More organs needed for transplants

Hey, buddy, can you spare a kidney?

What if you got $10,000 for your trouble? $100,000? Or more?

With 106,131 Americans now on waiting lists for an organ - 83,754 of them for kidneys - researchers at the University of Pennsylvania and the Philadelphia VA Medical Center sought to find out whether financial incentives would increase living organ donation.

Their findings - that payments would draw more participants without relying disproportionately on poor people - are highly controversial. Several ethicists yesterday criticized the study published in the Annals of Internal Medicine. See my full story here.

While, the idea of paying donors for organs has long been taboo because of concerns that it would unduly influence some people - particularly the poorest - to donate without fully appreciating the risks, concern about a shortage of donor organs is driving the search for new ways to increase the supply.

Last year, 6,453 people in the United States died waiting for an organ. Nearly 92 percent of them died waiting for organs that living donors could have supplied - 4,456 needed a new kidney and 1,452 a liver.

Last month in a commentary in the New York Times, Sander S. Florman of the Mount Sinai Medical Center wrote that the current transplant system is broken and that there is a thriving black market in human organs in the United States and across the globe. Moreover, he wrote, little is being done to enforce laws against selling organs. He proposed an opt-out system for deceased donation, where people are presumed to consent to organ donation at death unless they specifically decline to do so.

Lainie Ross, of the University of Chicago's MacLean Center for Clinical Medical Ethics, suggested an alternative approach would be to keep the current system where patients declare their interest in donating their organs. Upon their deaths, however, Ross proposes the we act on the donors declared intent to donate and avoid the problem of asking a grieving family for final consent as is currently the case.