Organ donation has been making small headlines since 2016 began drawing to a close. In October of last year, 30 members of Congress petitioned the Department of Health and Human Services to “issue guidance on organ transplant discrimination with regards to persons with disabilities,” reported the New England Journal of Medicine. This move was in response to low-profile cases of a 3-year-old with Wolf-Hirschhorn syndrome being denied a kidney and a 23-year-old autistic man permanently denied a heart transplant.
Imagine the frustration, being a parent or loved one of a patient with a cognitive impairment who needs a new organ and is unable to move to the front of the recipient line. The medical nightmare scenario reminds me of a scene from the Tom Cruise film “All the Right Moves.” Cruise, playing an undersized high school football player searching for a scholarship to a better life, calls out his blackballing gridiron coach, played by Craig T. Nelson.
“You know, [Coach] Nickerson, you are not God! Huh? You’re just a typing teacher!” Cruise shouted.
Healthcare providers are often put into the unfortunate role of playing God by deciding who gets and does not get the scarce organ, as well as where applicants fall on the waiting list, if at all. Organ recipients are selected based primarily on medical need, location and compatibility, according to the American Transplant Foundation.
Dr. Scott Halpern and Dr. David Goldberg penned in the January New England Journal of Medicine a Perspective piece with a recommendation for the creation of independent regional review boards to adjudicate disputes involving those with cognitive impairment. These review boards would be a far better solution than legal action in courts, which often cannot render a hearing in time to save a loved one.
Perhaps the best solutions for boosting organ donation, as well as advancing the dawning of a new age of organ regeneration, are already here. Reducing the scarcity of organs and advancing the ability of many organs to heal internally could one day remove the God-role from executive and physician offices entirely.
At the beginning of 2017, France reversed its organ donations policy so that all citizens could become donors on their death unless they joined an official register to opt out, according to an article in The Guardian. The new French law presumes consent for organs to be removed from the deceased, even if it goes against the wishes of the family.
Prior to the new law taking effect on January 1, a person who died who failed to express a clear wish for or against donation left French doctors being required to consult relatives. Studies show in these organ-donation inquiry scenarios, the deceased’s relatives refused to donate nearly 33 percent of the time.
French citizens who do not want all or any of their organs to be used must now put their name on a “refusal register.” By the end of January, 150,000 people have signed up to refuse organ donation. Alternatively, French citizens strongly opposed to their organs being used can leave a signed document with their next-of-kin or transmit their wish orally to relatives who must make a written declaration of non-consent to doctors at the time of death.
The U.S. has policies in place to register organ donors, such as when one if receiving a driver’s license in California and Nevada. However, these donation registry lists are still an opt-in program rather than an opt-out, like France now employs. The following statistics from the American Transplant Foundation website underscores the need for more organ donors.
- At the start of 2017, 120,000 people in the United States are currently on the waiting list for a lifesaving organ transplant with a new name being added to the list every 10 minutes.
- On average, 22 people die every day from the lack of available organs for transplant.
- One deceased donor can save up to eight lives through organ donation and can save and enhance more than 100 lives through the lifesaving and healing gift of tissue donation.
In the lab, scientists have been making strides in organ regeneration using a patient’s own stem cells to regenerate tissue. Gladstone Institutes researchers have made major breakthroughs in this area by using a combination of chemicals to transform skin cells into heart and brain cells.
The unprecedented feat merits notice since all previous attempts to reprogram cells required scientists to add outside genes. The research, published in Science and Stem Cell, gives scientists a foundation for one day being able to regenerate lost or damaged cells with pharmaceuticals. The significance of this new system is that it is both more reliable and efficient than previous processes, while avoiding medical concerns surrounding genetic engineering.
While the organ donation stories continue to be relegated to the back pages of newspapers, if at all, the good news is there appears to be a thawing to the glacier movement to solutions for one day ending the long waiting list for organ recipients. New hope to whittling down the organ waitlist is coming.