Opinion: How to prevent 15 to 20 deaths a day

Paramedic Bruno Fernandini prepares a room for the Paramedic Bruno Fernandini prepares a room for the next patient at the University of Miami Hospital's Emergency Department on April 30, 2012 in Miami, Fla. Photo Credit: Getty Images

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Fifteen to 20 avoidable deaths will occur in our country today. These people will die because they didn't receive a kidney transplant. Five more will have their names removed from the waiting list today, having now become too ill for a transplant.

The U.S. kidney transplant waiting list is approaching 100,000, nearly half the population of Huntington. Regrettably, the growing diabetes epidemic keeps adding names to the list.

Organs from deceased donors are not keeping pace with the growing need. "Presumed consent" legislation stipulating that all deaths are eligible for donation unless an individual has opted out is stalled. Compensating would-be donors, another legislative slog, raises concerns about exploitation.

The potential for healing by living donation, however, is huge. It's hard to imagine that the nearly 100,000 waiting do not have family members or friends who could be suitable donors. We just need to inform potential donors that this is an option, and educate them about the risks and rewards involved.

In our own experiences, family members' willingness to donate varied greatly. It had less to do with how much they wanted to help and more with their innate tolerance of risk, and experiences with hospitals, illness and doctors. More information helps potential donors figure out whether they're well suited.

Although many thousands of donations from living donors have occurred since 1954 -- the first donor lived to be 79, dying 56 years after his transplant surgery -- there is still reluctance on the part of the federal government to promote live organ donation. A recent U.S. Department of Health and Human Services grant solicitation for "social and behavioral" projects to increase both deceased and living donations stated that "because of the risks associated with any major surgical procedure, this grant program will not support projects that attempt to encourage living donation." The United Network for Organ Sharing, which holds a federal contract to manage the country's transplant system, is similarly caught between its goal of increasing the number of patients who receive transplants and the need to safeguard donor rights.

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Often, those who oppose more proactive living-donor outreach efforts say there's not enough long-term data proving its safety. "No one can argue [against] the need for more data," Shamkant Mulgaonkar, chief of the transplant division at Barnabas Health in New Jersey, has told us. "The constant evolution of modern medicine depends on it. However, the short-term risk is low, and long-term studies get terribly complicated with time passing, aging, genetics and other factors confounding the studies."

What we do know is that the risk of donating a kidney is low, and that, as one of our surgeons told us, the operation has become "almost routine." Studies show death rates for donor nephrectomy at one or two per 10,000 surgeries, and since 1988, more than 90,000 living-donor kidney transplants have been performed. One of the core principles of practicing medicine is to "do no harm," yet at what point do the daily deaths from a lack of donors amount to "doing more harm" than not educating people about the possibility of live organ donation?

The clock ticks, and another 15 to 20 leave us daily.

We encourage and honor those who volunteer as firefighters and rescue us. Volunteer soldiers assume a similar risk when they step up to safeguard our freedoms. Why not encourage the impulse to help an ill family member or friend?

Living donation is not a perfect science. It's not for everyone. So, let's continue further research. And let's keep medical standards high -- but not to the exclusion of other humane considerations. Let's allow some risk to transfer to willing and able living donors. Let's save some lives.

Rick Antosh is the founder and president of The Gift of Living Donation (www.giftoflivingdonation.org)and a kidney donor to his son. Nancy Matsumoto received a kidney from her sister.

 

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