Victoria Gonzales-Nunez
Professor Glenn
BIO 131
December 16, 2022
Ethics of Living Organ Donors
Only in the year 1954 was the first ever organ transplanted, a kidney. More than ten years
later the liver, pancreas and heart followed. The lungs and intestines came twenty years after
that. Today we as a society have made so many technological advances in medicine that the
transplant possibilities are becoming, and soon to be, endless.
Organ donations in the U.S. saves up to 40.000 lives in a single year. Only thirty percent
of those organs come from living donors and of that thirty only 5 total organs can be donated
while living. Imagine being able to give up 5 of your good healthy organs to aid in someone
else’s recovery. Overall it seems like a brilliant idea to donate an organ if you can, but take into
account all the stakeholders involved in the transplant. It isn’t just you who’s up for the
physical and phycological trauma, it’s also the recipient of your donation. The amount of donor
check-ups that occur after a transplant are significant for a reason. These follow-ups include
and aren’t limited to “reporting on medical complications, physical functioning, employment
and insurance” (Mathur, 20202).
Even after considering the physical and emotional possibilities, there are many people
still willing to give an organ either for the gratification of donating or thinking the unethical
question, can they get paid? Unfortunately for them it isn’t that simple due to the other
requirements set by the Human Resources and Services Administration. Some of the major set
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rules for organ donation have to deal with your weight, height, age, blood overall health, etc.
The location and urgency for the transplant is also one of the most important parts. Fortunately
enough for us we have a system nowadays that makes the location and urgency easier to
determine. In 1984 our country welcomed the United Network for Organ Sharing (UNOS).
They, with the assistance of HRSA, determine who, what, where and when someone gets an
organ. Before we got these lucky organizations the world had no way of knowing who needed
exactly what and when what they needed had become available. If the donor was not in the
same hospital as the recipient at the exact time they needed it, no one could be saved.
So what exactly is a living donor and why may it seem unethical to many people? A
living donor is exactly what it sounds like, someone who donates while still living. It’s a very
rigorous process depending on the organ being donated. Most doctors and transplant teams
prepare you with a series of tests, including but not limited to: cancer screenings, blood and
urine, ultrasounds, heart and lung, antibodies, etc. Not to mention the follow-up psychological
check-ins we briefly talked about. Most ethical problems fall under social-emotional, financial
or medical. On average, most donors have higher self-esteem and a good bond with their organ
recipient after a transplant (Transplant Living, 2022). However with good feelings, can come
bad ones as well. In instances where, for whatever reason, the organ isn’t accepted by the
recipient the donor can be overwhelmed by a feeling of anger or guilt/regret. There’s no right
feeling to losing something you didn’t have to and then see it be thrown out as ‘waste’ because
it wouldn’t work for somebody else. Those negative feelings can coincide with a donors
financial issues too. What if you took time off work or even traveled for the surgery and it
didn’t work? There’s so much wasted time in between for just a chance that it will work. Some
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figure in instances like that, donors should get some form of financial compensation however
that usually goes against transplant rules or else anyone would try it. Now when weighing
medical pros and cons we see many negatives that only go into affect should something go
wrong during surgery or the donors body react inappropriately. Besides you getting to be in
good health and higher on the UNOS list should you ever donate a kidney, you’re at risk for
things like lower organ function, high blood pressure, clots, pain, scars, etc. We’re still looking
at ways we can improve positive outcomes on both ends.
Multiple solutions are at play as of this moment. Multidisciplinary research at Wyss
Institute is finding ways to form vascularized tissues with living human cells through 3D
bioprinting (Lewis, 2022). This is a first revolutionary step in creating living and functioning
human organs of all kind that we’ll be able to use for donation. The long rigorous process of
creating these tissues will further not only regenerative medicine but also drug testing methods
which can lower another ethical issue of testing on animals. Biocompatible materials will one
day be the face of regenerative medicine.
