Would you consider being a live kidney donor? Here are some stats...
http://www.dailymarkets.com/economy/2011/11/22/charts-of-the-day-kidney-shortage-worsens-yearly/
Yes I am one of those waiting for a kidney. Want to know more about donating? Contact me...just click on my name, takes it to my website and contact info....
Jan... so the summary of the link was this:
"The only realistic, long-term and truly compassionate solution to address America’s worsening kidney shortage is to legalize some form of donor compensation. "
Agree or not?
This is the position of Swedish
Donation must be a voluntary act, with no monetary compensation or other forms of pressure or reward.
As much as I hate to say it, I kind of agree. There are a lot of healthy people out there with perfectly good kidneys. There are a lot of us that don't have functioning kidneys. The disparity between those who need kidneys, and those who are getting kidneys is tremendous. Money talks. It's that simple. Of course, that's where some kind of regulations comes in, but more people would think about doing it if they knew there would be some compensation. There would still be stringent testing, so it's not like it would become a huge "market" kinda thing, I don't think. The question is...who pays? I certainly can't compensate someone..so there is that.
What do you think?
Well, I am not a registered organ donor. Once I found out that they harvest hearts while on a ventilator... I tore up the card. However, the doctors get paid, the hospital gets paid, the donor registry gets paid, the harvest team gets paid. What would incentivize me to reconsider? The chance to leave my daughter an inheritance would. I think any parent would. Steve Jobs had no problem finding a liver. I assume that a larger pool including compensated donors would increase the total supply. Both compensated and non-compensated donors. If I was on life support and my kidney was worth 50K (non-taxable) I would say cut away. Ditto post mortem. Seems the donor is the only one being asked to be altruistic.
Being someone who needs a kidney, I sometimes have a hard time with the fact that my life literally depends on the goodness of someone else. Yes, there is dialysis, and I am happy that the technology is there. But it sure plays havoc at times with "quality of life". Fact is, getting a kidney form a live donor has a better outcome than form a deceased donor. Especially for someone my age.Would I turn down a deceased donors kidney? Of course not. But..how does one put the word out to try and get a live donor? One has to literally promote oneself, and almost beg people to please , please go get tested. And, I have a high amount of anti-bodies in my blood, so it makes a match even more difficult. I'm not one to beg...it puts one in a quandry.So I periodically put the information out there. If it doesn't help me, hopefully it may help someone who is needing a kidney. (Of course, tax free - lol)
Jan, if someone gives up a kidney, then 10 years later the other one starts to fail, would a kidney transplant work for them?
What blood type are you?
Go ahead and beg, ask, question etc, etc.
Just for the record: Steve Jobs had "no problem" finding a liver because he had enough money to establish a residence in every state so that he could get on each state's transplant list. He also had a jet ready to fly at any moment so that he could get himself to wherever a liver might become available for him. I'm sure he could have bought himself a liver (or two) had that option been available to him, but he's hardly the typical case.
Rich, I would assume that a kidney transplant would work for them, just like with anyone else whose kidneys have failed. So, yes, I understand what a BIG DECISION it is to become a donor. I just reassure people that people can function perfectly fine with only one kidney. I actually know one person who was born with only one kidney (she has already told me sorry - lol)
My blood type? I am B-. The negative and positive part doesn't matter. So I can receive from either B or O type blood.
more info about live organ donations...
http://www.kidney.org/transplantation/livingDonors/infoQA.cfm
Irukandji
Member Profile
@Kootch re Cadaveric Organ Donation:
FWIW2u, brain death must be declared by two physicians, one of whom is a neurologist or neurosurgeon, and the full brain death exams must be performed many hours apart (locally, the timing is at least six hours apart). The patient is then declared legally dead, and the time registered on the Death Certificate is the time of that second exam.
The deceased is registered with the medical examiner's office by the hospital, and family is notified before any work toward donation can occur. Even as a registered donor there is nothing that can be done outside of life-saving work by a hospital until there is a time of death.
