Transplant Surgery abroad is not the same in every country

[sandman]

If only all of the prisoners were like dialysis patients, there wouldn't be any need for guards, because the prisoners themselves would keep themselves locked in, thinking it was unethical to try to escape!   

You just don't seem to get it, do you?  That has to be one of the most ignorant statements I have ever heard.  Dialysis patients are NOT prisoners and they are NOT trying to keep themselves locked away.  It's not like these patients don't want a new kidney, because most of them do.  It's just that ethics do play a roll in where humanity concerned.  Let me ask you something.  If you were in need of an organ, would you willingly accept one from some shady, black marketeer?  ( keeping in mind that even though the black marketeer will most likely be faster, he/she is not your only option )  If you had even one ounce of respect for another persons life and/or well being, you would most likely pass.

As everyone else here has already tried to tell you, kidney transplants are NOT A CURE !!  At best, a kidney transplant is a temporary transition away from the dialysis machines. And even though your off the dialysis machines, you are not out of the woods.  You run into a new set of problems.  Transplanted kidneys are not perminate   Transplanted organs will fail because the human body will try to fight off any tissue that does not match it's own DNA and it's a never ending battle.

You know Mitch, you may want to listen to what these people have to say.  You may just learn something.

[stauffenberg]

While people who suffer endstage renal failure will never entirely escape all medical problems, transplant is a treatment option so much superior to dialysis that the difference between the two methods of treatment really does amount to an 'escape from prison' in my opinion.  On dialysis I felt unwell all the time on the physical level, muddle-headed on the intellectual level, and utterly trapped in social and psychological terms.  There was never a moment when I did not have to keep in mind that I had to structure my life so as to be back on the machine within a few days of the last time I was on it.  Counting time for travel to the dialysis unit, waiting to be put on the machine and taken off it, and time being treated, I lost about 21 hours a week -- the equivalent of having an unpaid, uninteresting part-time job.  But since my transplant I feel completely free, and there is nothing more essential to the human spirit than to be able to be spontaneous, to be able to break out of the structure of your life now and then.

In terms of physical well-being, since my transplant last year I feel about 90% as healthy as I did before I developed renal failure, instead of 20% as healthy as normal, which was how I felt on dialysis.  Aside from having to take pills and having to visit the doctor more often than most people, I don't experience myself as a sick person, and friends of mine don't even know I have a medical condition.  And the difference in life expectancy should not be left out of account either.  As I mentioned a while ago at this website, the differences in life expectancy with a transplant are as follows:

Average life expectancy on dialysis for the 20 to 39 year old age group:  diabetic: 8 years; non-diabetic: 20 years
Average life expectancy with a transplant for the same group:  diabetic: 25 years; non-diabetic: 32 years

Average life expectancy on dialysis for the 40 to 59 year old age group:  diabetic: 8 years; non-diabetic: 13 years
Average life expectancy with a transplant for the same group:  diabetic: 23 years; non-diabetic: 20 years

Average life expectancy on dialysis for the 60 to 74 year old age group:  diabetic: 5 years; non-diabetic: 8 years
Average life expectancy with a transplant for the same group:  diabetic: 8 years; non-diabetic: 12 years

[mitchorganbroker]

Sandmansa  You have taught me something I wasn't sure about. Your type of ethics, not logic is what keeps alot of people from seeking out a live un related donor transplant. Based on some of your statements , your version of ethics may be flawed. This is what traps you, sticking with the waiting list cadaver system.
   I never had ESRD ,nor has many of the doctors treating you guys, yet forming reasonable opinions is still possible.
   If I needed a kidney transplant, I would pick a certain Philippine transplant Surgeon, who is linked to 3 other leading Transplant Surgeons , one of which transplants mostly in the US.
   Each of the three Surgeons based in the Philippines have his own large list of donors who have been previously tested for HLA during the workup of other recipients..Between them, I would stand a good chance of a three antigen match (DR,B and A) Since it's reported that live donor transplants can last 30 years. That would last me a lifetime. The expected improvements in anti rejection medications will add more longevity with less side effects. Sounds like a cure. After reading the livecam story, I learned how much better he felt after his transplant and how strongly he recommends the transplant. I will add that a live one is much better than a cadaver organ.
   Therefore your question- "Would you willingly accept one from some shady, black marketeer?" sounds like a story from the National Inquirer. They do NOT exist. Therefore your ethics seem to be based on a make believe myth.  If your ethics is based on non existant black marketeers, then it's time to look specifically at the Philippines.
   The poor results in Pakistan and China are not to be blended with other countries in Asia , like the Philippines.

