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There’s a worldwide shortage of organs for transplantations.To tackle that shortage, many countries are experimenting with various strategies. Some Americans are pushing a controversial solution – legalizing the buying and selling of organs. But, can such a system meet the global demand for organs? And is it fair to the people who sell their organs? Come join the conversation with Dr. Mustafa Al-Miousawi, a Kuwaiti transplant surgeon and the past president of the Middle East Society for Transplantation.
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MARCO WERMAN: Israel isn’t the only country offering financial incentives to increase the supply of human organs. Iran offers money to living donors who are willing to give up a kidney. The going rate $1,200. Some call the program unethical and coercive but others say it’s a model worth copying, perhaps even in the U.S. Mustafa Al-Mousawi is a transplant surgeon and former president of the Middle East Society for Organ Transplantation. He has been following the Iranian system closely and he joins us from Kuwait City. Dr. Al-Mousawi, from a practical standpoint, the Iranian system seems to be working but some in Iran claim that the country has eliminated its waiting list for kidney transplants. Is that indeed right?
MUSTAFA AL-MOUSAWI: Well, the Iranians do claim that [INDISCERNIBLE] their waiting list and for sure the figure that we receive from Iran has increased the number of transplants tremendously since they launched their living unrelated donations in the country but if you look at the system very closely, ideally the donor shouldn’t be in touch with the recipient but what we find in Iran now is that the donor is in touch with the recipient and in fact is taking an amount of money from the recipient as well. And many people in Iran and a lot of people outside Iran are criticizing this sort of system.
WERMAN: And what exactly is the problem with donors and recipients speaking to each other? Is the concern just about money being transacted?
AL-MOUSAWI: Well, this is the question. Should money be transacted between the recipient and the donor? Now in Iran the government is supposed to do the payment but even if the government does still, at the end, it is inducing the poor and the vulnerable to sell their kidneys so this is some sort of coercion and the amount of money which is being given to the donor is still considered very little compared to the value for a kidney and the many studies from Iran and from India and Pakistan has showed that the poor donors, they don’t become much better off after giving their kidneys or selling their kidneys.
WERMAN: Right. Now even in countries where buying organs is illegal, it still happens in many parts of the world. There is a thriving black market as you know. In fact, you found that in your own country, Kuwait, there are often under the table financial transactions between the donor and recipient so why not just legalize a payment as Iran has done and have the government regulate the system?
AL-MOUSAWI: This is not a very nice road to go along you know because what will be next? Some people will be selling part of their liver? So where will we end? I think the problem is the organ shortage which should be addressed correctly and that is to increase donation from deceased donors and by the way, a living donor can only donate a kidney and sometimes part of his liver but a deceased donor can donate multiple organs and tissues and donate two kidneys, one liver, one heart, etcetera. So it is best to along this path and maybe you can discuss giving some sort of incentives for donor families after the deceased donation. Maybe that’s unethical but maybe this is a better way to discuss it rather than to pay the poor donor.
WERMAN: Dr. Mustafa Al-Mousawi, we’ll have to end it there. But our listeners will have a chance to continue this conversation with you online in our world science forum. You’ll be taking questions about transplant tourism and the black market in organs and how different countries are addressing the organ shortage. The discussion will continue through next week for our listeners. To participate they can just go to TheWorld.org/science. Dr. Al-Mousawi, a surgeon at Kuwait’s organ transplant center. Thank you very much for your time. We’ll be seeing you online.
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As the death toll from the organ shortage mounts, public opinion will eventually support an organ market. Changes in public policy will then follow.
In the mean time, there is an already-legal way to put a big dent in the organ shortage in the United States — allocate donated organs first to people who have agreed to donate their own organs when they die. UNOS, which manages the national organ allocation system, has the power to make this simple policy change. No legislative action is required.
Americans who want to donate their organs to other registered organ donors don’t have to wait for UNOS to act. They can join LifeSharers, 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.
Giving organs first to organ donors will convince more people to register as organ donors. It will also make the organ allocation system fairer. Non-donors should go to the back of the waiting list as long as there is a shortage of organs.
I ask myself ‘Why would someone in the US who is uninsured or under-insured want to donate their organs if they themselves are not eligible?’
If one doesn’t have health insurance or is uninsured (that is somewhere around 60 million Americans) one is not eligible for an organ transplant.