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Organ Shortage Crisis: Problems and Possible Solutions
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Abstract
The demand for organ transplantation has rapidly increased all over the world during
the past decade due to the increased incidence of vital organ failure, the rising
success and greater improvement in posttransplant outcome. However, the unavailability
of adequate organs for transplantation to meet the existing demand has resulted in
major organ shortage crises. As a result there has been a major increase in the number
of patients on transplant waiting lists as well as in the number of patients dying
while on the waiting list. In the United States, for example, the number of patients
on the waiting list in the year 2006 had risen to over 95,000, while the number of
patient deaths was over 6,300. This organ shortage crisis has deprived thousands of
patients of a new and better quality of life and has caused a substantial increase
in the cost of alternative medical care such as dialysis. There are several procedures
and pathways which have been shown to provide practical and effective solutions to
this crisis. These include implementation of appropriate educational programs for
the public and hospital staff regarding the need and benefits of organ donation, the
appropriate utilization of marginal (extended criteria donors), acceptance of paired
organ donation, the acceptance of the concept of "presumed consent," implementation
of a system of "rewarded gifting" for the family of the diseased donor and also for
the living donor, developing an altruistic system of donation from a living donor
to an unknown recipient, and accepting the concept of a controlled system of financial
payment for the donor. As is outlined in this presentation, we strongly believe that
the implementation of these pathways for obtaining organs from the living and the
dead donors, with appropriate consideration of the ethical, religious and social criteria
of the society, the organ shortage crisis will be eliminated and many lives will be
saved through the process of organ donation and transplantation.