It can take MANY hours to perform the tests needed to find blood and tissue type, get med-soc history, receive clearance from the medical examiner's office, and provide the family with the information they need before any surgery can be done. Without recipients located and ready, there is no recovery of organs EXCEPT for kidneys which can remain on a kidney pump pre-transplant for up to 72 hours.
Organs that have suffered anoxic damage cannot be transplanted, hence mechanical management on a ventilator of the deceased until the time of organ recovery. Without the extensive and precise medical/mechanical management, there are no transplantable organs.
For Non-Brain Dead Donation, or Asystolic Donation heart recovery has never yet occured. The process requires that a patient have such compromised respiratory and neurological function that asystole occurs within fewer than 60 minutes after removal of the ventilator.
Withdrawal of mechanical support is the decision made by the family even before the option for organ donation is offered (assuming they haven't asked the hospital about donation already). If the family wants to allow an organ recovery team the chance to be onsite and ready for surgery upon withdrawal, that lengthens the time a family waits after having resigned to the fact that life is no longer possibility. It's a LOT to ask of a family, and even more to WAIT, just for the potential to donate.
Because the timing is so specific, and the anoxic damage that occurs to a body as it shuts down is so great, the organs recovered for transplant are usually only kidneys, and even then (with all tests performed in advance), their suitability for transplant isn't assured until they are recovered. It's just within the last few years that livers have been recovered for transplant from an asystolic donor. the amount of time it takes to perform such delicate surgeries rules out all other organs for potential donation because of the simple process of shutting down. Still, even in these cases, tissue and cornea donation remain an option since these are always cadaveric surgeries.
More info available if desired.
Live well, donate a beautiful corpse.
irukandji..for the record...Kootchman does not let facts get in the way of his stories. It's so much easier (and more fun, I suppose) to make stuff up ;-)
And what was made up? They harvest whilst you are on a ventilator and the heart is still beating. I understand you must be declared brain dead. You try too hard Jan..mostly in error. The issue at hand was a simple one, IF organs are to be made more available, why not offer compensation? That was the issue. I merely posted my uncomfortableness with the method... and obviously some potential donors and health care providers feel similarly.
Irukandji-
Thanks for countering the paranoid sci-fi falsities. They serve no one. You don't have to be a donor (although I don't understand the decision to NOT be one at all - don't you hope someone else is there for you if you need it??), but implying that organs are ripped from the living (who might at any moment sit up and ask for it back!) is just silly.
what you fail to recognize, Kootch, is that irukandji worked in the organ donor field for quite some time. She knows the ins and outs far better than the likes of you. Time to keep the mouth shut...at least on this one...you are the delusional one here. You cannot be the expert on everything, and it's showing..
and Kootch...the issue of compensation has come up more and more lately. How about your compensation being the fact that you directly contributed to saving someone's life. Why does it all have to come down to money? I read your article. No source for that, of course. I saw the word "harvest" mentioned once...maybe twice. You, in your original post, made it sound like they were "harvesting" hearts while you were still alive. You said it that way to get a reaction, pure and simple. You have your own reasons for not being an organ donor, and I can live with that. But please don't use the "harvest" thing as an excuse. It's a procedure, that's all. An organ from a deceased person needs to be viable. I think you understand that. The wonders of modern science. Might possible save a life or two.Guess you need to be in my shoes for an hour or two, huh...
Irukandji
Member Profile
I personally prefer a system now used in many other countries in which all citizens are presumed donors unless they specifically opt-out: it's the right thing to do to help others. Since such a tiny few meet all the necessary heath requirements AND die in a way conducive to donation (both for asystolic and cadaveric donation), the larger pool there is of those WILLING to donate upon death leads to the chance that there will be a tiny percentage more that actually CAN donate.
So you tore up your donor card, kootch? Yeah, I can just see you doing that. Probably for the best anyway.
What if they'd taken your heart and put it into the chest of some flaming liberal? Just imagine the confusion that poor person would experience on election day . . .
