by: Caroline Thompson, Associated Press Writer
September 21, 2006
BUFFALO, N.Y.(AP) _ Paul Cardinale and William Thomas sat side by side at a Buffalo hospital Thursday, the real-life result of a policy change debated by officials at the region’s largest health care provider for more than a year.
Kaleida Health’s decision to allow “altruistic” organ donations cleared the way for Cardinale to receive a kidney from Thomas after the two met over the Internet. Health officials believe it may have been the first such Internet-arranged transplant in the state.
“At first we really didn’t know how to feel about it,” Dr. Oleh Pankewycz said of the idea of allowing a stranger to donate an organ to a patient met online. It was Cardinale’s mother who raised the idea with Kaleida executives.
There were legal and ethical issues to consider. Critics of such arrangements worry they may open the door to payment for organs, which is illegal, or that they favor people who can afford Web site fees or those whose stories are most moving. Profiles listed Thursday on the www.matchingdonors.com site through which Cardinale and Thomas met were titled “I want my Dad back,” “Mother of four,” and “Too young to die.”
Lengthy discussions with input from Kaleida’s ethics and legal experts satisfied those concerns, Pankewycz said, and the decision was reinforced by the success story of Cardinale and Thomas, who underwent surgery at Buffalo General Hospital last week.
“Now having lived through this, I see this is the right thing to do. There are individuals, carefully screened both for their benefit and the recipients’, in which this procedure is truly lifesaving and should be done,” Pankewycz said.
The demand for organs drastically exceeds the number that become available for transplant each year. The waiting list for organs from deceased donors now exceeds 92,000, said Annie Moore, spokeswoman for the United Network for Organ Sharing. Most of those people _ about 68,000 _ are waiting for kidneys.
With about 17 people on the waiting list dying every day, patients are increasingly seeking out donations on their own, whether through Web sites, billboards or personal ads. The number of patients who actually succeed remains relatively small. Last year, of the 6,563 kidneys donated by living donors, just 83 went to strangers, Moore said. That number has held fairly steady for the last three years, she said. Most donations are among family.
UNOS does not have the authority to tell transplant centers whether or not to perform altruistic transplants, but urges centers to have protocols in place for handling such arrangements.
“We just want to make sure patients are informed of the risks and challenges they may face,” Moore said. It is important, she said, that potential donors undergo not only a physical evaluation, but psychological screening to ensure they have not been coerced or made to feel guilty about donating.
“Obviously, Kaleida fully agrees and endorses a policy of careful screening, careful matching,” said Jim Kaskie, Kaleida’s president and chief executive.
Thomas said he had watched a news segment in which the practice of patients soliciting organ donations was debated and felt for those who were taking the initiative to try to save their own lives.
After visiting the Matching Donors Web site, he pasted his profile and then began sorting through those of people looking for organs. When he came to Cardinale’s, something clicked.
“It was just a feeling that this is the person I am supposed to help,” said Thomas, who lives in Kodiak, Ala., and works for a homeless shelter.
Cardinale’s efforts to find a donor inspired the creation of a Buffalo-area site, www.wnykidneyconnection.org, a free site whose goal is to match local people and save on the expense and hardship of travel. Cardinale’s family, which paid $600 for a lifetime membership to the Matching Donors site, paid for Thomas’ travel and hotel.
The local site’s founder, Patti Merritt, herself a kidney recipient, countered concerns that the Internet process was unfair to those on traditional waiting lists, saying any successful matchup helps everyone.
“You are benefiting everyone else who is awaiting a kidney because you’re no longer on that list,” she said.
After undergoing countless tests and the surgery, Thomas enthusiastically endorsed the process as he prepared to head home to Alaska on Friday.
“It’s a great leap for mankind, I think,” he said, referring to the ability to use technology in this way. “Brotherly love should not just be confined to our family.”