[meadowlandsnj]

Here's something I found that mentions our friend Mitch the Organ Broker

Website sells organs from poor foreigners to rich Britons
Main Category: Public Health News
Article Date: 09 Jun 2003 - 0:00am (PDT)


IoS investigation: Shortage of kidney and liver donors creates new international transplant trail

British patients with kidney and liver failure are being invited to buy replacement organs from living donors abroad by a broker who is promoting transplant operations in the Philippines, according to a charity.

The anonymous broker is offering the organ transplants at an undisclosed price via the website Liver4you.org. It was highlighted by the charity Organs Watch, which monitors the trade, as one of the first seeking European customers. A Filipino kidney can be bought for $1,300 (£780) and the operation is carried out in a private hospital in Manila, the charity says.

Yesterday the website, which gives a telephone number in the Netherlands but is registered in Paris, declared: 'You can travel to us for our surgeon. Live donations gives [sic] the best match. Things for the donor are legal.' It singles out the US and the UK as countries where there is a shortage of donor organs.

The website does not give the costs of the operation or the surgeon's fee but says patients will need $1,000 for the round-trip ticket, between $400 and $1,800 a month for accommodation and $200 for a pre-paid mobile phone. It says the average wait for the operation is two weeks.

In response to an inquiry to the website, The Independent on Sunday received an emailed reply, signed by Mitch Michaelson, which said the website was about 'getting transplant surgery, not selling organs'.

It added that live donor transplants were permitted 'as long as you follow the rules' and that the arrangements made by Liver4you.org were 'within the legal structure of the Philippines and their regulations'.

Elizabeth Ward, president of the British Kidney Patient Association, condemned the trade. 'I am absolutely horrified and sickened. It shouldn't be allowed.' She said it was immoral to put live donors in poor countries under pressure to give up their organs when there was a ready but untapped supply from cadavers in this country. 'There is not enough pressure on the Government to change the law to prevent these organs being burned and buried.'

The route from Europe and the US to the Philippines is only one on the transplant trail. The international trade in human organs is growing as wealthy patients in the West are turning to countries in the developing world where they can buy kidneys on the black market, despite an international ban on trafficking in human organs.

A donor can live a normal life with one kidney and can also give up part of the liver without harm, but there are risks involved in the operations.

Other transplant trails identified by Organs Watch, based at the University of California, Berkeley, include that followed by Israeli patients who fly to Turkey, where they are matched with kidney sellers from Moldova and Romania.

Brokers in Brooklyn, New York, posing as a non-profit organisation, traffic in Russian immigrants who provide organs to foreign patients. They are transplanted in some of the best medical facilities on the east coast of America, according to Nancy Scheper Hughes, a founder of Organs Watch.

She has also identified a Nigerian doctor/broker who links wealthy American patients with poor Nigerian kidney sellers for operations either in South Africa or Boston. In Britain, as elsewhere, the trade is fuelled by the desperate shortage of organs available for transplant.

A survey of UK transplant units conducted by specialists at Queen Elizabeth Hospital, Birmingham, last year found 29 NHS patients had travelled abroad to buy kidneys illegally. In more than half the cases the kidney failed and more than a third of the patients died.

Kidney failure is a particular problem among Asians who represent 4 per cent of the population but 14 per cent of those on the waiting list for kidneys. Patients from British-Asian families are among those who have gone to India to buy organs. But the donors, who are mostly poor, may be duped into agreeing to the operation.

A 16-year-old boy from the Punjabi capital Amritsar, interviewed for BBC Radio 4's File on Four, described how he was taken to a safe house near a hospital and introduced to the patient he was being paid to help - without being told the truth. 'I'd been told I was donating blood but the doctor said he had removed a stone,' he said. 'It was when I left hospital I found out they had removed my kidney.'

A police investigation into at least 2,000 questionable transplants in and around Amritsar found that 22 donors had died after giving their kidneys. A leading doctor has been accused of culpable homicide.

To curb the trade and boost the supply of organs in Britain, specialists have suggested radical measures to attract living donors. Last week Professor Nadey Hakim, of St Mary's Hospital, London, who is president of the Royal Society of Medicine's transplant committee, suggested payments of up to £2,000 could help to persuade donors to come forward. 'If it's done safely the donor will not suffer,' he said.

The Department of Health is due to publish a White Paper on organ donation following a consultation paper last year which outlined a number of ways of boosting transplants.

Banned in Britain

The sale of organs was banned in Britain in 1989 after three doctors who offered kidney transplants using paid Turkish donors were found guilty of serious professional misconduct by the General Medical Council.