Oh, this is agony! My head says "Patty" but my heart says "Dino." What do I do? What do I do?
What "donor card"? It's a heart symbol on your driver's license, no? Those things are hard to tear up! I tried when I saw my photo.
Selling organs is not a good idea because . . .
♥ The rich WON'T do it
♥ The poor SHOULDN'T do it
And the middle class?
Excuse me . . . What middle class?
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I understand that selling organs is a well-intentioned proposal, and I'm not trashing anyone for merely floating it. But let's consider some hypotheticals.
Suppose there's an impoverished single mother out there, and she's got a kidney compatible with Jan's bod. She'd never thought about donating before, but in the past year, her kid has come down with a rare disease and she needs $45,000 for treatment.
Then she sees an ad in the paper:
Wanted: Kidney. Offering $45,000. Contact Jan at _______
So Jan, whaddaya think? Would you still want this lady's kidney, knowing the circumstances?
Or let's say her kid's healthy, but she just wants to move to a better neighborhood, or take him to Disneyland while he's still little.
Maybe there's a loan-shark she needs to pay off.
Oh, hell. What does it matter what she wants to do with the money? Could anything be a worthy trade for her own kidney?
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365Stairs
Member Profile
Pretty easy thought for me at least...Won't need it anymore...if it's still useful - take it.
I found the movie Seven Pounds (Will Smith) to be pretty thought provoking.
Another one - I think it was called "Repo Men" told the story of folks that could not pay for their elected or otherwise donor items and well...had to "give" them back...so to speak. Off topic a bit...but plays into the selling discussion...
I might be convinced to support the selling of an organ under kootch's scenario of a brain-dead person on a ventilator. Certainly, no harm would come to that person from parting with an organ. And with the proceeds, they could leave a tidy legacy for their family.
However, there is STILL a potential problem, even with this limited, post-mortem type of sale.
Think of the millions of death-donors out there now who, if death-bed selling were to be allowed, might just revoke their free donation, based on this line of reasoning:
Hey, I'm not rich. If something happened to me, my family would really be hurting. Why should I give away what I can sell for good money? Why not let my family sell my organs to the highest bidder?
As this kind of thinking spreads, the number of on-death free organ donors drops, and the organs that are "harvested" for sale after death now end up going not to the impoverished Jans of this country, but to the Steve Jobs's . . .
How does that outcome square with the original intention of using the marketplace to increase the availability of organs?
Jan..
Here is the direct quote:
"Once I found out that they harvest hearts while on a ventilator... I tore up the card"
I didn't imply anything. I tried to open the discussion a bit and send a URL on the emotional response of others... and resistance to the same decision. You sure find a lot of stuff...in a one sentence. I sent an article.. not a treatise. Don't know how better sourced it can be than the person who wrote the article , can you? I can be an expert on how I feel about an issue, an emotional, gut reaction. You read all these Jan 'thingies" into some pretty simple statements. irukundji I would have presumed is in the organ donation field...and the issue still remains, greater availability. So far the transplant industry has monopolized the ethics, the procedures, while the demand increases and supply does not. And, yes, I had a laminated unifirm donor card Ms. A.
"You, in your original post, made it sound like they were "harvesting" hearts while you were still alive"
DPB a more reasoned response:
"I understand that selling organs is a well-intentioned proposal, and I'm not trashing anyone for merely floating it. But let's consider some hypotheticals"
DBP... why follow your heart, of course. :-)
Selling organs..let's not call it that. Let's call it compensating for a donation. Imagine the regulations involved with that. Yes, I do agree that money talks and that would make more people open to it. It just seems to me that "doing the right thing" should prevail, money not withstanding. But doing the right thing isn't cutting it, it seems.I'm sorry that I seemed to have misunderstood.
