Strangers Are Giving Needed Organs To Strangers

By Christopher Snowbeck

Post-Gazette Staff Writer

The two women were strangers more than a year ago, when Lane started working the night shift at the VA Medical Center and met Hall's mother, Willa Robinson. As the women talked together on the job, they found common ground in their deep religious faith, and eventually, Lane learned about the kidney problems of her co-worker's daughter.

In time, Lane felt called to donate one of her kidneys to Hall, 38, of North Braddock.

"There was one particular night when [Robinson] was talking to me and she just began to cry," said Lane, of Swissvale. "The Lord just let me see a mother's heart hurting for her child."

The generosity that moved Lane to give one of her organs Monday to Hall at UPMC Presbyterian is extraordinary, but it's the sort of kindness from strangers that transplant centers here and across the country are turning to ever more frequently because of the chronic shortage of organs that can be transplanted from cadavers.

While Lane got a chance to meet Hall and know her before the donation, some medical centers have gone so far as to allow complete strangers to donate body parts to one another.

Soon, that option will be available in Pittsburgh, too.

"The number of phone calls asking if they can do this has increased each year," said Brian Broznick, executive director of the Center for Organ Recovery and Education, the local group responsible for recovering organs for transplant. "People will call and say, I have two kidneys and I want to donate one."

CORE is working on a plan now that would devise guidelines for these "living-unrelated donor" transplants.

About five people a year at UPMC are like Manerva Lane in donating kidneys to people with whom they are emotionally attached but not biologically related. That often means giving an organ to a spouse, but a recent case at UPMC featured a long-lost friend donating a kidney, and another kidney transplant this year at Allegheny General Hospital involved one man donating to his co-worker's wife.

Unrelated Donations Grow

Back in 1989, there were only 29 living-unrelated donations in the country. By 1998, the number had jumped to 177. What drove the change was a scientific understanding that even when the blood and tissues of the live donor and recipient didn't match very well, the recipient did as well as or better with a kidney coming from a live donor as he did with one coming from a cadaver, said Joel Newman, spokesman for the United Network for Organ Sharing.

As confidence has grown with letting unrelated people donate kidneys, transplant centers have grown more liberal in their policies.

The University of Maryland is among the small group of transplant centers that perform what Dr. Stephen Bartlett, director of the transplant program there, calls "anonymous/altruistic" donation. Since the program at Maryland started last week, about five people have successfully donated kidneys to strangers.

Living kidney donors face a risk of death that is "quite low," Bartlett said, at 3 per 10,000. So the biggest risk, he said, is that people will try to donate for reasons that aren't purely altruistic and are difficult to discover.

"They're either seeking attention or they could possibly have it in their mind that they could seek something from the recipient in the future," Bartlett said.

Potential donors are evaluated by a psychiatrist and must give a complete medical and social history. If the donor and recipient want to get to know each other, they are allowed to do that, and all of the pairs so far have met.

At the Washington Regional Transplant Consortium in Washington, D.C., the stranger donation practices have gone a few steps further.

The brand new Washington program allows for "paired exchanges." In that program, officials will pair people who want to donate their kidneys to friends or relatives and don't have the right tissue match to do so -- but do have the proper match with the other donor's friend or relative.

The Washington program also allows another twist. In some cases, it will let a person donate to a stranger, and in return the donor's relative or friend will move up on the waiting list for a cadaver transplant.

Giving Fair Warning

The program is open to donors 18 to 70 years old and involves lengthy screening of donors' medical and social histories, said Cindy Speas, spokeswoman for the Washington consortium. Before getting the green light from the agency, donors are asked to consider that their future health is unpredictable and that by giving now, they would not be able to help a friend or relative who might need a kidney in the future.

Another consideration for donors is that recovery can take as long as six weeks, meaning two or three weeks away from work. The federal government gives employees 30 days' leave for donating a kidney, but Speas said that was not the case with many companies.

The Washington program expects to produce donors by the end of the summer, Speas said. One person is currently going through the process, and about 25 have made inquiries.

While these approaches are innovative, Maryland's Bartlett is not convinced that altruistic donation will produce a wealth of donors.

"I think it's going to be a highly publicized handful at every center," Bartlett said. "You have to ask yourself, would you do it. What would the common man say? ... I think the majority would say, no, they wouldn't do it."

Broznick, the CORE director, said he received about 30 to 40 calls a year from people asking if they can donate. Not all hospitals in CORE's service area of Western Pennsylvania, West Virginia and a small bit of New York are comfortable with the idea of letting complete strangers donate to one another, he said.

But a group of doctors will travel with CORE this summer to Washington to see how that program is working.

The Washington project was among the topics discussed this month at a conference called "Living Donor Organ Transplantation: A National Consensus Conference."

Sponsored in part by the National Kidney Foundation, participants addressed the need for transplant centers to reach agreement on the best way to protect people who agree to donate. Many participants agreed that a donor registry was needed to track the long-term health of people who give up a kidney, said Gigi Politoski, one of the organizers from the kidney foundation.

No Ethical Bar

The foundation is in the process of doing research on public willingness to donate to strangers, Politoski said.

Local interest in expanding the pool of kidney donors goes beyond CORE.

Dr. Michael DeVita, a bioethicist at the University of Pittsburgh, said he had not heard persuasive arguments against stranger donation.

"It seems to be a reasonable thing to do if people are so inclined," DeVita said. "I haven't heard anyone give a good argument why fathers can donate to their sons but they can't donate to others."

Dr. Ron Shapiro, the director of kidney transplants at Pitt, said doctors had begun working with ethicists to develop a policy on stranger donation prior to joining the CORE effort.

Manerva Lane doesn't have a kidney to give anymore, but she says she could imagine having donated to a stranger. The driving force in her donation is summed up by a plaque that hangs in the living room of her home. The Bible passage reads: "As for me and my house, we serve the Lord."

She adds: "One of the ways we serve the Lord is, we serve each other."

There was no denying the back pain and the discomfort that Lane experienced this past week as she recovered in her hospital room -- doctors told her she would feel as if a truck had hit her, and they weren't lying.

But none of that makes an argument against donating, Lane said.

"I would suggest to anybody that if they're healthy, get in and do it," she said. "Because for the little bit of inconvenience, the little bit of pain that you have to endure, you're talking about that vs. someone's life. It becomes very meaningful when you talk about a life."

"We do have spare parts that we don't need in order to survive," she said.

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This article posted June 22, 2000.