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    The Transplant List Grows Longer


    Is this an ethical problem? "I'm not for buying organs. I'm not for payment, but I am for handling reasonable costs and making it convenient when you have to do this," says Arthur Caplan, PhD, director of the Center for Bioethics at the University of Pennsylvania in Philadelphia. "I think everybody understands that there's no incentive to make your kidney available [just] because someone's going to give you a free ride to the hospital," Caplan tells WebMD.

    Various schemes have been proposed to increase organ supply, including covering funeral expenses for donors, or setting up an insurance fund for the family, or perhaps even some kind of a scholarship.

    "Everybody's tried in many ways to game the situation and come up with something that's palatable and ethical and legal, but thus far, it's always come back to the fact that buying and selling of organs is illegal," Edward Nelson, MD, a transplant surgeon at the University of Utah in Salt Lake City, tells WebMD.

    What about the possibility of getting a prisoner to donate an organ in return for an earlier parole?

    "The main reason that's a terrible idea ... is prisoners have the highest rates of infectious disease of anybody," Caplan says.

    There are new technologies to "grow" organs for transplant -- literally -- from the ground up by using primitive "stem cells" as building blocks. So-called "xenotransplants" would genetically modify organs from pigs and adapt them to humans.

    "These high-tech ... solutions to the organ shortage, I would love to see one make a significant impact, but I don't think it's practical for us to depend on that," says Nelson, who's also chairman of the UNOS ethics committee.

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