DBP
"As this kind of thinking spreads, the number of on-death free organ donors drops, and the organs that are "harvested" for sale after death now end up going not to the impoverished Jans of this country, but to the Steve Jobs's . . "
Steve Jobs level of wealth could fly to India, Sri Lanka, Bulgaria, etc. today and purchase a living donor organ, and we know China sells executed prisoner organs. That is a given. The unknown is would transparant compensation increase the total available transplant organs? A person on the wait list as I understand it lives in the confines of a harvest protocol. A scenario: A church member needs a transplant. That community who embraces that person has time to mobilize resources, raise funds, and generate enough income to offer donor compensation. Social networks have built barns, harvested crops, remodeled homes for handicap access...and importantly, pulls others into the organ shortage debate. It's not like a whole lot of people LIKE to encounter or discuss the issue, that, confronting mortality thing. Being part of social mobilizing effort would bring a degree of familiarity, perhaps a better comfort level, and exposure to different view points.. alturism is sometimes a marinating and extended thought process.a twice a year 30 second ad campaign doesn't work.. opting out is not consent,..altruism I would suspect is hard to coax in the middle of the event that makes donation a possibility. As it stands today, there is no planning horizon to mobilize a procurement effort since compensation is not part of the equation.
All good points, my man. I could be persuaded to change my views on this, as long as two conditions are met:
1) We DO end up with more donated organs avaiable and
2) We DON'T end up with poor people trading their body parts for basic necessities.
I go through the Swedish Transplant Clinic here in Seattle. I know that the level of testing is great, for both me, and for donors. DBP, your point # 2 would presume that these donors would be going through intensive testing, including psychological and financial discussions. It's what happens now. The question of compensation is...who pays? Do the organs go to the highest bidder, and us folks with little money go by the wayside? Does the gov't. pay? I'm sure some would have a problem with that. Does insurance pay? Seriously? We all know how they just LOVE to pay for things. Compensation brings up many many questions. And lots of problems. Kootch says he wouldn't mind having an "inheritance" for his daughter in exchange for an organ. How much money does one person want for an organ? Who's the decider? Kootch brings up altruism. Here I am coming to the blog forum. I'm just putting out information. I was even hesitant to do that, as I figured it would be intrusive. But that's me. I don't know any other way to put the word out there that there are organs needed desperately. Sure, I have an ulterior motive. And I've only been on the national transplant list for three months. There are many who have waited much, much longer than that. But, how do we "advertise"? I post on Facebook, talk about it, share info. If I can get an organ for one person, even if not me, it will be worth it. I will admit...before I was dx with failed kidneys, I didn't ever seriously consider a live donation. Maybe I just needed to be asked. So..here I am asking :)
the problem with paying for organs is that not everyone can afford them.
we already live in a society where your checkbook determines whether you will receive anything but emergency medical care... let alone experimental care for life threatening conditions.
monetizing medical care has clearly not worked out well for us as a nation.
we need to reverse the trend.. not exacerbate it.
money is not always the answer
I commend your courage, Jan.
And I'm GLAD you started this thread.
This is an important topic, but without your participation many of us would feel shy talking about it here.
"monetizing medical care has clearly now worked" oh? transplant is possible because of a monetized healthcare system. The technology, the surgical teams, the hospital... all results of a monetized system. Eliminating the "underground and illegal" transplant destinations, Iran, India, China etc... the USA has the highest transplant rate in the world... 22 per million. Socialist medicine countries, .ie France.. 4 per 1 million, Italy 2 per million... Sweden..has only 14 registered donors (donors, not actual transpalnts) per million. Lowest transplant rate in Europe.
Job, methinks there is at a minimum, a short sighted view, to condemn a monetized system. Reverse the "trend" and the shortage grows more critical. Maybe the "right" combination is insurance paying less to the current industry... allowing access to offshore hospitals, with compensation to donors for that lowered cost? Is the transplant "industry", surgeons, hospitals, ... all those now benefitting from the status perpetuating a system where critical donor shortage means they can maintain their margins and not have to share revenue with a donor?