Despite the ban the trade continues, fuelled by the shortage of organs. About 7,000 patients are waiting for kidney transplants in the UK but only 3,000 operations are conducted each year. Some kidney patients spend years on dialysis before a replacement organ becomes available.

The number of kidneys available has been falling because safer roads have led to a steep decline in fatal accidents, one of the main sources of cadaver organs. The growing recognition that kidneys taken from living donors are more successful, doubling life expectancy to 20 years, is also driving the trade.

Last year Bhagat Singh Makkar, a London GP, was struck off the medical register for offering to procure a kidney for a patient, and a second GP, Jarnail Singh from Coventry, was suspended from the register after being found guilty on a similar charge. Jarnail Singh was reinstated to the register in April.

Both doctors were exposed by undercover reporters from a Sunday newspaper posing as patients seeking a kidney for the father of one of them.

Three years ago Mick Taylor, 26, a dialysis patient from Halifax, Yorkshire, who won £4.1m on the National Lottery, was inundated with offers after he said at a news conference that he would swap his winnings for a new kidney.

A small but growing number of transplant surgeons around the world say the sale of organs should be made legal to improve the supply and to safeguard those involved, given the desperation of patients and the readiness of donors to sell their body parts on the black market.

One suggestion is that governments could control the trade by inviting living donors to donate kidneys to a 'pool' in return for payment. The organs would be allocated from the pool to the most suitable recipient and the safety of the donors would be assured by careful screening and monitoring of their care.

Governments could have an interest in such a scheme because of the huge cost of maintaining kidney patients on dialysis: £20,000 to £30,000 a year, double the cost of maintaining a transplant patient and for a worse quality of life.

Case study

Jennifer Ainsworth scans the website that promises to change her life. The 44-year-old mother of two has had to live with kidney failure for the past seven years. She needs constant dialysis treatment and has been waiting for a kidney transplant for the past five years. But the Liver4you.org website raises more concerns than interest.

'This is clearly a hard-sell website and is not done out of any altruistic motives,' said Jennifer, an office worker from Glasgow, who was diagnosed with kidney failure as a result of systemic sclerosis.

'There is no way I would go to doctors I didn't know or contemplate going abroad to buy a kidney, but I can see how others might be tempted. A commercial site like this just shows how dire the problem is becoming in finding donors.' Jennifer is faced with the prospect of never again being able to lead a 'normal' life.

Everything she, her husband George and their two teenage children do revolves around her medical care three times a week at Glasgow Royal Infirmary.

'What we need in this country is an opt-out system where everyone can be considered a donor unless they carry a card expressly wishing that their organs are not used for transplant,' she added. 'This site plays on the desperation of people, especially liver patients, who face death unless they get a transplant.'

[stauffenberg]

It has been estimated that only 15% of cadaver organs suitable for transplant are actually collected, in part because they families refuse, preferring to bury the organs to feed worms in the cemetery rather than to save human lives with them, and in part because physicians feel too uncomfortable about approaching families to donate the organs of a relative who has just died in order to get their permission (Arthur Kaplan, "The Ethics of Organ Transplants," p. 49).  Governments can and should have policies in place to prevent this waste, but until they do, where do they get the moral standing, in the face of their refusal to stop this massive waste of life-saving organs, to tell patients it is unethical to buy a transplant?  If all countries introduced the 'presumed consent' laws which exist in Austria, Belgium, and Spain, according to which every cadaver is presumed to be available for organ harvesting unless the person has signed, during his lifetime, a special form denying this permission, the organ shortage could be solved over night.  But this reasonable proposal is considered in many countries to be too much of an imposition of state power on the freedom of the individual, so it is not adopted.  But then how can these same governments turn around and say that they can impose state power on dialysis patients to keep them from buying their way out of the medical trap they find themselves in?  Is the right to have your corpse buried intact higher than the right to live by getting a transplant?  Why don't governments institute a policy where everyone has to sign up at age 18 to donate their organs if they die; then if they don't, they will never be eligible for a transplant.  Why should a person be able to benefit from a donated organ that he was not willing to donate himself?  Again, if governments introduced this policy, the organ shortage problem would cease overnight, but the truth is, they really don't care all that much about the tiny, vulnerable minority of people with endstage renal failure.  But then why do they suddenly care so much about the ethics of the situation when we try to escape the trap they won't help us out of?

I have investigated Mitch's program in the Philippines as thoroughly as possible, talking to the doctors he works with, the patients he has treated, and the organ donors that the doctors have provided.  Everyone I spoke with was well satisfied with his service and everyone said he was scrupulously honest with every penny he was paid.  You may not agree with the ethics of what he is doing, but you can't fault the internal integrity of the service he offers or its medical efficiency and successes.

