California Healthline Daily Edition

Summaries of health policy coverage from major news organizations

More Live Organ Donations Needed To Address Gap in California

While the number of deceased organ donors in California has increased in recent years, observers say more live donors are needed to meet the need of residents awaiting donations, the San Francisco Chronicle reports.

However, stakeholders disagree on whether offering compensation for live donors would be a successful strategy to increase organ donations.


About 20% of the more than 120,000 U.S. residents who are waiting to receive an organ donation live in California, according to the California Transplant Donor Network.

Such individuals wait an average of three to five years to receive a kidney donation and transplant. Every day, about 18 patients die while waiting for a kidney donation.

A deceased donor can provide organs for up to eight individuals awaiting donations. However, organs can be collected in only about 1% of deaths -- typically from individuals who died from a car accident, homicide or stroke, according to Tom Mone, CEO of the not-for-profit organ recovery firm OneLegacy in Los Angeles.

The National Organ Transplant Act of 1984 made selling organs illegal. However the law does not prohibit payments for the cost of medical care related to organ donations, such as transportation or lost wages.

Stakeholders' Comments

Some stakeholders say that offering compensation to living donors would increase donations and fill the gap.

Most individuals waiting on donations need kidney transplants. According to the Chronicle, individuals can live with just one fully functional kidney, and kidneys from live donors tend to last longer.

During a panel discussion at Stanford University last week, Sally Satel, a psychiatrist and American Enterprise Institute scholar, said a pilot program should be implemented to determine whether offering compensation would prompt more living donors to volunteer.

Satel said, "If voluntariness is not sufficient, we should think about and move to an incentive system, or at least test it," adding, "We're not talking about cash; we're talking about some kind of in-kind incentive or reward," such as long-term health insurance or tuition reimbursement. She noted that such a program would be funded by a third party so that "the opportunity is open to anybody who needs an organ."

However, David Magnus -- a Stanford professor of medicine and biomedical ethics who also spoke at the panel discussion -- said that the current system is working and that creating a program that compensates live donors probably would not entice enough living donors to significantly reduce the organ transplant waiting list.

In addition, Magnus said that if a program to provide compensation was unsuccessful, it could weaken the National Organ Transplant Act and eventually turn donors into vendors (Kaul, San Francisco Chronicle, 8/5).

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