Prison blocks inmate from donating organ

Meanwhile, would-Be recipient sits, waits

By John Pope and Mark Schleifstein

January 2, 2005

Staff writers

Charlene Wiltz needs a kidney, and Stephen Stage is willing to give her one of his, but he may not even get the chance to learn whether he's a match with the New Orleans grandmother.

Stage, 53, is an Orleans Parish Prison inmate who is serving a four-year sentence for aggravated battery.

The prison can't let Stage act on his gesture because it would be a drain on the budget and staff of the Orleans Parish Criminal Sheriff's Office, which runs the prison, said Dr. Demaree Inglese, its medical director.

The Sheriff's Office's delicate dance involving the inmate's unexpected offer is in line with policies at the state and federal level that don't always prohibit organ donation but make it difficult to bring off, officials say.

Wiltz, 45, went into kidney failure after heart surgery. As a result, she has had to undergo four-hour dialysis sessions three times a week for the past four years.

"One (kidney) went all the way bad, so I have only one functioning kidney," she said, "and it's not functioning too well."

Her eldest daughter is a match, but Wiltz said she has refused to donate. Wiltz is on the national waiting list for a kidney, but, she said, "I know I'm way down there."

Stage learned of Wiltz's plight from a story in The Times-Picayune, and he responded in a letter to the newspaper. Citing Sheriff's Office policy, the prison did not make Stage available for an interview.

"Christmas is the celebration of the birth of a man who gave his life to others," Stage wrote. "I can certainly spare a kidney."

But he probably won't get the chance to do so.

Even though Medicaid, Wiltz's insurer, would cover all medical fees, including a blood test to determine whether she could receive Stage's kidney, Inglese said transferring deputy sheriffs to a hospital to guard Stage around the clock would be a drain on the department's already tight budget and leave the prison vulnerable.

That money "is the taxpayers' money," he said. "The Orleans Parish Criminal Sheriff's Office doesn't have the right to donate that money so someone can have a kidney transplant. . . . We need the money for people in the jail to receive health care, not people in the community."

Even though Stage is in Orleans Parish Prison, he is a state inmate, a status that makes him subject to laws governing the state Department of Safety and Corrections.

One provision bars use of state money to pay costs associated with organ transplants, but the law doesn't prohibit an inmate from participating in a transplant if someone else pays the expenses, Corrections Department spokeswoman Pam Laborde said.

She said another provision of state law that prohibits prisoners from participating in medical experiments or pharmaceutical trials would not apply to Stage's situation.

If Stage were a federal prisoner, he would be prohibited from donating his kidney except to a member of his immediate family, according to the regulations of the federal Bureau of Prisons. The federal rules also require all expenses, including the cost of U.S. Marshal Service guards, be paid by someone other than the government.

The ethical question of whether prisoners should be allowed to donate organs for transplant has been discussed for a number of years.

The United Network for Organ Sharing, which oversees the donation of organs from deceased persons, had an internal discussion about two years ago of the ethics of setting up a system that would allow organs to be harvested from condemned prisoners after they were executed. But the organization never adopted a policy concerning the possibility.

The discussion also laid out the ethical problems involved with trading sentence commutations for successful organ transplants for healthy death row prisoners, when similar prisoners suffering from common prison maladies like tuberculosis or hepatitis would not be eligible for commutations.

Network spokeswoman Annie Moore said the decision making for prisoner organ donor offers now rests in the hands of the individual transplant centers and the federal, state and local prison rules.

In Stage's letter, he said his health is excellent but offered no details.

Inglese was dubious about that claim because, he said, at least 70 percent of the inmates have conditions that disqualify them from donating, such as a history of sexually transmitted diseases or intravenous drug use, or infection with hepatitis C or the virus that causes AIDS.

But Amy Ferguson, a spokeswoman for the Tulane Center for Abdominal Transplantation, said the track record for so-called "altruistic donors" is actually pretty good, if the donor's blood type matches that of the patient.

In matching an organ, doctors look for similar blood and tissue types, as well as the presence of antibodies in the recipient that might reject the organ.

If Stage were allowed to be considered for donation, she said, he'd first have to go through a thorough vetting process, including a psychosocial examination, a medical history check and a thorough medical work-up to determine whether he's a good match.

"We would be thorough in making sure he's doing it for altruistic reasons and is not expecting some sort of compensation, and that he has realistic expectations of how it's going to go," Ferguson said.

Stage's ability to receive treatment while recovering from the transplant surgery also would have to be guaranteed, she said.

"A prison might not be the best environment for someone to recover in," she said. "It's still a big surgery to take an organ out of the body, even though it's now a minimally invasive surgery procedure, without an open wound."

Another major obstacle, Ferguson said, are rules prohibiting patients from jumping out of the timeline of organ transplant recipients governed by the United Network for Organ Sharing.

A few Orleans Parish Prison inmates have been allowed to donate, Inglese said, but those exceptions were made for men who had been found to be matches for relatives before going behind bars.

"There's no formal policy," he said. "I weigh them on an individual basis. If a family member calls in and says, 'Mom's dying and needs half a liver. Can we include him in the screen?' I would say yes."

Meanwhile, Stage would not be eligible for parole until October 2006, and would have another two years left on his sentence if it is not granted, Laborde said.

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John Pope can be reached at jpope@timespicayune.com or (504) 826-3317. Mark Schleifstein can be reached at mschleifstein@timespicayune.com or (504) 826-3327.

Copyright © 2005 The Times-Picayune

This article posted January 24, 2005.