FRED DE SAM LAZARO: For several weeks, Houston commuters have been tuned in to an unusual and highly personal campaign for a transplant. It included billboards and a Web site which sparked news reports, even national TV appearances(CNN Broadcast): Joining me now from Houston, Texas, Todd and Julie Krampitz.
DE SAM LAZARO: Thirty-two-year-old Todd Krampitz, his liver riddled with cancer, pleaded along with his wife for an organ donation.
(CNN Broadcast): This is his only chance, which means anyone out there who knows of an unfortunate, tragic situation where someone is on life support, and they are in a situation where they can donate the organ, we need the liver to go directly to Todd.
DE SAM LAZARO: The advertising and media campaign paid off. A donor liver became available. The donor's family remained anonymous but specifically directed that the liver go to Todd Krampitz.
Todd Krampitz got the transplant in late August, but it was not a happily ever after ending. His story set off a torrent of criticism.
Dr. ARTHUR CAPLAN (Medical Ethicist, University of Pennsylvania): I appreciate he had the initiative to do it, but he also knew, as any person waiting for a liver does, what the rules are. They tell you. And he knows that if he jumps ahead when he's not desperately in need that someone who was in need on that day may have died because the liver didn't go to him.DE SAM LAZARO: In a motel near the hospital operating room where Todd Krampitz was receiving his transplant, Bobby and Sharleen Bridgeman waited -- waited for the all-important call that would tell them a donor had been located for the 49-year-old Texas truck driver.
SHARLEEN BRIDGEMAN: The kids kind of try to call about the same time every afternoon so I won't panic when the phone rings. So if it rings in between those times, we go, "Huh!"DE SAM LAZARO: Bobby Bridgeman was diagnosed with end-stage liver disease in July. He was given about three months to live unless he got a transplant. The wait has been agonizing, says Sharleen Bridgeman, but they have stuck by the rules, as Todd Krampitz did not.
Ms. BRIDGEMAN: I was angry. I did not feel that being able to publicize on a billboard was right. I think she says she couldn't sit there and watch her loved one die. Well, I don't want to watch my loved one die. None of us does, but we've got to -- got to stick to a system.
DE SAM LAZARO: The "system" is headquartered in Richmond, Virginia at the United Network for Organ Sharing, or UNOS.
PHONE BANK OPERATOR: This is coming from Louisiana. It's a 52-year-old Caucasian female, blood group O like Oscar. She's O positive.
WALTER GRAHAM (Director, United Network for Organ Sharing): This is the nerve center for UNOS. Every patient in the country who's waiting for an organ transplant is listed on our computer system here. Every time there's an organ donation, information about that donor is placed in the computer system and matched.DE SAM LAZARO: Donors and recipients are matched on a number of criteria. Is there biological compatibility? How close is the hopeful recipient to dying? And what is the prognosis for long-term survival with the transplant? In the 1980s, amid what appeared to be a rash of media appeals for transplants, Congress authorized UNOS in order to level the playing field for all transplant patients
Mr. GRAHAM: The U.S. Congress made the decision in 1984 that organs should be allocated in this country based on medical criteria. So in our policies, for example, we do not take into account a person's wealth, their social stature, their social worth, any of those things.
DE SAM LAZARO: Which does not mean that those things haven't mattered.
Dr. BOISAUBIN: Maybe there's even a certain admiration for an individual or family who somehow finds a way to sort of game the system. And for that individual, for that family, if we were put in that position, one of our loved ones was desperately ill, I suspect that many of us would say, "What can I do to really help my mother, my child?"
DE SAM LAZARO: Krampitz was able to take advantage of regulations which permit so-called "directed" donations. These usually occur within families and in living donor situations -- someone donating a kidney to a sibling, for example. Ethicist Caplan wants to close what he calls a loophole.
Mr. GRAHAM: There's a story, for example, of a pastor who needed a heart transplant, announced to his congregation that he had to step down, go on sabbatical, and wait for a transplant. He wasn't soliciting anything, but that information then prompted someone in his congregation, when a terrible accident occurred, to donate their loved one's heart to him. Is that a bad thing? Is that a good thing? Those are questions that will be very difficult to answer.
ABERNETHY: There's better news for the other family in that story. Last week, Bobby Bridgeman got the phone call he'd waited for. Doctors at St. Luke's Episcopal Hospital in Houston say his liver transplant went without complications.
