Organ Grinders

Organ trafficking, organ brokers and "transplant tourism" exist throughout the world, but if a number of groups and individuals have their say, the battle is on to put such practices out of business.

The situation is so bad that every attempt to help overcome the global crisis — created by too few individuals consenting to be donors — is a necessity, including increased activity in Israel, which has one of the lowest records in the world in organ donation, according to members and officials of the International Organ and Tissue Donation Congress, which recently held its convention in Philadelphia.

Good choice, Philadelphia. The city holds the record of having the largest number of organ donations in the nation in terms of population per million. That's because Philadelphia is headquarters of the Gift of Life Donor Program, one of the largest and oldest organ-procurement organizations not only in the United States, but in the world.

Thousands of men, women and children need heart, kidney, liver, lung and pancreas transplants, and tens of thousands of others need corneas to restore sight, skin to heal burns and heart valves to replace diseased ones. These facts provided the background for 400 international organ- and tissue-procurement and transplant professionals who gathered here, in part discussing how to combat unethical "transplant tourism" — i.e., people going to other countries for transplants and paying organ brokers for arranging those transplants.

Because of a large donor-organ shortage, such an activity is often facilitated by unscrupulous and anonymous Internet brokers. While it's illegal in the United States to buy or sell organs, they can be purchased in countries like China, India, Turkey, the Philippines and throughout the Balkans, according to Dr. Francis L. Delmonico of the World Health Organization, Advisory for Human Transplantation.

Disclosed at the convention was the fact that Israelis are traveling abroad to Turkey and other countries for transplant surgery arranged through donor brokers. While it is not illegal in Israel to journey outside the country to have a transplant, what is disappointing to those attending the convention was that the Israeli health system will pay for the organ transplant, creating a negative impact on donor rates in that country.

Efforts, however, are under way to change this policy.

"Israel has one of the worst records in the world" in organ donation — there are eight donors per million, compared to 40 donors per million here, according to Howard M. Nathan, president and CEO of the Gift of Life Donor Program in Philadelphia

The Israeli health-care system has not embraced organ donation and has not built a system like America or the Gift of Life Donor Program here, according to Nathan, who has just been elected president of the International Society of Organ Donation and Procurement.

That organization and the International Transplant Coordinators Society participated in the Philadelphia meeting. Nathan is considered to be one of the nation's leading authorities on organ and tissue donation.

"The World Health Organization is trying to stop the buying and selling of organs," said Nathan. Improving organ donation throughout the world would help alleviate the problem, he added.

Moreover, Delmonico, who also is director of medical affairs of the Transplantation Society, stressed ethical problems of "the poor person who donates an organ in some of those countries, and is victimized and exploited in selling his or her organs."

Part of the problem in Israel involves religious issues. Many believe that it is "against their faith to donate," according to Dr. Jonathan Cohen, associate director of the General Intensive Care Unit at the Rabin Medical Center in Petach Tikvah.

Here in the United States, it appears that all four branches of Judaism support and encourage organ donation. According to Orthodox Rabbi Moshe B. Tendler, professor at Yeshiva University: "If one is in a position to donate an organ to save another's life, it's obligatory to do so, even if the donor never knows who the beneficiary will be."

Cohen stressed that an active campaign in hospitals and other institutions is ongoing in his country to overcome the lack of donors.

Waiting to Be Saved
Every day in America, an average of 18 people die waiting for organ transplants. About 98,000 Americans, currently on a waiting list, will die without an organ transplant. Worldwide, the number is unknown. A single donor has the potential to save, as well as enhance, up to 50 lives and take up to eight people off the transplant waiting list.

Amazingly, a whopping 85 percent of the population here supports organ donation, including strong support from health-care professionals and virtually all organized religions, though less than 30 percent have actually signed a donor card or discussed the issue with their families.

Right here in the Philadelphia area, 5,300 people await transplants at the Gift of Life Donor Program. This local organization works with area hospitals and institutions to create awareness of organ donation.

Nathan recalled a saying that he heard years ago: "Don't take your organs to heaven; heaven knows we need them here!"

To learn more, call the Gift of Life Donor Program at 215-557-8090.



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