Organ Donation

 

KIM LAWTON, correspondent: It’s early morning at Washington Hospital Center and time for a quick prayer before Flavia Walton heads into surgery. For eight years, Flavia’s husband, Bill, has had severe kidney disease, and Flavia is donating a kidney. But her kidney isn’t going to Bill. They weren’t compatible enough—at least when it came to kidneys. So Bill had to be put on the transplant list.

BILL WALTON: You are placed on the list, and then the wait begins, and it goes on and on and on, and your only hope is you can check the list on the Internet and see if the numbers are getting any smaller. But they never do.

LAWTON: Then Bill and Flavia heard about a program known as a paired kidney exchange, where Flavia could donate her kidney to somebody else, and in exchange Bill would get a kidney from another donor who was a perfect match.

BILL WALTON: Bottom line here is you’ve got to give one to get one.

post07-organdonationLAWTON: The Waltons were part of the world’s largest kidney swap to date, sponsored by Washington Hospital Center and Georgetown University Hospital. It involved a complex chain of 28 surgeries at four different hospitals. Most of the donors gave a kidney in order to benefit a friend or family member. But a couple of donors did it out of a sense of altruism, with no particular recipient in mind. In the end 14 patients who had been particularly hard to match received kidney transplants. The donors and recipients were introduced to each other at an emotional news conference.

RALPH WOLFE (kidney donor speaking at press conference): I love this guy. I don’t even know him, but I love him.

GARY JOHNSON (kidney recipient speaking at press conference): You can’t imagine how fortunate I feel that somebody from somewhere in the universe came and gave me a kidney.

FLAVIA WALTON (speaking at press conference): To see someone that you love most in the world deteriorate is a sense of helplessness and powerlessness that you just cannot comprehend unless you’ve been there. But to be able to do something is so empowering, but it is such a blessing.

LAWTON: More than 100,000 Americans are currently on the waiting list for an organ transplant, the vast majority of them waiting for a kidney. Over the last decade, an estimated 60,000 people died while still waiting for a transplant. Given those numbers, many experts say there is a moral obligation to encourage more people to become organ donors.

post04-organdonationPROFESSOR ROBERT VEATCH (Kennedy Institute of Ethics, Georgetown University): Just a little nudge would do enormous amounts of good in terms of saving lives and making sick people’s lives better.

LAWTON: The incentive for Flavia Walton to become an organ donor was clearly to benefit her husband of 42 years.

FLAVIA WALTON: If God could give his son for me, or for us, I could certainly give a kidney to keep someone else alive. And I certainly want to keep him around as long as possible. I don’t know if he wants to keep me around that much longer.

BILL WALTON: No, I got no complaints.

FLAVIA: Okay, okay. But no, it was not a hard decision at all.

LAWTON: Living donors are screened psychologically to ensure they are not being unduly pressured into the surgery. It is major surgery, but because of medical advances the risks to the donors are quite low. Because of these factors, Professor Veatch at Georgetown University’s Kennedy Institute of Ethics says there are few ethical problems with kidney swaps such as the one the Waltons were part of.

VEATCH: If we can get a living donor we get a better kidney, a more viable kidney, and it shows up in the survival-rate statistics.

post02-organdonationLAWTON: His main ethical concern with the swaps is making sure that kidney patients without a loved one willing to donate are not pushed lower on the waiting list, particularly those with hard-to-match blood types.

VEATCH: We at least want to be fair with the people on the wait list who don’t have a family member available. Being fair might mean waiting a trivial extra amount of time, but we certainly don’t want to make those people wait years extra just because of the swap arrangements.

LAWTON: While the swap program has been successful, some other strategies to encourage organ donation have run into roadblocks because of the National Organ Transplant Act, which forbids any monetary compensation for organ donation. Twenty-five years ago, Veatch testified in support of that law, but he’s now urging that it be revisited. He’s calling for experimentation with some token financial incentives. For example, he would support a modest discount on driver’s license renewals for people who sign up to be organ donors. Or, he says, there could be a question on income tax returns asking people to be donors, and even offering a tax deduction for those who say yes.

VEATCH: It sort of taints the altruism of organ donation. On the other hand, real human lives are at stake here, and I would be willing to compromise the altruism at the margins if we can really save some lives.

post05-organdonationLAWTON: Veatch also says the religious community should do more to promote organ donation.

VEATCH: It’s considered an altruistic, charitable act, and all the major religions look favorably upon that behavior.

LAWTON: Veatch tries to counter one theological concern he hears among some conservative Christians, especially in the black church, who believe individuals will be bodily resurrected in the end times, and therefore they worry about the implications of organ donation.

VEATCH: The doctrine is when you are resurrected you will be resurrected to look like you, but with all the bad stuff fixed. So if you had cancer, the cancer won’t be there, and if organs had been procured, or consumed by fire, you will get a new version of the body.

