The great majority of organ transplantation occurs under the management of the government-sanctioned United Network for Organ Sharing (UNOS, www.unos.org), which maintains waiting lists, determines the priority of patients on the lists, and places available organs. Historically, UNOS has discouraged patients from soliciting organs from non-related donors, but the Internet now offers the potential to facilitate solicitation on a large scale.
One website, MatchingDonors.com, has already successfully paired several organ donors to recipients, which have resulted in seven successful surgeries in the past six months. The site lists nearly 2,000 potential donors offering a kidney or parts of a pancreas, liver, lung, bone marrow, or intestine. For a fee (waived if the patient cannot afford to pay), patients searching for these organs may post a solicitation as well. While praised by many patient advocates, the MatchingDonors.com program has also been severely criticized by those who believe it will subvert the UNOS system of organ allocation.
However, as the circle of acceptable living donors grows beyond family and friends, the medical community has had to confront the ethics of the situation. Both MatchingDonors.com and the medical community at large have decided that living donors should not receive financial remuneration for their organs, but policing this has proven to be difficult, if not impossible.
Contact: Leah Gourley
Harvard Medical School