Amjad Ali, a poor villager from the Cholistan Desert in eastern Pakistan, was promised a job and money in exchange for a kidney. Asim Tanveer/Reuters.
In Bloomberg, a feature story posted this week focuses on the growing number of Americans who are going abroad to get kidney transplants, and the danger these illicit procedures pose to donors and recipients alike. It is very safe to donate a kidney given a good hospital and doctor. The fact that so many people are traveling to developing nations for this procedure is yet another reminder that organ donation policy in the United States is in immediate need of reform. Peru is an especially popular destination of people seeking kidneys, the story notes, but medical tourism of all kinds, and folks seeking new organs in particular, are more common than ever.
The desperation of those who need kidneys is easy to understand. Even if dialysis is working, it's a costly, grueling, and dangerous process, as Robin Fields showed so memorably in the December 2010 issue of The Atlantic. That's why it's maddening that the status quo in kidney donations remains in effect, even though it could easily be improved in ways that leave no one worse off.
Virginia Postrel, herself a kidney donor, explained in another piece for this magazine. Let's look at the context she provided:
In the United States, more than 80,000 people are on the official waiting list, all hoping that someone will die in just the right circumstances and bequeath them the "gift of life." Last year, only 16,517 got transplants: 10,550 with the cadaver organs allocated through the list, and 5,967 from living donors. More than 4,000 on the list, or about 11 a day, died. And the list gets longer every year.
...With 300 million people in the United States, the numbers shouldn't be so daunting. Eighty thousand people wouldn't even fill the Rose Bowl. Surely we could find enough kidney donors to end the list. But solving that problem demands creativity, daring, and, above all, a sense of urgency--a radical break with the fatalism fostered by dialysis culture. Kidney patients ought to command the kind of outrage that demanded a cure for AIDS. The list doesn't have to exist. It is a result not of medical necessity or economic constraints but of public ignorance, conscious policy, and complacent institutions. Too many people are suffering unnecessarily.
Her whole piece is worth your time. For our purposes, however, let's skip right to the solutions she proposes:
1) "...one way to end the list would be to find more altruists. With, say, 50,000 new living donors, deceased donation could easily pick up the slack. Again, the numbers aren't that big. The Southern Baptist Convention includes 42,000 member churches; the United Methodist Church, whose Web site earlier this year featured the quote, "As United Methodists, we're life savers," counts more than 34,000 U.S. congregations. If each congregation produced just one new living donor, the waiting list would disappear. But kidney donation is a more visceral mission than mainstream religious groups want to contemplate. The only sect to adopt kidney donation as a formal cause is a tiny Australia-based group called Jesus Christians; instead of lauding them, critics point to their donations as evidence that they're a cult."