LAWTON: Flavia Walton, who is a member of the African Methodist Episcopal Church, says she tries to address that theological issue in her community as well.

FLAVIA WALTON: I think that there’s some notion or some belief among many that feel that when we meet our maker, we have to meet our maker all in one piece. For me, it means I just want to meet the maker. I don’t think the maker cares whether I’m all in one piece or not. I don’t think that’s the issue.

post06-organdonationLAWTON: The Waltons say organ donation is of particular concern to African Americans because more than 60 percent of patients who need transplants are non-white. At the same time, African Americans have a disproportionately low rate of organ donation. The Waltons hope their story can help change that.

BILL WALTON: Exposure is key, and the more we can expose to that population that it works and we’re examples of that, the more emphasis we can get out there that spread the word and let’s proceed.

LAWTON: After two years on dialysis, Bill says he can’t believe how great he feels now. He says the gift of someone else’s kidney has meant everything to him.

BILL WALTON: Life, basically. You can’t get any more basic than that—life with a little ginger thrown in, because it’s a life that is much more comfortable than what I had.

LAWTON: Flavia says donating a kidney turned out to be a spiritual experience for her, definitely worth the short time she spent recovering from surgery.

FLAVIA WALTON: Just feeling good that I’ve been able to do something and that hopefully I’ll be able to make a difference not only in the life of the recipient of my kidney, but hopefully it’ll spread, and hopefully I’ll be able to make a difference in helping other people make a decision to make a difference in the lives of others.

LAWTON: And as politicians and ethicists wrestle over how to encourage more organ donations, the Waltons hope stories like theirs will be the best incentive of all.

I’m Kim Lawton in Washington.

  • TJ

    Under no circumstances should there be monetary compensation for organ donation. Better education is always the answer to ethical questions, not religion, not money. Placing monetary compensation or the possibility of religious bias in any form negates the “fairness” of the system. Any ideas what unspeakable acts humans have committed in the name of religion or money, or both?

  • David J Undis

    The generosity of live organ donors is wonderful. It’s a shame we need so many live organ donors. There are now over 108,000 people on the National Transplant Waiting List. Americans bury or cremate 20,000 transplantable organs every year.

    There is another good way to put a big dent in the organ shortage — if you don’t agree to donate your organs when you die, then you go to the back of the waiting list if you ever need an organ to live.

    Giving organs first to organ donors will convince more people to register as organ donors. It will also make the organ allocation system fairer. About 50% of the organs transplanted in the United States go to people who haven’t agreed to donate their own organs when they die.

    Anyone who wants to donate their organs to others who have agreed to donate theirs can join LifeSharers. LifeSharers is a non-profit network of organ donors who agree to offer their organs first to other organ donors when they die. Membership is free at http://www.lifesharers.org or by calling 1-888-ORGAN88. There is no age limit, parents can enroll their minor children, and no one is excluded due to any pre-existing medical condition. LifeSharers has over 14,000 members, including 339 members in Washington.

    David J. Undis
    Executive Director
    LifeSharers
    http://www.lifesharers.org

  • Stephen Volante

    As a living kidney donor, I enjoyed this report but wish it had provided more detail about the donor evaluation process – examinations, tests, and consultations with a nephrologist, psychiatrist, and transplant surgeon – and how donors arrive at an informed decision to donate. These professionals explained to me several crucial considerations I was not aware of and that I needed to understand before I could make an informed decision.

    First, they were confident a transplant would succeed but that I had to be prepared for the possibility that it would not. I and the recipient were fortunate that the transplant was effective immediately and freed him from dialysis, but I cannot know what I would have experienced if it had failed.

    It seemed to me that a few of my friends presumed that the transplant team must have been a bunch of ghouls who wanted to take an organ from me with no regard for my well-being (and that this attitude is a barrier to donation). I found that, on the contrary, they made clear that they didn’t want me to donate unless I was entirely convinced it was the right decision for me. When I informed them that I wanted to proceed with the donation, they insisted that I take 1-2 weeks to examine my decision before scheduling the surgery. Their attention to my concerns before the transplant and the care they provided after it were exemplary.

    The mental health evaluation in this transplant program includes a frank discussion of the potential donor’s relationship to the recipient and whether the latter was offering any inducements, such as money, or applying any pressure, such as attempting to induce guilt, that would sway the former (the July 29, 2009 New Yorker magazine story “The Kindest Cut” is an excellent examination of what can happen between two strangers when one agrees to donate a kidney to the other).

    Lastly, the transplant surgeon explained that a good indication that donation is safe for a healthy person is that life insurance companies don’t charge higher premiums for donors, a fact I verified with an insurance agent.

