Lars Larson and I discussed the urgent issue of organ transplants. Every day, 17 people in the US die waiting for a life-saving organ, and more than 100,000 are on the transplant list. Lars shared his frustration with the inefficiency of the current system.
I explained that the US organ transplant system is inefficient, inconsistent, and unaccountable, largely because it's government-run. The main issue, however, is the insufficient supply of organs. With about 17 deaths daily due to organ shortages, the quality of life for those with failing organs, especially those on kidney dialysis, is very poor. Dialysis is burdensome, time-consuming, and highly costly, much of the expense of which is covered by taxpayers.
Lars asked whether I supported a policy where everyone is automatically signed up as an organ donor, as in Belgium. I said no and suggested offering federal tax credits to incentivize organ donations. Technology also holds promise, such as 3-D printing of organs, but I’m skeptical about its immediate feasibility, especially for complex organs like kidneys and livers. More promising is the use of genetically engineered pigs. These pigs can provide organs that are less likely to be rejected and can carry out necessary functions without transmitting diseases to immunosuppressed patients.
Lars suggested a system where a quarter of available organs are auctioned to the highest bidder, with the proceeds used to cover the costs for other patients and compensate donor families. He believed this would attract wealthy bidders and create a financial incentive for people to become donors. While plausible, I thought it would be resisted by those prioritizing equity; we both agreed that implementing a new system requires overcoming significant ethical and societal hurdles.
You can find our entire conversation here.
Looking for more?
You can find my article on solutions for organ shortages co-authored with Dr. Sally Satel here
We Urgently Need New Approaches to Obtaining Organs for Transplantation
We Urgently Need More Organs for Transplantation. Science and Policy Can Come to the Rescue.
Henry I. Miller, MS, MD
Henry I. Miller, MS, MD, is the Glenn Swogger Distinguished Fellow at the American Council on Science and Health. His research focuses on public policy toward science, technology, and medicine, encompassing a number of areas, including pharmaceutical development, genetic engineering, models for regulatory reform, precision medicine, and the emergence of new viral diseases. Dr. Miller served for fifteen years at the US Food and Drug Administration (FDA) in a number of posts, including as the founding director of the Office of Biotechnology.