[Rerun]

Stauff, a couple of things. 

If I buy an organ in the Philippines, when I come back I can't get medical coverage for follow-up because "Mitch" is not a preferred provider.

Second thing:  Why start at age 18.  It is a waste to bury a 9 year old's organs as well, and there are plenty of children waiting for organ transplants.  When you start at 18 you are wimping out on your ethical plan and it makes it sound like something is WRONG with the plan if children are excluded.  Does Spain etc., have an age limit on presumed conscent?

[livecam]

MItch and Stauffenberg are the same person and if not boys prove me wrong.  Stauffenberg you were a respected professor in England and Germany?  Would you please post a link to a site or sites that describe you or your work?  I'm getting a little tired of the Mitch/Stauffenberg good cop bad cop game being played out before patients who are trying to survive and get better.  Prove me wrong Mitch/Stauffenberg.  Epoman take note, it is time to put an end to this.

[stauffenberg]

The system proposed by Rupert Jarvis for organ transplants to be available only to those who signed up ahead of their renal failure to indicate their willingness to be donors starts with people 18 years of age just for the simple reason that that is the earliest age at which legal consent can be given.  Obviously special cases, such as people incompetent to consent, people developing renal failure before age 18, people who just moved to the country before renal failure, etc., would have to be taken care of by special legislation within the overall plan.  But the idea is a fair one, that if you expect to benefit by a cadaver organ you should be prepared to donate one, and would end overnight the organ shortage problem, since probably everyone would sign onto the plan.  But it would still preserve autonomy, since people who had profound objections to organ donation could simply stay out of the plan if they wanted.

Mitch and I are not the same person, as anyone can easily tell from the difference in our writing styles!  Also, my personal knowledge of the dialysis and transplant experience should be sufficient indication that I am not Mitch, who does not claim to have had any such experience himself.  I was registered with this message board long before Mitch appeared, and I am sure that with such a technologically advanced website as Epoman has constructed, he can tell that Mitch and I are never using the same server, and that we are in fact posting occasionally at nearly the same time from commerical networks which cover areas of the globe many thousands of miles distant from each other.  Since I speak frankly about my personal experiences on this message board, I claim the same right to anonymity, however, as everyone else here does.

[sandman]

Sandmansa  You have taught me something I wasn't sure about. Your type of ethics, not logic is what keeps alot of people from seeking out a live un related donor transplant. Based on some of your statements , your version of ethics may be flawed. This is what traps you, sticking with the waiting list cadaver system.  I never had ESRD ,nor has many of the doctors treating you guys, yet forming reasonable opinions is still possible.

Mitch, I am glad you have learned something.  My ethics are not important, nor are they like everyone else's.  I never said I was right.  I only suggested that your point of view was of ignorance and disrespect toward those in which you are trying to solicit.  Maybe your right and my ethics are flawed.  Who knows but may I let you in on a little secret?  Well, not so much a secret but I am not a kidney patient, not like I was hiding that fact.  I don't know what kidney patients go through but I am learning as much as I can from sites like this one for the sake of my girlfriend who is a kidney patient.

Therefore your question- "Would you willingly accept one from some shady, black marketeer?" sounds like a story from the National Inquirer. They do NOT exist. Therefore your ethics seem to be based on a make believe myth.  If your ethics is based on non existant black marketeers, then it's time to look specifically at the Philippines.

Oh, and forgive me for comparing you to that of a black marketeer.  It's just the way you are presenting your arguments, make you seem like you are selling something to good to be true.  And ummm, I don't know where you get your information about black markets but they do exist.  Just because you have not seen that kind of activity, does not mean it doesn't happen.  Can you show me proof that black markets are a myth?

[angieskidney]

If all countries introduced the 'presumed consent' laws which exist in Austria, Belgium, and Spain, according to which every cadaver is presumed to be available for organ harvesting unless the person has signed, during his lifetime, a special form denying this permission, the organ shortage could be solved over night.  But this reasonable proposal is considered in many countries to be too much of an imposition of state power on the freedom of the individual, so it is not adopted. 

I was hoping that my province would pass that (they put it up and it was voted on) but the majority voted against it because sadly enough most of the public is NOT aware of kidney disease since it is not widely talked about as let's say AIDS or Cancer has been... But I was hoping that we could get that Presumed Consent thing!!

