More on "Illegal" 5-Way Kidney Transplant

There is more information about the 5-way kidney transplant swap at Johns Hopkins. (Here's the original Washington Post article I reported on earlier today.)

An Illinois television station called the process "illegal."

Okay, sometimes issues are illegal but not immoral or unethical. Sometimes, good things are done for motives that are both ethical and slightly less than clear. At the same time. In the same person.

It seems that Dr. Montgomery, while doing a good thing in transplanting the kidneys, is using the "domino transplant" to make a point against the long-standing law that prohibits trading organs in exchange for any thing of value, including other organs for someone else.

From the Orlando Sentinel:

Some institutions feel multiple arrangements come uncomfortably close to quid pro quo, Montgomery said. He called for a clarification of the law.

The complicated swap worked this way:

Rothstein donated her kidney to Jantzi. Jantzi was incompatible with the kidney offered by her adoptive mother, Florence Jantzi, a Christian missionary who donated her kidney to George Brooks, 52, a mechanic who was not compatible with the kidney offered by his wife, Sharon Brooks.

Sharon Brooks, 55, a telephone company maintenance administrator, donated her kidney to Gary Persell, 61, a retired film distributor. His wife, Leslie, 61, a retired history teacher, gave her kidney to Gerald Loevner, 77, a real estate developer. Loevner's wife, Sandra, gave a kidney to Sheila Thornton, a retired elementary school teacher.

I'm afraid that the 10 hour, 12 surgeon, 11 anesthesiologists procedure followed by press conferences and petitions to Congress do not lessen the appearance of ensuring that everyone involved follows through with their part of the "bargain."

On the other hand, Sally Satel, M.D., has an article published at the American Enterprise Institute website that gives reassuring answers to some of my concerns about the safety of becoming a kidney donor:

Long-term risks are also low. Typical is a 1997 study from Norway that followed 1,332 kidney donors for an average of 32 years. It found no difference in mortality rates between people who give kidneys and the general population. A 25-year follow-up of seventy donors conducted by the Cleveland Clinic found that the renal function is "well preserved" and that the overall incidence of hypertension was comparable to that of non-donors. The truth is that a normal person can get along perfectly well with one kidney. The risk a donor runs is that his single functioning kidney will become diseased or injured, and he'll need a transplant himself--a highly unlikely event.

Dr. Satel is a recipient of a non-related donor's kidney, herself. She did know her donor before the transplant, however. Unfortunately, she is championing "Organs for Sale."

(Maybe I just don't like complicated questions, but it seems that the more I have to think about the ethics of a practice, the less I like to see it codified in law.)