The Main Challenge for Organ Transplants
The National Organ Transplant Act (NOTA) of 1984 set the stage for the current organ procurement process. Organ Procurement Organizations (OPOs), as well as their oversight network, the Organ Procurement and Transplantation Network (OPTN), manage organ donations. NOTA also made the purchase of organs a federal crime to prevent the poor from resorting to organ donation as a source of income. This would also present equity issues for healthcare, with the wealthy receiving the organs donated by the poor. Unfortunately, the law has reduced the availability of organs for transplant.
The incentive for Organ Donations
Without financial incentives, it is harder to acquire organ donations. Organ donation often comes appears unethical. Many believe organs are bought and sold like a commodity, with the wealthy accessing the organs first. However, this is not the case. Payment for organs does pose issues, yet incentive is required to increase donations. There is the possibility that donor compensation could be designed to avoid exploitation while reaping the benefits of higher availability for transplant patients.
According to Mario Macis, a Johns Hopkins University economist, the public attitude towards compensation for kidney donation calls for ethical considerations. The research found support for compensation if there was transparency to ensure equity in the distribution of organs. Also, compensation should not be paid in “cash” but instead something less liquid such as retirement account contributions, to avoid exploitation of the poor. Over 60% of respondents would support a public agency providing compensation to kidney donors only if basing allocation on medical urgency, blood and tissue match, and how long a recipient has waited.
Exploring Israel’s Donor System
Waitlist Zero, an advocacy group for transplant patients, considers Israel’s donor support system the gold standard for organ donation. Their system offers temporary benefits to living organ donors that include:
- Exemption from the national health insurance tax
- Reimbursement for health, life, and disability insurance expenses
- Paid time off work
- Recuperative vacation time
- Reimbursement for travel expenses
The Israeli system has seen living donation rates quadruple since its introduction in 2008. Using a similar system in the U.S. could result in billions of dollars saved in medical treatments and as many as 18,000 lives saved each year.
A proposal presented by the American Enterprise Institute suggests direct compensation through tax credits. A $50,000 tax credit would be offered to living donors and a $5,000 credit for deceased donors. Setting criteria for donors based on physical and emotional health is also recommended, along with a waiting period of six months to provide time for people to consider their decision to donate carefully. The approach would avoid the “dealing” of organs and provide fair treatment to donors who are the only party not compensated for their participation. The risk for living donors can be high, and it makes little sense for them not to receive compensation for their sacrifice.
Telepathology and Telecardiology to Expedite Delivery
Expediting the process can also help save lives. The Washington Post reported that transplant doctors find the system for sharing data and acquiring organs “archaic.” Their goal is to find ways to share data so organs are delivered as quickly as possible. Because almost all transplant hospitals use electronic records, relying on manual data entry and outdated modes of data sharing is irresponsible.
Telepathology and telecardiology use digital transmissions for medical diagnostics, offering an updated solution that allows pathologists to share biopsies and other medical images quickly and remotely. Required tests are conducted by telepathologists who can then immediately share their findings with transplant patients’ surgeons.
Telepathology uses three methods that allow doctors to assess organs for donation must faster:
- Static image-based systems: Pathologists can share images captured from a digital camera connected to a microscope through digital transmission.
- Virtual slide systems: Specimen slides can be scanned in high-resolution, producing high-quality images for digital transmission and assessment.
- Real-time systems: Robotically controlled microscopes allow surgeons to access and participate in autopsies in real-time remotely. They can adjust the microscope used during the medical tests to make quick assessments and expedite the approval process.
Through telepathology, interpretations are often available in less than an hour following the donor’s death, significantly reducing wait time for transplant patients. Effective, remote testing confirms the viability of organs, improving patient outcomes.
OPO and Specialist Direct
Specialist Direct offers telepathology and telecardiology services to expedite the organ donation process. Contact our team today to learn more about medical testing and technology to improve the OPO process.