A lifesaving law
FIFTY YEARS ago during this week of gifts, a 22-year-old man gave life to his dying identical twin by donating one of his kidneys. The transplant allowed the young man to live an extra eight years. The donor is still alive, as is the Brigham surgeon, Dr. Joseph Murray, who made medical history with that first successful organ transplant.
In the half-century since then, medicine has made great advances in dealing with the body's natural tendency to reject transplanted tissue and in expanding the kinds of organs that can be transplanted. The chief hurdle now to this means of saving lives is the shortage of organs. That is why it was so disheartening when the spending bill Congress passed early this month failed to fund a law enacted in April to encourage donations.
The Organ Donation and Recovery Improvement Act would have funded education programs for the public and healthcare professionals on issues of organ, tissue, and eye donations. It would have paid for programs to coordinate the activities of hospitals with qualified organ procurement organizations. The law would also have provided funds for transplant centers or organ procurement organizations to provide travel reimbursements and subsistence expenses for individuals making living organ donations.
The law's bipartisan sponsors, who included the Senate majority leader, Bill Frist (himself a transplant surgeon), and Senator Edward Kennedy, had sought $25 million for the law's first year. But while Congress appropriated billions for pork-barrel projects -- including a groundhog museum in Pennsylvania -- the Frist-Kennedy law did not get its money.
There are 83,000 patients on waiting lists, with more than 6,000 dying each year before an organ can be found for them. Each year, advances in healthcare make it possible for more patients to be eligible for transplants, but the growth in donors fails to keep up.
That is why the funds for coordination between hospitals and organ procurement organizations would be particularly helpful. The trained coordinators can often be more effective in guiding the decision-making of grief-stricken family members than emergency room personnel can be. When the Massachusetts Department of Public Health instituted such a program with several hospitals a few years ago, the rate of donation among the survivors of brain-dead patients rose. The Boston-based Institute for Healthcare Improvement is helping the nationwide Organ Donation Breakthrough Collaboration to apply techniques learned here.
The United States will probably never achieve the nearly 100 percent donation rates of Scandinavian countries, but the initiatives outlined in the organ donation act would surely raise the rate and save lives. Congress should make funding this law a top priority next year.
