By the time a would-be recipient is listed for transplant (or told by their specialist they should start looking for a living donor because they’ll never obtain a deceased donor transplant – scare tactics 101), they’ve been dealing with their chronic illness long enough to have a legion of doctors, specialists and probably an affiliation with a transplant program already in place.
Because of this, and the fact that living donors are an accomodating, giving lot, the person who presents themselves as the prospective living donor will immediately decide to have their evaluation and surgery conducted at the same facility as the recipient, even if that means great inconvenience and traveling thousands of miles away from home.
I’m here to say this is a profoungly bad idea.
Most people, especially women, won’t see a hairstylist unless s/he comes with recommendations and most people won’t hire a contractor to tile their bathroom floor without researching them first. So why do living donors blindly choose a transplant center based on what’s good for the recipient* and then take whatever surgeon they’re handed?
I cannot stress this enough – THE TRANSPLANT INDUSTRY IS STRUCTURED TO CATER TO THE NEEDS OF THE RECIPIENT. THE LIVING DONOR IS A MEANS TO THE END GOAL OF GETTING THE RECIPIENT A TRANSPLANT.
Sounds harsh, doesn’t it? Maybe so, but it’s also the only philosophy that will fully protect the (propsective) living donor from the sometimes ignorant, sometimes misinformed, sometimes naive, sometimes profit-driven, sometimes arrogant, sometimes well-intended-but-misguided attitudes of everyone connected to a hospital’s transplant program. In other words, the only true and best advocate a prospective living donor can have is themselves**.
A prospective living donor has the right to choose their surgeon and surgical facility like any other patient, independent of the recipient.
Here are the practical reasons for a living donor to have their procedure close to their home:
1. This is a person’s life and health we’re talking about. A living donor is already undergoing a needless, major surgery with untold risks; having the best (most trustworthy, lowest mortality/morbidity rate, high level of expertise, etc) surgeon and facility only makes sense.
2. A living donor is often discharged after two days, but complications can and do arise. The transplant program who performed the surgery is legally and ethically responsible for treating and resolving any complications. That would be impossible if the living donor returned home, hundreds or thousands of miles away.
3. Continuity of care is important in any patient’s treatment. If a living donor does experience a complication and seeks treatment at a different facility, s/he will be under the care of different practitioners who may or may not have access to the treatment records at the other hospital.
4. The recipient’s insurance is responsible for any expenses related to the living donor evaluation or surgery. Any facility other than the transplant center where the surgery was performed won’t have the recipient’s insurance information. They will demand the living donor’s insurance information and most likely, the living donor will be billed for the treatment (and imagine if the living donor doesn’t have insurance). There have been media stories of such things; real occurrances are much higher.
“But, but, but,” I’ve heard folks argue, “such-n-such transplant program wouldn’t allow me to have my surgery at a different center [insert reason here].”
In short – fuck ’em. There is no reason why a living donor can’t be at a different center than the recipient. Donated organs are transported all the time, every day. All those swaps and chains that keep making the newspapers, compliments of the transplant center’s PR machines – those exist because we have the technology to take an organ from point A to B (they’re called cars, planes and traines), and keep an organ viable for many, many hours, sometimes days. Any statement to the contrary is simply hooey.
If a surgeon/program’s true priority is the care of the would-be recipient, they won’t let something like geography stand in the way of a transplant. To do otherwise is putting the center’s ego and profits first. And the last thing anyone should do is put their literal lives and well-being in the hands of an organization like that.
*Yes, I know; because that’s why people become living donors in the first place – to do what they think is best for the recipient.
**Or a real independent donor advocate, someone not affiliated with a transplant center in any way, but that will put your best interests first.