In the bigger picture of organ donation, the conversation about fairness has been a common refrain. Complicating this picture is the cold, simple math – more people need an organ than there are organs to go around. As of May 2013 there were 15,826 patients awaiting transplant in the U.S., according to Anne Paschke, a spokeswoman for the United Network for Organ Sharing, a nonprofit that manages the country's organ transplant system. Last year, only 6,256 patients got the organ they needed – and 1,497 patients on the waiting list died.
Medical experts' continuing mantra is for more in the public to sign up as organ donors. Special efforts, such as New York's "Hate-the-Wait" campaign launched during Organ Donor Awareness month (April) to further encourage organ donation; one of the messages of the campaign is that in New York alone, every 15 hours a patient dies waiting for an organ. And a Johns Hopkins study published in June noted that since Facebook included a link to organ donation registries and put in an "I'm a Donor" option, registration climbed dramatically.
But pragmatic voices point to the fact that there will simply never be enough organs for everyone in need through current means. Allocating them fairly continues to be a burden that rests squarely on the shoulders of the UNOS. Recently, the Department of Health and Human Services has urged this federally governed organization to come up with a way to broaden the system so that organs can move more easily across state lines and between different regions of the country. This effort has been ongoing since 2000 – but organ sharing across state lines has only been implemented for the very sickest patients on the waiting list. Most recently, UNOS met in March to discuss possible solutions to address the huge disparity in deaths and transplant rates across regions, and it is trying to come up with a "new map" to address this issue.
Meanwhile, for Matthew Rosiello, crossing state lines paid off. After multiple trips, tests, and even preparatory surgery, he was finally cleared for transplant and was placed on Ohio's list. On July 7, 2012, he and his family got the good news – a liver was available, and he received the transplant at the Cleveland Clinic. Matthew, now 23, is a DJ back in Staten Island, N.Y., who has made it his "life's mission" to educate others about liver disease and encourage organ donation.
"Matthew was given the gift of life," Randy Rosiello said. "That gift should not be wasted."
Matthew participates in awareness effort through Mt. Sinai, in New York City. "If more people were organ donors," he says, "there wouldn't be so many people waiting on the list and dying each day."