22 per million..why do I not like those odds? For you, Kootch, money in your pocket, no matter how it's gotten, is always the answer, isn't it? I don't want to go to an "offshore" hospital. I want to stay right here and go to Swedish. Is that OK with you? Is your last sentence a question? If so, could you rephrase it? 'Cause I don't understand what you're asking...
kootch...
sure.. i hear the justifications too
the truth is that the American taxpayer subsidizes new procedures and drugs that are then sold at a discount in other countries...
yes, people from our neighbor to the north travel to America for procedures they would have to wait for in their own country...
or for experimental procedures...
but people from America travel to other countries to replace a hip.. or get a transplant... or for experimental procedures that are either rationed through their insurance company.. or unavailable.. or unaffordable here.
so if our "monetized" system is such a great deal for Americans
why are medical vacations to other countries for necessary surgeries such a hot ticket?
kootch...
you speak of increased availability for organs...
but just how available do you think organs would be for people without the ability to pay?
because here is the ugly truth...
failed organs much pretty make people unemployable
and the longer they live with failure the less likely they are to be employed
thus making them un-insurable in the standard employer driven market.
do you really think organs for sale are going to increase availability in a market with high demand but no purchasing power?
my business sense says no.
kootch-math:
Socialist medicine countries, .ie France.. 4 per 1 million, Italy 2 per million... Sweden..has only 14 registered donors (donors, not actual transpalnts) per million. Lowest transplant rate in Europe.
For our edification, where did you get those numbers? My sources show that Sweden actually had 15.1 cadaveric transplants per million in 2007 and 14.4 live donations per million in 2006.
That's not "registered donors," kootch, that's actual transplants. From live donors.
Source: Council of Europe, Directorate General for Health and Consumers
Link to downloadable source PDF document: http://tinyurl.com/7j23557
again, DBP, don't let facts get in the way of a good story ;-)
Well, if kootch can either cite his source or give us a retraction, I'll be happy. I suspect he's a little confused about his numbers, though.
Either that, or he's just lazy.
( Time for the remedial statistics class at Evergreen College? )
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According to the source I listed in my previous post:
France: 23.4 cadaveric donors per million, per year (4 live)
Spain: 33.6 (2.3)
UK: 12.9 (11.1)
Belgium: 27.1 (3.9)
Depending on what you're calling "Europe," Romania (not France) actually has the lowest rate, at 1 cadaveric donation per million people, per year.
In countries where they have automatic cadaveric donation, it figures that you would have a lower rate of live donors, since people from those countries may assume that there are enough cadaveric donations to meet demand – even though such is not the case.
(Please note that when I say transplants or organ donations, I'm talking primarily about kidneys.)
Huh? An offshore hospital option has improved access. Affordability seems to the major criteria . It seems to be a solution that is growing. The more options, the more access, I would guess is better than the alternative. Is is ok with me? I don't what that means.
kootch..
perhaps you should re-read what you posted.
DBP... sorry I didn't source it.. I wasn't in defending thesis mode..rather the general discussion a "monetized" system entered they discussion...but I can find the absolute number of transplants ... Eurotransplant... it did not differentiate between live and cadaver transplants for kidneys. But.. money IS the name of the medicine game. I found this interesting for Ms. Job... actuarial data... it is now cheaper to receive a transplant then dialysis... varies by age, other conditions etc... but.. the costs of surgery have dropped...hence the acceptance of insurance of transplants as an alternate therapy to dilaysis. Now... that being the case... if that savings is so substantial, IF kidney/organ costs are lower than dialysis AND it was legal... donor compensation would probably be covered by insurance. As Jan stated, live donor procurement is even less expensive as a therapy.. soooo...because of lower stays, oral vs intravenous drugs, the least expensive therapy would be a live donor. The difference in that cost is large... if an insurer was to pay for live donor compensation, and transplant costs, it would cost less than 4 years of dialysis. Make sense? Given a choice...which would an insurer do? "Bottom Line"... thank god for a monetized health system JoB that has reduced those costs eh? Seriously...instead of general service ads... imagine the insurance industry with a Madison Avenue approach to cost savings.. actively promoting transplant options...and donor compensation being a component. I believe the donor pool would expand. Jan would not be putting it out there by herself..her insurance company would also be putting it out there too. Maybe? Donor compensation might be part of the solution. I am done with the issue... just some thoughts..interpreted widely as they are.
