Organ Donations and Organ Procurement

How much would you be willing to pay to save your life?  Anything it takes, right?  This is the ultimately question that stumps even the best public health and social justice experts when trying to establish a just system.  In the end, we are probably willing to do pretty much anything and pay almost any cost if it meant we got to keep living.  So then it comes to no surprise that people are willing to exploit this desire to live by buying and selling organs on the black market. 

The horrors of the black market have been increasingly disturbing in the past years.  The shortage of transplantation organs, and the meticulous process of acquiring and assigning needed organ based on a ranking system has led people to turn to other options.  “Black market organ donations” offer not only a relatively simpler means of acquiring organs in need for the sick, but it also stimulates impoverished people to sell their spare organs (ie. kidneys, corneas, etc.) for quick money.  The darkest side of the black market for organs is the rising increase in organ theft.  If placing a monetary value on body parts isn’t already disturbing, it is something else to acknowledge the rising number of organ thefts occurring, even to the point of committing murder for the purpose of either getting rich or not wanting to wait on the list.  In addition, much of the black market, especially when it comes to the donation and receiving of organs acts in a unidirectional manner: third-world to the frist-world market.  Obviously this is a violation of basic human rights.  The entire system in general exploits the poor and vulnerable while benefiting the rich.  Yet the reward value on both ends of the black market system perpetuates its existence and sets up a pathway for perfectly healthy individuals to become victims of the organ scavengers of the rich.

On the other hand, those lawfully awaiting an organ on the donor-list also feel that the process by which organs are extracted and allocated are not always the most just proceedings.  It is true that when dealing with organ transplantation, especially heart or lung transplantation, that there are many factors that should be considered from a biological perspective as to who should receive the organs. The fact is that organs are on short supply and it is no laughing matter that someone usually must die before another life can be saved.  Therefore, in order to make the process as fair and just as possible, the UNOS has devised a ranking system which numbers candidates by biological information, as well as clinical characteristics and time spent on the waiting list.  While this appears to be a procedural and fair way of determining where organs will be distributed from an outside perspective, it doesn’t always come across this clear-cut when you become personally involved with the situation.  Below are the five steps used to match donor organs to waiting recipients.  What makes this process difficult is that it doesn’t always take into account whether a person is “deserving” of organs over another.  It is possible that a patient who has smoked their entire life will receive a new set of lungs before a non-smoker simply because they have been on the waiting list longer and “promise not to smoke” after the surgery.  The fact is there are no guarantees and this is what makes this process so difficult in placing “worth” on human life.   

The Five Steps of the Matching Process

  1. An organ is donated. When the organ becomes available, the OPO managing the donor sends information to UNOS. The OPO procurement team reports medical and genetic information, including organ size, and condition, blood type and tissue type by entering this information into UNet.
  2. UNOS generates a list of potential recipients. The UNOS computer generates a list of potential transplant candidates who have medical and biologic profiles compatible with the donor. The computer ranks candidates by this biologic information, as well as clinical characteristics and time spent on the waiting list.
  3. The transplant center is notified of an available organ. Organ placement specialists at the OPO or the UNOS Organ Center contact the centers whose patients appear on the local list.
  4. The transplant team considers the organ for the patient. When the team is offered an organ, it bases its acceptance or refusal of the organ upon established medical criteria, organ condition, candidate condition, staff and patient availability and organ transportation. By policy, the transplant team has only one hour to make its decision.
  5. The organ is accepted or declined. If the organ is not accepted, the OPO continues to offer it for patients at other centers until it is placed.

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