Along a busy Chicago expressway sits a billboard that's hard to miss, an ad for a dying man.
Featuring a photo of a smiling family, it says, "Please Help! My Daddy Needs a Liver." It also gives a phone number and Internet address.
Without a liver transplant, doctors say the "daddy" in question, 45-year-old Jorge Miranda, will likely die within months.
"I'm young," Miranda says. "I have four young kids that I want to see grow up."
As the number of organ donors doubled to 14,154 between 1992 and 2004, the number of patients on the waiting list tripled to more than 89,110, according to the United Network for Organ Sharing. Last year, about one in 12 of them died before receiving an organ.
Desperate to avoid the same fate, more and more patients are pleading for donations in classifieds and on the Internet. There are now hundreds of Web sites, with names like helpmygrandpa.com, and jimneedsakidney.com.
After two years on the national organ waiting list, Miranda and his wife, Laura, decided waiting was not enough.
"I started calling billboard companies, phoning people," Laura Miranda said. "I started calling newspapers."
The proliferation of such public appeals has sparked a contentious debate in medical circles. While there's nothing illegal about the practice, unless an organ is bought or sold, many say the ads raise ethical concerns.
"These Web sites are full of misinformation about the true risks and benefits of transplantation," said Dr. Robert Truog, a medical ethicist at the Harvard Medical School.
One Web site has taken particular heat, matchingdonors.com, a kind of clearing house that puts potential donors in contact with more than 150 patients.
"We're bringing new people into a system that is not doing very well, right now," said Dr. Jeremiah Lowney, the site's founder.
The year-old site claims to have helped at least a dozen people get transplants, miracle matches that critics consider a form of line jumping.
"Public appeals favor those individuals who have the ability, the financial wherewithal, the contacts to make the public appeal," said Dr. Doug Hanto of the American Society of Transplant Surgeons. "And that's really not fair."
But Laura Miranda takes issue with that view.
"How? What? Fair? Where? What?" she said. "Is it fair that he got Hepatitis C from a transfusion? Is it fair that my children see him sick? None of it's fair."
Despite receiving hundreds of phone calls from strangers, Jorge Miranda still has not found a matching donor, though he remains convinced this roadside plea is his best hope.
ABC News' Eric Horng and Andrew Fies originally reported this story for "World News Tonight" on July 24, 2005.