Posted Wednesday --- February 27, 2008 --- 10:00pm
Three days a week, three hours at a time, Adele Christensen of Dodgeville waits, while a machine does the work her kidneys can no longer do. Without a dialysis machine cleaning her blood, removing excess fluid, Adele would die.
Christensen has had three kidney transplants at U.W. Hospital. Her body rejected the first two. But before it also failed, the third kidney gave her a decade dialysis-free. She says, "It was like getting your life back!"
Now, Adele needs another kidney….and she's not alone. According to Dr. Hans Sollinger, who heads up U.W.'s Transplant Program, there are about 90-thousand patients in this country waiting for a kidney.
Sollinger has to break the bad news about the kidney shortage to patients all the time. "We tell them they might have to wait 3 or 4 years and they are very shocked, they are surprised, and they are depressed. It's not a pleasant conversation which takes place between doctor and patient. "
So, Dr. Sollinger has joined Dr. Arthur Matas of the University of Minnesota and others around the country calling on Congress to reverse a federal law that bans organ sales. They want the federal government to pay you $90,000 to $100,000 if you're willing to sell a kidney to someone in need.
Sollinger says, "You might be surprised where these people (paid donors) come from. You might have hundreds of people here at this university who get up and say 'I want to do this', and this provides them with that incentive."
Under the proposal, the government would screen potential donors, provide them with follow-up care, and keep a close eye on how the kidneys are allocated. That way, Sollinger says, "The donor could not say, 'I want the kidney to go to Mr. Smith, or Mr. Brown, or a good looking young female'. The kidney would go in a pool and would be distributed to the medically neediest person."
He estimates if kidney donors were paid, hospitals would have all the kidneys they need in a year or two, and that the government would come out ahead financially because dialysis costs programs like Medicare more than it would cost to pay kidney donors.
Women are paid to be egg donors. So, he says, why can't we pay kidney donors? He says we should compensate donors the same way we pay people like firefighters, who take special risks to help others. Sollinger says, "There are many people who are very close and want to be a donor in an altruistic manner, and they just need a little push. They see there is some compensation and they will happily do it!"
The proposal is controversial in the medical community. As Harvard University Surgeon Dr. Francis Delmonico puts it, "What's the ethical justification for that? We're selling kidneys!"
Dr. Delmonico worries a cash for kidney program in America would prey on the poor the way it does in other countries. He says in Pakistan, poor people sell a kidney to get out of debt....or even force others, like their children, to sell one. He says, in countries where people are paid to donate, altruistic--unpaid-- kidney donations drop off.
"The public policy is not to exploit a person because they are poor. that's a social injustice!", Delmonico says. "That's what we are holding to....regulated or not. I don't think that we can overcome that as a basic problem...of someone being a predator. You'll sell your kidney because you are poor. Get over it! That's what's next, and that's what's going on." He adds, "There is a repugnance we have about this as a society."
Delmonico's concerned a 100-thousand dollar payment will also encourage poor immigrants already in America, and poor people from overseas to sell here. Delmonico questions, "Where's the ethics of saying, who are you, America, to stop me from coming to sell my kidney? Who are you! We get into a lot of who are you questions, don't we?"
But U.W.'s Dr. Hans Sollinger counters, "Clearly, there will be more people donating who need the money than Bill Gates and his family. That is no question. On the other hand, firefighters usually don't come from the Rockefeller family."
Sollinger says the government would closely regulate the kidney donor screening and sales process, which would actually bring an end to shady black market sales and bring an end to the kidney shortage in just a couple of years.
Adele Christensen, someone who's awaiting a transplant, says, "You probably wouldn't find a dialysis patient that wouldn't be for that." However, while she thinks it would be good to encourage and reward donors, she feels they shouldn't be paid too much. "The kidney is priceless! How can you come up with a reasonable figure? But I think anything over, say, $10,000 would encourage people for all the wrong reasons."
Dr. Sollinger says he used to agree with Dr. Delmonico and other opponents. But seeing too many patients like Adele waiting for a new lease on life has changed his mind about the notion of paying cash for kidneys. Sollinger says, "It doesn't sound good. It didn't sound good to me four years ago, and it doesn't sound good now. However, we have to be realistic. There is an enormous donor shortage. If only one out of 13,000 adult individuals would donate a kidney, the waiting list would disappear tomorrow!"
CLICK HERE for Kidney Association Link
CLICK HERE for Information on becoming an organ donor in Wisconsin