Can America Answer the Call of Kidney Karma?
Can America Answer the Call of Kidney Karma?
Lives are at stake, and the next person needing help could easily be you, a member of your family, or, like me, an old friend’s husband
O. Henry died over a hundred years ago, but his story The Gift of the Magi about a poor woman who sold her long hair to buy a gift for her husband on the same day he bought her a hard-sought gift of combs for her long hair still echoes through our culture.
In a modern-day variation on the story, my friend of many decades, Elizabeth Barlow Montes, donated one of her kidneys to a friend’s sister back in 2004. Now her husband, whose lifelong diabetes finally destroyed his own kidneys, needs a kidney to save his life but Elizabeth can’t be that donor as she only has one left.
While Hector lost his kidneys to diabetes, Covid has revealed a number of cracks in our healthcare system, from the way for-profit hospitals are failing us to the just-fixed-by-Democrats problem of “surprise billings.” Among the most tragic and long-term problems Covid is leaving us, however, are an as-yet-unknown number, probably thousands to tens-of-thousands, of Americans who will need transplants for organs the virus ravaged.
Covid infection can damage the heart, lungs, kidneys and other solid organs so severely that long-term survival after a Covid infection depends on getting an organ transplant.
“COVID-related transplants are surging as hospitals grapple with a growing subset of patients whose organs are ‘basically destroyed by the virus,’” noted Johns Hopkins’ Dr. Jonathan Orens in a recent interview.
Dr. Tae Song, the surgical director of the lung transplant program at the University of Chicago Medical Center, told Kaiser Health News of the increase in demand for transplants caused by Covid:
“I think this is just the beginning. I expect this to be a completely new category of transplant patients.”
Currently, 17 Americans die every day waiting for an organ transplant: there are over 100,000 people on the official lists. As a result, people like my friend Elizabeth are putting up websites for anybody who may consider donating a kidney. Hers and her husband Hector’s, who live in Manhattan, are at KidneyKarma.com.
One sign of the stresses on our system is that while people sick with Covid are needing transplants, people dying of Covid have become a source of transplantable organs, depending on which are damaged or not damaged by the virus.
The Midwest Transplant Network’s COO Lori Markham told a Kansas City TV station:
“We had a record number of organ donors in 2021, compared to the previous year, and some of that is due to the COVID.”
If you sign up to donate your organs at your death, you can literally save the lives of 8 people and enhance the lives of 75 more.
But you must sign up because America has an “opt-in” system where people must enroll to become organ donors. Thus, last year we only saw 41,000 organ transplants nationwide.
Many other developed countries around the world have, over the past 20 years as organ donation has become more routine and medically easy, shifted from “opt-in” to “opt-out,” where everybody is automatically an organ donor at death unless they’ve specified otherwise.
A study published last year on the National Institutes of Health website notes that the United States “could enjoy an additional 4,753–17,201 transplants annually if an opt-out system were introduced. Interestingly, if any country were to benefit fully from an opt-out system, it may be the USA, thanks to the infrastructure for organ donation and transplantation that is already in place.”
Meanwhile, the situation for live organ donation — almost exclusively kidneys — has become bizarre in the US for a variety of reasons, most having to do with the consequences of centuries of institutional racism.
An editorial in The Journal of the American Medical Association notes that between 1995 and 2014, the percentage of white people on the kidney transplant list who got a live kidney rose from 7.0 to 11.4 percent.
During that same period, however, successful recipients who were Black declined from 3.4 to 2.9 percent and among Hispanic patients like Elizabeth’s husband Hector, transplants declined from 6.8 to 5.9 percent.
Transplants at death and live transplants are somewhat different universes, although for kidneys there’s a substantial overlap.
Both systems, however, are in need of a 21st century overhaul. And there are some good beginnings. For example, New York’s Senator Kirsten Gillibrand recently introduce bipartisan legislation to make organ donation easier.
“The Living Donor Protection Act,” her website notes, “would protect living donors from high insurance premiums, codify Department of Labor (DOL) guidance that covers living donors under the Family Medical Leave Act (FMLA) in the private and civil service, remove barriers to organ donation, and provide certainty to donors and recipients.”
It’s a start. Lives are at stake, and the next person needing help could easily be you, a member of your family, or, like me, an old friend’s husband.
Implementing an “Opt-out” policy sounds like a reasonable solution to help alleviate organ donor problems. However, I think it’s as likely to happen as getting the tech oligarchs to allow Congress to implement an “Opt-in” policy for our citizens, so they can only gain access to our personal information if we choose to sell it to them.
I thought opt-out might run-up against religious or age related problems; turns out neither are much of a consideration concerning donation of organs. Most of the UK is opt-out, but they still talk to the families and urge individuals to let their families know their wishes. That sounds logical as well.