For a contrary view, this comment on Marginal Revolution is worth considering (<a href="https://marginalrevolution.com/marginalrevolution/2024/04/unos-kills.html?commentID=160742427" rel="nofollow">https://marginalrevolution.com/marginalrevolution/2024/04/un...</a>)<p>> My spouse works for a doctor who specializes in kidney transplants. This post has numerous errors and misleading statements; so many that it probably should be taken down.<p>> Firstly, there is a very good reason why some recovered organs are not transplanted. It’s because they arent healthy kidneys. Either due to the health of the donor or a long cold ischemic time, these kidneys would not function properly in a recipient. The center my spouse works for is nationally recognized as being aggressive; making use of kidneys that other doctors reject, but there are plenty of kidneys that they will mot use and no center will.<p>> Secondly, organs are GPS tracked.<p>> Next, UNOS requires each center to remove someone from the wait list within 24 hours of finding out about the death. My spouses center checks in with patients once every 3 months, so, at most, there can be a 3 month delay between death and list maintenance. In practice, the family or dialysis center will notify the doctors office much earlier than that. I highly doubt the 17 percent of matches are against deceased patients stat because it has never happened in all the years my spouse has been working there<p>> Also prior living donors are given priority
I saw an interesting article arguing that we should legalize paying for kidney donations. [1]<p>I'm not sure how I feel about it, but the article was well argued. The main argument is that even if it is immoral, we are still short hundreds of thousands of kidneys unless we can somehow make them, and so this would save lives.<p>[1] <a href="https://www.nytimes.com/2024/04/02/opinion/kidney-donations-compensation.html" rel="nofollow">https://www.nytimes.com/2024/04/02/opinion/kidney-donations-...</a>
17,500 doesn’t really hit that hard, at least for me—I don’t have a good intuition for how many kidney transplants happen per… whatever, day, year. The number in the article is more intuitive, I wonder why they didn’t put it in the headline.<p>> If you're an organ donor in the U.S., there's a 25% chance your kidney ends up in the trash.<p>That’s a <i>wild</i> number of wasted kidneys compared to the supply.
The reason I'm not an organ donor is simple. Everyone in the chain makes money: the OPO, the hospital, the doctor, and the insurance company. The only one who doesn't is my family, but they're the ones offering the scarce resource. If there were a pre-registered organ market then I would gladly opt-in if the price were sufficiently high.<p>If no one else will work for free, I will not either.
Some things jumped out from the article as feeling sloppy.<p>> The tech is so bad. The United States Digital Service found 17 days of downtime in recent years.<p>If anyone is curious, a total of 17 days since 1999 according to a report obtained by the Washington Post from 2021.<p>> Until recently, the algorithm that was protecting all organ donor patient information in the country, so STI status, mental health, every physical history, was from 1996.<p>The algorithm? Huh? But it actually does seem serious that they have "denied nearly 100 federal requests to audit source code, reported The Washington Post." UNOS said they would have pentesting done in the WaPo article, but I couldn't find any reporting on if they actually followed through.<p>Additional sources:<p><a href="https://fedscoop.com/usds-organ-transplant-system-shakeup/" rel="nofollow">https://fedscoop.com/usds-organ-transplant-system-shakeup/</a><p><a href="https://www.washingtonpost.com/health/2022/07/31/unos-transplants-kindeys-hearts-technology/" rel="nofollow">https://www.washingtonpost.com/health/2022/07/31/unos-transp...</a>
There was a recent article in the NYT on technology being developed to better deliver organs:
<a href="https://www.nytimes.com/2024/04/02/health/organ-transplants-perfusion.html" rel="nofollow">https://www.nytimes.com/2024/04/02/health/organ-transplants-...</a>
"Perfusion, as its called, is changing every aspect of the organ transplant process, from the way surgeons operate, to the types of patients who can donate organs, to the outcomes for recipients."
I don't know if the red tape described involving UNOs and OPTN will get in the way of more progress. But this seems like an area that could use a lot more attention.
Also make donation opt-out instead of opt-in because most people don't care either way and with opt-out those who actually care have to take measures and not the other way around. That's how it works here in my and in many other European countries.
>First pig kidney transplant in a person: what it means for the future<p><a href="https://www.nature.com/articles/d41586-024-00879-y" rel="nofollow">https://www.nature.com/articles/d41586-024-00879-y</a>
The airlines are less likely to lose your suitcase than this organization is to lose your kidney and one percent of the federal budget goes to dialysis.<p>I hope they fix this and I'm a longstanding critic of organ donation who routinely gets mountains of hatred and downvotes for it.
Non profit is such a silly term. All it means is that shareholders don't profit (because there are no shares). It says nothing about employees or executives.<p>IMO, we should be honest. Only volunteers or those sworn to poverty should be allowed employment in these things. This is why they were originally implemented, so things like your local Masons or Knights of Columbus or convent can have some legal structure.<p>They were not intended for something like this. Let's be honest. We have new corporate structures like public benefit corporations that make more sense.