I didn't say"live donor procurement is even less expensive as a therapy". Live donors give better outcomes than cadaveric donors...that's a fact...
and the drugs that you take for the rest of your life are not cheap, whether a live donor or a dead one...right now Medicare will pay for some of that...but in the future? who the hell knows...lolol..."my insurance company" is the government...and we all know how you feel about their spending..just saying...
and..insurance companies already have a Madison Ave. approach...
You didn't... I messed up my editing track... you did say..."live donation is preferable"...and the article concurred...saying less complications... less expense. Poor editing, my bad. I have a WFA issue with Medicare... and... the government is not active as far as I can tell seeking the least cost (and in this case, best?) method because as it currently stands... it can't solicit... As I would interpret the article, your preferred solution is the most cost effective.
kootch...
there are two fatal flaws in this argument...
"if an insurer was to pay for live donor compensation, and transplant costs, it would cost less than 4 years of dialysis. Make sense? Given a choice...which would an insurer do? "
you left out the option of the patient dieing before the costs of the dialysis exceed the costs of transplant
and .. if those who require transplants become unemployed as a result of their kidney failure and can no longer afford insurance...
the insurance company doesn't foot the bill
the taxpayer does.
either way it's cheaper for insurance companies to pay for limited dialysis.
As for the feds..
an option that returned taxpayers to gainful employment would be more cost effective for the government...
live transplants stand the best chance of doing that.. for both participants.
How did this thread ever get so discombobulated?
Jan and kootch, you shouldn't even be arguing, because you agree on the main question, which is whether to allow the selling of organs. You are both in favor, right?
I, like JoB, have strong reservations about the idea. However, I'm not willing to let those reservations stand in the way of Jan's survival or the survival of thousands of other Americans currently waiting for organ transplants.
As a compromise, perhaps we could agree to drop the ban on selling for, say, 10 years and then review the situation . . .
Kootch..re:your post 41....my preferred solution is always a live donor, whenever that happens, because as an older person, I want what has the best outcome right now.If a deceased donor comes along, I damned well am not going to turn it down. And my preference would be, sooner than later , for whatever kidney I may get. Money is not the important deciding factor here. Getting a transplant is. And that's why I started this thread..to get the info out that I, and many other, need kidneys...from , preferably, live donors. It's Christmas...give the gift that's much more important than that iPad...the gift of life.
DBP...I am on the fence about compensation for kidneys,other organs. I prefer to not call it selling. While I understand that it may bring in more donors, altho that's not a given, I also understand why it might not be such a good idea. Just a Mugwump here.....
a success story :)
http://www.king5.com/news/local/Facebook-Kidney-Transplant-135625443.html
maybe there's hope for me , too :)
JanS..
there is always hope for you :)
2 Much Whine
Member Profile
Hey Kootch, if I am on a ventilator and am brain dead I would gladly let them "harvest" my heart and donate it to you at no charge if it would help improve your quality of life. Unfortunately, I fear your body would reject the heart of a democrat. . . . .
miws
Member Profile
Ya know, a few weeks ago Jan started this thread on a topic that is very important to her personally, (and knowing Jan, even if it didn't hit so close to home for her, she'd still be nearly as passionate about it), in the interest of raising awareness for the critical need for organ donors.
W(hy)TF did this have to turn in to a controversy?
Of all of the threads currently being discussed on these forums, W(hy)TF couldn't this have remained on a positive note, to educate and inspire others to become organ donors, and to get involved in other ways to help Jan and others who are on long waiting lists.
I won't say what's really on my mind here regarding the negative comments, but would like to put out the reminder; 'Tis the Season.....
Mike
thanks, Mike..
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