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Living Donor Misinformation Living Donor Protections

Misinformation and Mixed Message from Someone Who Should Know Better

http://www.nephronline.com/features.asp?F_ID=479

At the above link, Dr. Cooper, a transplant surgeon in Maryland and the head of the OPTN Living Donor Committee, waxes poetic on why living donation rates have decreased over the past five years, citing barriers such as out-of-pocket expenses and insurance issues.

His first error, however resides in this statement:

no coverage exists beyond three to six months from donation even for conditions that may be related to the donation.

Wrong. 42 USC 1399 rr, aka the Social Security Act 1881, passed in 1972 gave living donors a Medicare benefit, to whit:

Any individual who donates a kidney for transplant surgery shall be entitled to benefits… Reimbursement for the reasonable expenses incurred by such an individual with respect to a kidney donation shall be made…for all reasonable preparatory, operation, and post-operation recovery expenses associated with such donation… Payments for post-operation recovery expenses shall be limited to the actual period of recovery.

However, in 1974, the director of the SSA insisted that transplant centers send all living donor-related bills to a recipient’s insurance (gotta keep those Medicare costs down). Since private insurance provides a much higher reimbursement than Medicare, transplant centers happily complied. Meanwhile, living donors are unaware of this benefit, and people like Dr. Cooper perpetuate the misnomer that it doesn’t exist, creating the very barriers he’s now protesting against.

Dr. Cooper then praises the National Kidney Foundation’s “end the wait!” initiative for addressing these problems, displaying its recommendations as examples:

– improve the outcomes of first transplants
– increase deceased donation
– make the donation system and processes more efficient and equitable, and increase living donation.

I’ve read and re-read these objectives multiple times and nowhere do I see anything that benefits living donors. Nothing about a living donor registry to FINALLY begin compiling comprehensive data on living donors to determine the true long-term effects; Nothing about improving Informed Consent; Nothing about mental health services; Nothing about aftercare. Dr. Cooper spends an entire essay trying to convince the reader that the safety and care of living donors are his first priority when his admiration of NKF’s goals reveals the wolf beneath the wool cloak, the man behind the curtain, and the true lizard countenance of the Visitors – like so many of his counterparts (including NKF), his primary concern is really about procuring more organs for would-be recipients, and coincidentally (or not) generating more revenue for his transplant center. This revelation is contradictory considering Dr. Cooper’s position with OPTN, and worse, disappointing to those of us trusted him to do the right thing.

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