Opinion

Living donor transplants underscore failures in obtaining cadaver organs

LETTER — Posted March 19, 2007

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Regarding "23 doctors, 10 hours, 6 ORs, 5 lives: The logistics of an innovative kidney exchange" (Article, Jan. 1/8): At the Medical College of Virginia in 1964, David Hume, MD, envisioned organ transplantation to become the "NAPA auto parts" for humans' organs. Our research to study the efficacy of cadaver transplantation was sponsored by the National Institutes of Health. Tissue typing was primitive to nonexistent, so based on Dr. Hume's personal experience with identical twin transplantation, we performed a few living donor transplants.

We agreed that a living donor did not need to lose a kidney. The danger to the donor, although minimal, was apparent to all. We acknowledged that cadaver kidneys should take precedence. We knew then what we know now: We bury more organs than we will ever need to meet our transplant demands. Dr. Hume then founded the Southeastern Organ Procurement Foundation, which morphed into UNOS to obtain cadaver organs.

The demand for organs has exceeded the supply, and now it is acceptable once again to remove a kidney from a healthy volunteer. In our benevolent society, there will always be a person to donate or sell a kidney. That is not the issue. The real issue is, as a physician, how do we rationalize, justify or even explain taking a kidney away from a person who does not need a nephrectomy?

Religious philosophy and ethics will justify about anything, but the ethics of burying good organs in a time of identified organ need deserves another serious look by us all.

John D. Bower, MD, Brandon, Miss.

Editor's note: Dr. Bower is professor emeritus, Dept. of Internal Medicine, chief of Division of Nephrology, University of Mississippi Medical Center.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2007/03/19/edlt0319.htm.

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