But then how can these same governments turn around and say that they can impose state power on dialysis patients to keep them from buying their way out of the medical trap they find themselves in?  Is the right to have your corpse buried intact higher than the right to live by getting a transplant?  Why don't governments institute a policy where everyone has to sign up at age 18 to donate their organs if they die; then if they don't, they will never be eligible for a transplant.  Why should a person be able to benefit from a donated organ that he was not willing to donate himself?

That is just wrong! Everyone has a right to a transplant! But no one has the right to demand people donate their organs. It is part of FREEDOM!

And who the heck is Rupert Jarvis??

The system proposed by Rupert Jarvis for organ transplants to be available only to those who signed up ahead of their renal failure to indicate their willingness to be donors starts with people 18 years of age just for the simple reason that that is the earliest age at which legal consent can be given. Obviously special cases, such as people incompetent to consent, people developing renal failure before age 18, people who just moved to the country before renal failure, etc., would have to be taken care of by special legislation within the overall plan. But the idea is a fair one, that if you expect to benefit by a cadaver organ you should be prepared to donate one, and would end overnight the organ shortage problem, since probably everyone would sign onto the plan. But it would still preserve autonomy, since people who had profound objections to organ donation could simply stay out of the plan if they wanted.

That would NOT solve the problem! What would solve the problem would be better publication of the disease so that the public can be MUCH BETTER INFORMED!!

Mitch and I are not the same person, as anyone can easily tell from the difference in our writing styles! Also, my personal knowledge of the dialysis and transplant experience should be sufficient indication that I am not Mitch, who does not claim to have had any such experience himself. I was registered with this message board long before Mitch appeared, and I am sure that with such a technologically advanced website as Epoman has constructed, he can tell that Mitch and I are never using the same server, and that we are in fact posting occasionally at nearly the same time from commerical networks which cover areas of the globe many thousands of miles distant from each other. Since I speak frankly about my personal experiences on this message board, I claim the same right to anonymity, however, as everyone else here does.

Mitch was actually here LONG before YOU but was banned REPEATEDLY. He just kept coming back under several names.

Oh, and forgive me for comparing you to that of a black marketeer.  It's just the way you are presenting your arguments, make you seem like you are selling something to good to be true.  And ummm, I don't know where you get your information about black markets but they do exist.  Just because you have not seen that kind of activity, does not mean it doesn't happen. Can you show me proof that black markets are a myth?

And how about proof that you are NOT a black marketeer and what exactly is the difference between YOU and THEM

[mitchorganbroker]

Proving I am not a black marketeer . Will you take my word for it ?
Mr.Sandman ,Have you ever seen a picture of a black marketeer ? If they exist, where are the pics. ? The absence of hard proof by Nancy Scheper of Organ Watch and the horrified British lady.
 The people who believe those fairy tales are indeed closing their mind to
a major transplant option and indeed throwing away the key to their invisible cell.
   Angie if you are really poor can you prove it ? How about a due diligence or disability letter.?
Mr Livecam, please post some more benefits of getting your transplant. Was it a cadaver ? Are you the person
e-mailing me virus attachments, since this occurs at the same time you post nasty name calling to me.?
    I do indeed know the side effects of the meds, I read about it from Livecam and the rest of you guys.I also research them on the internet and get the latest from the Surgeons.
    As a group you guys seem to have one similar opinion about how bad foreign transplants are based on incomplete reports and no pictures of the white marketeer.

[angieskidney]

   Angie if you are really poor can you prove it ? How about a due diligence or disability letter.?

It would be EASY to prove with my Income tax returns, My Apartment Manager's Yearly Income Report Records on me considering I live in a government Subsidized residence, and the past documents for claiming bankruptcy. There is ALWAYS a way to prove things! Now prove to US who YOU are!!

I don't really care about proving myself to anyone but in your case, you are trying to sell icecudes to Eskimos who get icecubes for FREE. You had better be prepared to do a better job. We can all get kidneys eventually just fine in our own countries.

[sandman]

Proving I am not a black marketeer . Will you take my word for it ?
Mr.Sandman ,Have you ever seen a picture of a black marketeer ? If they exist, where are the pics. ? The absence of hard proof by Nancy Scheper of Organ Watch and the horrified British lady.
 The people who believe those fairy tales are indeed closing their mind to
a major transplant option and indeed throwing away the key to their invisible cell.

Well, since I don't really know you, I can't exactly just take your word for it.  But I will give you the benefit of the doubt.
I don't need to see pictures of black marketeers, I was involved with apprehending a ring of them that found their way into my city.  Well, people who believe those fairy tales as you like to call them, have a reason to believe.  And if these people choose to close their minds to your opinionated option, well then that is their choice, isn't it?

