Organ Donation: Should Younger Patients Get Better Kidneys?


Powell, who lives in Sallisaw, Okla., was healthy and active until he was attacked by three men in 1995. Since then, he's suffered from uncontrollable hypertension that has wreaked havoc on his kidneys. Powell's wife, Melissa, plans to get dialysis training so she can treat her husband at home.

Older patients with kidney failure tend to suffer from other health conditions, such as diabetes, that increase their risk of death while on dialysis. They are often offered extended criteria donations because, although the kidneys aren't perfect, they are better than dialysis.

"If you're older, this change would reduce the number of kidney you have access to, increase the age of kidney you can get and increase the likelihood of extended criteria donation," said Dr. Daniel Salomon, co-director of the Center for Organ and Cell Transplantation at Scripps Green Hospital.

Powell, father of four and grandfather of five, just wants a fair chance at a good kidney as soon as possible.

"I think we should give an individual as much opportunity to have a good quality of life as possible, regardless of what their age is."

But it's important to consider the ethical responsibility to donors, too, Caplan said.

"I don't think people donate organs so that everyone has an equal chance. I think they do it to save lives," he said.

Supply and Demand

Although the proposal raises sensitive issues surrounding health care and social justice, the topic of rationing is one that, at least for kidney transplants, is very real.

"Decisions about organ allocation are already being made. This proposal is just another way," said Jackie Hancock, president of the National Foundation for Transplants. "It's heart-wrenching that someone has to make these kinds of decisions, and that's the sad part about the whole thing. But the decisions have to be made because there are not enough organs."

UNOS is inviting feedback on the proposal until April 1.

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