    As someone who agreed to donate organs and tissues at death upon obtaining his first driver’s license and saw no reason to draw distinctions about who would benefit from them, I find Mr. Undis’s post and his use of this forum to promote his organization’s agenda distasteful. Though I’m sure his desire to ameliorate a grave public health problem is sincere, I would hope that as a nation we would promote organ donation through education and incentives (I’ve read about proposals for tax breaks, reimbursement of travel expenses, or possibly reducing health insurance costs for donors) before we start forming self-selected groups that encourage decisions that disadvantage those who make a different one.

  • livingdonor101

    “It is major surgery, but because of medical advances the risks to the donors are quite low. Because of these factors, Professor Veatch at Georgetown University’s Kennedy Institute of Ethics says there are few ethical problems with kidney swaps such as the one the Waltons were part of.”

    It’s unfortunate this misinformation is being perpetrated. According to OPTN, 4.4 living donors in the US die every year within 12 months of surgery. In addition, many others experience permanent nerve damage, intestinal blocking, pancreatitis, adrenal dysfunction, testicular swelling and sensitivity requiring surgery, hernias, organ laceration, and chylous ascites (lymph damage and leakage).

    Many others (some studies say 20-30%) of living donors struggle with depression, anxiety and PTSD symptoms. Yet not a single transplant center offers support resources or aftercare. In fact, even though living donors have been utilized since 1954, no one bothered to collect social security numbers until 1994.

    THERE IS NO LONG-TERM COMPREHENSIVE DATA ON LIVING DONORS. Does this sound ‘low-risk’ to you?

    If Prof. Veatch is so concerned about the ‘real human lives’ of recipients, why hasn’t he become a living donor himself? Last time I checked, living donors are people too; don’t we deserve the same consideration and care as the recipients?

    livingdonor101.com

  • Michele Hurst

    This is truly a touching story. I came across this story because I had the honor of working with Colonel Walton and knowing the Walton family 24 years ago. I had heard the Walton name on the news last night and he came across my mind so I decided to google him because he truly touched my life in my duties with the Air Force. I am so thankful he was blessed to have a chance to keep living because he is truly a man that loves life and everybody in it. Blessings to Col Walton and Flavia they are truly genuine people that have done so much good for others all their lives. I have never forgotten them. Blessing Michele Hurst.

  • Laurie

    I currently work in two hospitals. There isn’t one nurse in both hospitals who would allow their loved ones to donate organs because of how the deceased are handled by harvesters after death. Several of our nurses had to go through counseling after witnessing the uncaring butchery of the harvesters. Young Men, crank up the music and go to work without concern or respect for the deceased or the nurses witnessing their actions. The emergency room looked like a slaughter house, a month later our cleaning crews were still finding pieces in the vents etc. After speaking with friends in other hospitals those nurses feel the same way. So it is not just a local phenomenon. If you want to promote organ donation – have some compassion! Maybe the hospital employees would back you up. As it stands right now. . . You have a lot of sin to atone for.

  • Angela

    Maybe they’ld have more donors if they opened up the donation process to more people. I understand donor heath is paramount and that my weight might make organ donation more complicated but I fail to see how my rear end is too big for a needle bone marrow extraction. Over half of the US is overweight and while I’m one of them my blood pressure is normal, my blood sugar is healthy and I have no major medical problems. There are plenty of thinner people who can’t say that but I don’t even qualify as a bone marrow donor.

  • Erin Snyder

    In responce to livingdonor101: your comment about not one transplant center offering support after living donation is inaccurate. As well as the follow up care. I know this because the transplant center where I received my LRD (my brother gave me his kidney) requires that he see them at least once a year. Offers support services such as social workers connecting LD’s with therapists as well as support groups with other donors. My brother has gotten involved with our States Organ and Tissue donation organization. Yes, being a living donor can cause those effects that you mentioned, but up until right before a donor is given the anesthesia they are asked if they are positive the understand what they are about to do. They can stop surgery! If I had told my brother that I didn’t want him to do this because of the risks, he would have laughed at me! With surgery there is never any guarantee, not for the donor and not for the one getting the kidney. There was no guarantee my brothers kidney would work, but those are the risks one takes.

  • MD Kroll

    I am currently in the liver transplant program at a universitie hospital awaiting my gift. In response to Mr. Undis post on this site Aug. 21 2010: There are many people like myself who are unsuitable donors for numerous
    reasons; mental disorders, blood disorders, disease, genetic abnormalities, victoms of violence, victoms of ignorance from the medical field, there is probably no end to the list of reasons why we are unsuitable. To think
    that any one of these lives gets bumped to the back of the line is ludicris at best. Instead of forming a list of names for the sake of cutting in line, Life Sharers populance could better serve the process by being pretested
    and educating the masses. The fact that Life Sharers allows anyone into their club with any pre-existing conditions
    throws a red flag up for the entire group.