And who is Nancy Scheper?

you are trying to sell icecudes to Eskimos who get icecubes for FREE. You had better be prepared to do a better job. We can all get kidneys eventually just fine in our own countries.

Well there you go Mr salesman, looks like you have your work cut out for you here. 

[AlasdairUK]

In the UK the law changed at the beginning of the month: When a cadaveric patient carries an organ donation card his wishes are now carried out even if the family objects. Previously the family could veto any organ donation from someone who who carried an organ donation card. Putting the donors rights first.

There was an article in a newspaper that mentioned the state should buy kidneys from donors who where willing and they would then be given to patients across the country depending on tissue typing. The idea is that the money saved from transplantation in the long run could be used to pay the donating individuals.

This idea was not given much thought as the why would a state pay for something it does not have to. The debate of presumed consent comes up.

A few years ago there was a vote in our House of Commons about presumed consent and it was voted against, but times are changing and I feel in a few years presumed consent might be an option in the UK. It would be a (soft) presumed consent where the family could veto the donation if they have not previously opted out. The reason for this is polls have shown that a high percentage of the population would be willing to donate an organ if they where to die, but are too apathetic to sign up.

This would then eliminate what I feel are unethical sources of organ donation. I hope it comes soon for you.

Alasdair.

[angieskidney]

The debate of presumed consent comes up.

My country voted against it .. and here I was all excited about it. I mean it just made sense as a lot of people are just too lazy or chicken to fill the form or they don't know or they fill those small cards from the kidney foundation and then lose it or it is not on their person when they die so it is never known. Presumed Consent would make it easier as the people who really have something against it would then want to opt out and laziness would not hold them back if they are really against it.

Also getting the knowledge out would help tremendously. Get the people informed! Look how fast people learned about AIDS yet look how many years later so many people don't even know what kidneys DO!

[stauffenberg]

It is a typical phenomenon in human culture that when people object to something on the basis of intangible ethical values, they like to assume that some tangible facts support their condemnation of what their theory does not like.  Thus, for example, years ago people who did not like cannibis use because they did not approve of others adopting a non-bourgeois form of consciousness also liked to suppose that the drug must be a gateway drug to more dangerous substances, that it must be addictive, that it must cause insanity, etc.  Or, at a more primitive level, prudes who objected to masturbation liked to believe that it caused blindness, impotence, and hairy palms, just to have some objective data backing up their subjective dislike.  The same sort of thing is now going on on this message board, with people wanting to assume, just because they have intangible ethical objections to buying organs for transplant, that all the ways to do this must necessarily be dangerous, corrupt, fraudulent, etc.  But here as in the other examples I have given, the objective world refuses to give tangible support to ethical values, which have to stand on their own.  A healthy kidney from a medically qualified donor can be bought for a not unreasonably high price in a foreign country from a reputable organ provision system, in a way consistent with local laws and local ethical standards, and the transplant operation can be done within a few weeks in an excellent hospital with highly qualified doctors.  I agree with those who object that you may still have purely ethical reasons for saying it is wrong, but I know from my own personal inspection that it is not also dangerous, corrupt, or fradulent.

It is odd when one poster says that everyone has a right to a transplant but no one has a right to demand that a healthy person donate his surplus kidney, since under the current system the right to a transplant is denied to 50% of patients on the waiting list who die before receiving a transplant, so it is not a real right at all.  In a war even a free society claims the right to draft people against their will into the armed forces to save the lives of the people back home, even if this means that the conscripted people risk serious injury or death, but such a draft would never be imposed on people with one surplus kidney each in order to save the lives of dialysis patients who face a much greater risk than any faced by any American citizen back home during any war of the 20th century, but since we are a small minority, no one cares to be consistent.

To say that Mitch is selling icecubes to Eskimos is also not correct, since even though you may have a claim to be on the waiting list for a free kidney, there is a high likelihood that it will come too late to save your life, that you will have gotten so sick on dialysis while waiting that you will be dropped from the list before getting the kidney, or that you will suffer considerable irreversible worsening of your health from the long wait before getting an organ, to say nothing of all the time of your life when you could have been healthy and active which you will never get back.  So Mitch is offering you something very real indeed.

To recommend public information campaigns as a way to solve the organ donor shortage simply will not work, since such campaigns have been going on for more than 40 years now, and yet now the shortfall of donor organs is greater than it ever was before in history, as the number of cadaver and live donor organs levels off, while the number of dialysis patients continues to increase.

[angieskidney]

Hog wash!

My ethics come from my strong religious upbringing which I will never give up!

