fundamental shift in thought would occur from the body as some sacrosanct object to a useable source of salvation.
15
I guess all those billionaire condo owners simply intend to have themselves cryogenically frozen until mortality can be "disrupted."
4
Dear Erin,
What you say is unfortunately true, but there's nothing that can be done about it. The rich will always be able to extend their lives more than the non-rich. But the poor in America are rich by comparison to most of humanity, and they too consume more resources than the norm.
Also, keep in mind that I am a donor, and I don't do anything directly about reducing humanity's numbers, asides from not having children. But as for the notion that whatever kills more humans helps the world, there is no rational denial of the situation.
Dear Frank F.,
Doesn't matter if they do. Cryogenically frozen means an ice cold corpse. Freezing breaks cell walls and there will never be a way to revive a body that's been frozen.
1
This is one of those problems that a huge PR campaign should solve. There's no shortage of deaths. Congrats to the NY Times for shining its bright light o this very important issue.
The most crucial health care issue, by far, is transitioning to single payer, medicare for all.
America needs to join the rest of the industrialized world and make a healthy, well educated, population, our top priority. Bernie Sanders brilliantly advanced this argument and the momentum must be kept up. The Trump crowd, of course, is a huge obstacle of massive ignorance. However, they are the minority, and a massive demand for change can make it happen.
Get active!
14
I've seen no evidence here that other nations with universal health care (you don't mean "single payer" as no nation in Europe has single payer!) have better outcomes for transplantations nor higher rates of donors.
"Massive demand for change" -- that's funny!!! if your numbers are so vast....why have you lost not just the White House...but the House, the Senate, 37 Governorships, 1000 other public offices and oh yeah...SCOTUS for the next 30 years?
Organ donation should be an "opt out" not an "opt in".
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Yes, yes, "opt out," just like the motor-voter prevision in driver's license issuance. Get a DL, give an organ, save a life or two. I recommend this listening to this podcast about becoming a living donor: http://www.nephtalk.org/nephtalk-magazine/2018/may/an-act-of-love-donati...
3
Opt out instead of opt in. I am for it when they do it with our corrupt income tax system
2
It might help if they started paying peoples' estates for organs considering how much the hospitals charge.
5
Ryan, rethink that. Do you really want bidding wars over organs, where rich people would outbid the poor every time? Rich geezers like "Mr. Burns" on The Simpsons would get the organs, not poor little children?
Where donors could be seduced by the idea of making $150,000 -- getting them out financial peril -- by selling off body parts?
Not a dystopian future that I would enjoy living in!
3
I would support the introduction of an opt-out system for organ donation. Also there was no discussion of live donor donations for kidneys or liver. What efforts are in place to encourage this?
9
Two words: Presumed Consent. Many European Countries presume that you are a willing Donor, unless you opt out. It works, for everyone.
82
Actually the truth why NYr’s donate less was addressed by Times columnist Nick Kristin in one of his columns:
.................
Bleeding Heart Tightwads
Nicholas Kristof
Nicholas Kristof DEC. 20, 2008
..........................
This holiday season is a time to examine who’s been naughty and who’s been nice, but I’m unhappy with my findings. The problem is this: We liberals are personally stingy.
Liberals show tremendous compassion in pushing for generous government spending to help the neediest people at home and abroad. Yet when it comes to individual contributions to charitable causes, liberals are cheapskates.
Arthur Brooks, the author of a book on donors to charity, “Who Really Cares,” cites data that households headed by conservatives give 30 percent more to charity than households headed by liberals. A study by Google found an even greater disproportion: average annual contributions reported by conservatives were almost double those of liberals.
4
My brother waited 3 1/2 years for a liver and a kidney. He endured dialysis three times a week for 3 hours per session. It was a horrible journey. I am a teacher and encourage my 16 year old students to donate. I am proud that I have an organ donor sticker on my drivers license. Unfortunately, my brother passed away. Donation is the gift of life that I pray more people will consider. You can give someone another chance, or let your organs rot in the ground. Your choice.
47
The entire health care industry in this country revolves around profit. Doctors, nurses and other health care providers deserve to be well compensated. No problem with that. It is the business element between the patient and medical community that gets under my skin with obscene compensation to bring profits to share holders while doing everything to deny healthcare. If the profit motive is permitted for one segment of the health care industry, why not compensate organ donors? It works in other places. I refuse to donate until there is a public health option or a single payer with an option to purchase a supplemental private policy and the middleman role is minimized.
7
Paying organ donors is a disaster.
The Journal of the American Medical Association had an article about paid organ donors in Pakistan, and the New York Times Magazine sent a reporter to interview the people involved for a first-hand look.
They both found that organ donors are the poorest people, who are in debt and sell a kidney in hopes of paying off their debt.
The organ donors almost never get the amount they were promised, and sometimes don't get paid at all. The donors usually wind up debilitated, and often can't work at all any more. They don't get followup care. And they quickly wind up back in debt again.
I used to see the argument in the Wall Street Journal editorial page, written by people who believed that the free market was (literally) a panacea that could solve all problems.
The market for organs is like the market for prostitution. Wealthy buyers exploit desperate, poor sellers.
46
Of course the AMA is not at all biased.
3
Interesting stuff, looks like the main reasons for the lack of available organs to transplant are the LiveOnNY organization and the hospital system. If a third of New Yorkers are registered organ donors, that is a pretty good rate, and I'd say we're generous enough. Probably eliminating the LiveOnNY organization and replacing it with a new one, and exhorting hospitals to focus more on organ reclamation, would solve this problem.
Larry Niven has a recurring theme of the logical consequence of this medical process; eventually we will probably make it legal to harvest the organs of prisoners we execute. When that happens, the move to eliminate the death penalty will evaporate, and death penalty crimes will start being added. Everyone wants to live a bit longer.
For now, I'm a donor myself, but this isn't a big deal to me. I can't help but see how every problem on earth results from an abundance of humans, so having more humans die, particularly rich ones like Americans who use the most resources, is always a good thing.
1
"So having more humans die... is always a good thing." Wow. The article did explain how the richer people in need are able to go out of state to get organs. It's the poorer people, less likely to "use the most resources", who are stuck waiting longer and/or dying. So once again, people are not "generous enough" to those who really need it.
3
Dear Erin,
Sorry, I responded but it got applied to the wrong comment due to some sort of glitch. My apologies for repeating myself a bit, but we can't do anything about the rich using their wealth to get unfair advantage. Poor people in the U.S. are still using far more resources than the average human. And even though I'm an organ donor, and not doing anything to reduce humanity's numbers, it's rather obvious that whatever kills people helps the planet.
2
I really cannot see many people looking at a population, covered in tattoos from dubious places, a lifetime engaging in dubious behaviors of all kind, poison pumped into the body, and saying, “Let me have one of those organs.”
3
I work in a transplant center in another part of the country. Most patients and families believe that organs are grown in a lab somewhere, and show little respect for the gift of life they have received from a donor. I for one I am not a registered donor. And upon my death my organs will incinerate with the rest of me.
19
Please reconsider. Your organs would provide life saving treatment for others. As ashes they would be trash.
4
A very sad commentary from one who works in a transplant center.......You would rather waste your organs than help someone to continue to live?
24
I encourage you to reach out to more people who have received this gift of life. Your sample sounds skewed.
The hundreds of transplant recipients I've met have incredible gratitude for the generosity of not just their own donor and donor family, but ALL donors and donor families.
8