A St Petersburg Times Editorial
Advances in organ donation save lives

SINCE THE NUMBER OF KIDNEYS available from deceased donors doesn't come close to meeting the demand, donating a kidney is truly giving the gift of life. A new approach to living donor transplants — one that allows people in essence to donate a kidney to a loved one even when they don't qualify as a match — could save thousands more lives yearly. This advance, coupled with a new system for distributing organs that better matches the condition of a donated kidney to its recipient, should make the system more responsive and rational.

There would not be a perpetual crisis in kidney donations if more people promised to donate their kidneys at death. In 2009, there were only 10,400 kidneys available from deceased donors to help the nearly 90,000 people on waiting lists for a transplant. With these long odds, living donors are increasingly stepping in. In 2009, there were 6,300 kidneys transplanted from living donors, who in most cases identify the recipient of the kidney.

But the problem with this system has always been that a living donor who wanted to give his or her kidney to a specified recipient — usually a friend or relative — had to be a good match or the organ would be rejected. All that has changed under a new system of living donor chains, where donors give a kidney to a biochemically matched recipient, with the proviso that their designated recipient gets one as well. St. Petersburg Times staff writer Letitia Stein described a recent chain involving 32 people at a dozen hospitals across the country, including for the first time a hospital in the Tampa Bay area. Estimates are that this program could make 2,000 to 3,000 more kidneys available for transplant annually.

Another change to the way kidneys are made available is being proposed by the United Network for Organ Sharing, the organization that supervises the distribution of organs for transplants. The new system would segregate into a separate pool the transplant patients with the best likelihood for long-term survival and provide them the best 20 percent of organs available. That way, a young person wouldn't be given a kidney that may only have a usable life of another 20 years, or someone in their later years would not receive a kidney from a teen killed in a car accident whose kidneys would be functional for decades beyond the recipient's lifespan. The network would then try to match the remaining 80 percent of recipients to the approximate age of the organ donor, trying to keep the match within 15 years.

In the best of all worlds, Americans would more readily designate themselves as organ donors upon death, minimizing the roulette wheel of transplant waiting lists. But as long as potential recipients outnumber the kidneys available, changing the way organs are allotted to extract the greatest useful life for each one makes good sense. And in the meantime, paired kidney exchanges give newfound hope to those people with friends and relatives eager to help with the most precious gift of all.