My first transplant I got in only 2 months!

I won't die before I get a transplant as long as I take care of my health and watch my fluid intakes.

I will NEVER be able to afford a kidney in ANY other country but my OWN! (I Don't pay in Canada)

I won't get worse on dialysis! Dialysis KEEPS ME ALIVE! I would get worse withOUT DIALYSIS!!

I will get a kidney MUCH FASTER through a cadaver list than any overseas thing!

I am only speaking for myself as Mitch is generalizing a lot.

Where did YOU get your last transplant? Did Mitch supply it for you??

[mallory]

Yes, Stauffenberg, how about it?  Did you buy your kidney?

[stauffenberg]

I am not sure where Angie got her religious convictions, but the last time I read the Bible, both Old and New Testaments, I did not see anything in there about organ donors.  The Bible is so metaphorical in its statements that it requires extensive interpretation to be applied to any ethical situation, so my recommendation would be to concentrate on the rational part of the ethical analysis, rather than on linking it up with cryptic statements written by or for people who knew nothing of organ donation.

Living on dialysis does in fact make patients sicker, since it replaces only 10% of normal renal function and so leaves you in a perpetual state of severe toxicity.  Just look at how dramatically dialysis shortens the lifespan.  Someone in the 15 to 19 year old age group starting dialysis has a 78% chance of surviving 10 years.  Is this normal?  A 40 year old caucasian starting dialysis in the U.S. can expect to live 6.9 years, and a 30 year old can expect to live 9.4 years. (Jeremy Levy, et al, "Oxford Handbook of Dialysis" (2001) page 5.)  The serious damage which dialysis does to the musculature, the vasculature, the bone mass, and the nervous system will occur whether you watch your fluid intake or not.

If you live in British Columbia the average wait for a second-rate cadaver kidney is 4.5 years.  The silting up of patients in Canada is getting progressively worse so the waiting lists will continue to get longer, because while from 1993 to 2002 there was a 111% increase in the number of people on dialysis in Canada, there was only a 73% increase in cadaver organ donations over the same period.  From 1994 to 1996 there were 2007 cadaver kidney transplants in Canada, but, because of the continuing decline in donation of organs, there were only 1879 cadaver transplants of kidneys in Canada from 2001 to 2003.  With around 2000 cadaver kidney transplants a year and 17,000 patients on dialysis in Canada, you figure out how long you are likely to wait for an organ.  For many people, the longer they wait the sicker they get, and before they know it, they are taken off the transplant list as 'medically no longer eligible' as their reward for their patience!  In contrast, if you want to buy a medically much preferable kidney from a live donor in the Philippines, you will have to wait only about three weeks or so for everything to be arranged, from payment to transplant.

Given the enormous benefits of purchasing a live kidney over waiting for a cadaver, before you decide that 'ethics' precludes the medically preferable option, you owe it to yourself that you can 100% defeat every single argument I have made why buying an organ for transplant is ethical before you deny this option for yourself or for anyone else.

[mallory]

One thing is for sure, Stauffenberg, if we listen to you there will be a lot less people getting dialysis.  Here's a quote from you in another thread, I apologize, I didn't know how to use the quote function to copy from a separate thread:

"Personally, I applaud those on dialysis who have the courage to commit suicide, since I find these courageous people in some ways more life-affirming than those who continue with dialysis.  To kill oneself on dialysis says that the patient values the dignity of true human life so highly he is so profoundly offended by the living death that one is forced to endure on dialysis that he prefers to die rather than disgrace his humanness with the inadequate existence provided by a machine that can only replace 10% of normal renal function.  I say this as someone who, during the eight years I was on dialysis, frequently considered suicide but simply lacked the courage to do it, however right the decision seemed.  The irrational, instinctive will to live at all costs, even if life has become a disgrace to human dignity, is very difficult to overcome."

Buy a kidney or kill yourself.  That certainly simplifies things.  Most of us would be gone now, lacking the resources to purchase kidneys.  Perhaps we're lucky that we have ethical aversions to giving up on our own lives or taking advantage of others since that appears to be part of what keeps us going.

You just seem so cynical.  Seriously, don't you ever read anything positive?

[livecam]

Mallory, don't you understand? Stauffenberg and Mitch are the same person.  They've been getting off by making kidney patients feel bad on numerous other boards for years.  Don't argue with him/them.  Just accept that these guys are playing your emotions like a fiddle and ignore them.  I don't know for the life of me why Epoman and Angie are allowing this nonsense to continue on their boards.  It was the undoing of other boards and it will darn well wreck these boards if it is allowed to continue.