By today’s date, there’s no solid long term answer to the need of a transplant other than a
donation. One of our only short-term solutions is covered by xenotransplantation, the use of
animal parts. The very first man with a pigs heart was only able to survive for 2 months after
his transplant surgery. Doctors and other medical professionals modified the pigs dna to their
best ability to try and lower the possibility of rejection on the recipients part. To some extent
we’re still using small parts of multiple animals for short term care such as hearts, valves and
kidneys. Out of every method we try to use to replace the use of a real human organ ,
xenotransplantation should always be one of the last suggestions.
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Along with 3D printing we tread the line of other forms of regenerative medicine. There
are times where doctors will try to stimulate our bodies own repair mechanisms to make us
heal ourselves. One of the more known versions of regenerative medicine includes the use of
stems cells harvested from the patient or a compatible donor. These fixes sound promising for
the future but there is still plenty of work to do. The hard work can in turn be used to improve
another short term solution to heart problems, the artificial heart. The THC is a form of durable
mechanical circulatory support used for failing hearts. The creation is almost like a durable
stent inserted into the ventricles to help relieve the stress on the heart to pump blood through
out the entire body. Again, not the longest solution to a medical problem as mechanical issues
can always occur and the machine will need a few touch ups or replacements throughout the
patients life.
Of the previous content covering every aspect of living organ donors we can see that
investing in the different forms of medicine in which we can create human organs needed
rather than taking them from another source is the most profitable and acceptable answer. We
will continue to innovate in the coming years combining new medicine and technology in the
hopes we can create a firm and permanent solution to our lacking number of organs donated.
Eventually our transplant numbers will be low enough that we won’t have patients stressing
about if they can live long enough to actually survive. We can ‘loosen’ requirements for donors
now and possibly provide aid to those willing to help so badly. Today we continue to think of
change, tomorrow we can achieve it.
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Citations
"Organ Donation and Transplantation." Gale Opposing Viewpoints Online Collection,
Gale, 2019. Gale In Context: Opposing Viewpoints, link.gale.com/apps/doc/PC3010999165/
OVIC?u=csumb_main&sid=bookmark-OVIC&xid=0f1ac27d. Accessed 30 Nov. 2022.
“Ethics - Ethical Principles in the Allocation of Human Organs - OPTN.” Organ
Procurement and Transplantation Network, https://optn.transplant.hrsa.gov/professionals/bytopic/ethical-considerations/ethical-principles-in-the-allocation-of-human-organs/
#:~:text=Utility%2C%20justice%2C%20and%20respect%20for,of%20scarce%20organs%20fo
r%20transplantation. Accessed 28 Nov. 2022.
Vega, J. D. (n.d.). American Society of Transplantation. Retrieved November 30, 2022,
from https://www.myast.org/
Adair, Anya, and Stephen J Wigmore. “Paid Organ Donation: The Case Against.” Annals
of The Royal College of Surgeons of England, The Royal College of Surgeons of England, Apr.
2011, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3291132/.
Mathur, Amit, et al. Shibboleth Authentication Request, Clinical Transplantation: The
Journal of Clinical and Translational Research, 19 Feb. 2020, https://onlinelibrary-wileycom.csumb.idm.oclc.org/doi/full/10.1111/ctr.13838.
“Preparing for Your Living Kidney Donation.” American Kidney Fund, 2 Nov. 2021,
https://www.kidneyfund.org/kidney-donation-and-transplant/preparing-your-living-kidneydonation.
Pros and cons for a living donor. Transplant Living. (2022, September 12). Retrieved
November 26, 2022, from https://transplantliving.org/kidney/pros-and-cons-for-a-living-donor/
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Lewis, J. (2022, May 9). 3D bioprinting of living tissues. Wyss Institute. Retrieved
November 26, 2022, from https://wyss.harvard.edu/technology/3d-bioprinting/
Press, The Associated. “A Man Who Got the 1st Pig Heart Transplant Has Died after 2
Months.” NPR, NPR, 9 Mar. 2022, https://www.npr.org/2022/03/09/1085420836/pig-hearttransplant.
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