[sandman]

I have to agree with livecam.  I think this conversation has gone on long enough and there is no way to settle this debate other then by putting a lock on the door.  It would appear that Mitch and stauffenberg are pushing the idea that if every dialysis patient here were to spend up-to $120.000 for a transplant procedure, that all their kidney troubles will be washed away.  And it has been suggested that if dialysis patients don't take this offer, then they are fools.  I for one, was not happy to see that being suggested.  This simply can not be allowed to continue for two main reasons.

1.) Hardly anyone here has access to that kind of money to begin with.
2.) Kidney transplants, no matter how good they are, are never a "cure" to kidney disease.

I would imagine that most everyone suffering on dialysis, would someday like to get another kidney but Mitch is not debating the issue, he is pressuring the issue.  But no matter how long we debate this issue, Mitch and stauffenberg just don't seem to be willing to get that through to their heads.

[Joe Paul]

It would take more than a troll to piss me off, I say hit the road, tired of hearing the same stuff over and over.

[stauffenberg]

To Livecam I would say that it does not matter whether someone is trying to 'play on your emotions,' whether Mitch and I are the same person (we are not!), or whether you feel this discussion has gone on long enough or not.  You can always have doubts about the motives or the people behind anything and everything you read.  But the only rational thing to focus on is whether the arguments you read make sense or not.  I am ready to answer any objections anyone might raise, and I have already given a very extensive defense of the position -- now accepted as valid by an ever increasing number of professional medical ethicists -- that buying an organ for transplant is not an unethical thing to do.  So if you find the argument convincing and you can't defeat it's logic, then you should rationally accept it, whether it was written by a hundred monkeys randomly banging on the keyboard or by an honest human being.

To Sandman I would say that I never said that getting a transplant was a cure for renal disease, but it is a million times better than dialysis, as I know from my own experience.  Something does not have to be perfect to be worth preferring over the alternative.  During the time you are on dialysis, you make successive accommodations to your declining energy levels, your increasing discomforts, and your progressive loss of mental focus.  These accommodations are so continuous and subtle that over time you don't notice how far you have dropped below normal functioning.  But from my own experience, as soon as I was back in my hospital bed after being wheeled out of the recovery room following the transplant, I felt enormously more energetic, clear-headed, and inwardly well than I ever had on dialysis, even though, at that moment, I had just been through a four-hour operation.  I was shocked and profoundly disturbed to realize, for the first time in years, just how sick I had become on dialysis without noticing its full dimension.  I am sure other transplant patients here can confirm what I say from their own experience.

Also, the price of a Philippine transplant which was cited, $120,000, is way out of range and much higher than the actual price.  I have read that Israelis make a practice of going to Turkey to get a Moldavan organ for $100,000, since such a move enjoys much more cultural acceptance in Israel than in the West, and there are also no laws against citizens leaving Israel for a paid organ transplant from a live donor.  One transplant facilitator I spoke with said he charges $200,000, and another facilitator in the Philippines, who got into the business because this was the only way he could get a transplant for his wife, who had been taken off the waiting list in the U.S., said he charges $95,000.  Mitch is less expensive.  

[sandman]

To Sandman I would say that I never said that getting a transplant was a cure for renal disease, but it is a million times better than dialysis, as I know from my own experience.  Something does not have to be perfect to be worth preferring over the alternative.  During the time you are on dialysis, you make successive accommodations to your declining energy levels, your increasing discomforts, and your progressive loss of mental focus.  These accommodations are so continuous and subtle that over time you don't notice how far you have dropped below normal functioning.  But from my own experience, as soon as I was back in my hospital bed after being wheeled out of the recovery room following the transplant, I felt enormously more energetic, clear-headed, and inwardly well than I ever had on dialysis, even though, at that moment, I had just been through a four-hour operation.  I was shocked and profoundly disturbed to realize, for the first time in years, just how sick I had become on dialysis without noticing its full dimension.  I am sure other transplant patients here can confirm what I say from their own experience.

I understand all that as I have seen what dialysis has done to my girlfriend and she has repeatedly told me stories of how sweet it was when she got her first transplant and how eager she is to try for another.  But one key thing you and Mitch seem to keep overlooking is that most people on dialysis are on some form of government assistance to help pay their medical bills.  Some are even in geared to income housing.  How are these patients suppose to pay in up wards of nearly $100.000 when they can barely even pay the rent?  Why would anyone want go abroad to another country and pay an enormous amount of money for something they can get right at home AND maintain follow up sessions and check-ups for next to nothing?  Your preaching to the wrong quire here my friend.