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Board opposes solicitation for deceased organ donation

Published on: Friday, November 19, 2004

Reston, Va. -- The OPTN/UNOS Board of Directors, at its semi-annual meeting today, adopted a position statement opposing efforts to solicit deceased organ donors for transplant candidates where no personal bond exists between the patient and the donor or donor family.

"Organ donation is a gift, not a transaction," said OPTN/UNOS President Robert Metzger, M.D. "Most deceased organ donation takes place anonymously through the national organ distribution system. At times donors or donor families want to donate to a specific person they know, and we support that. But we strongly oppose public or private appeals that effectively put the needs of one candidate above all others and pose concerns of fairness. Transplant candidates rely on the public's trust in the fairness of the allocation system and support of that system through donation. Public appeals may jeopardize that trust."

A special OPTN/UNOS committee was formed to study donor solicitation in light of recent efforts to advertise for donors for specific transplant candidates, or to approach family members of people who have recently died and might be potential organ donors. The statement adopted by the Board applies only to deceased donation. The committee will continue to study solicitation for living donation.

The statement approved by the Board is as follows:

OPTN/UNOS Board of Directors Statement Regarding Solicitation of Deceased Donation

The overwhelming majority of deceased donor transplants occur anonymously and without specifying an intended recipient of the donated organ. The existence of a personal bond that would cause a donor or donor family to favor a named transplant candidate is rare. Attempts to develop such a personal bond through unsolicited contact with or public appeals to families of deceased donors are problematic.

The national system for allocating organs from deceased donors for transplantation is founded on the principles of equity and medical benefit. All involved in the OPTN/UNOS work diligently to increase organ donation in ways that contribute to fairness for all transplant candidates and uphold the national standards developed and approved after thorough review and consensus-building among all affected groups, including donor and patient representatives.

Recognizing that organ donation and transplantation are founded on altruism and equity, the OPTN/UNOS Board of Directors opposes any attempt by an individual transplant candidate (or his/her representatives) to solicit organ donation from a deceased donor ahead of other waiting candidates in a manner that subverts the established principles and objectives of equitable organ allocation. This is a particular concern when commercial space is utilized to solicit directed donation from a member of the public for a specific candidate. Such efforts may divert organs from patients with critical need to those who are less ill. In addition, such appeals, although well-intentioned, compromise the principle of fairness.

The Board encourages anyone considering a public appeal to promote the overall need for organ donation and not solicit an organ donation for an individual candidate.

If an OPTN member institution is involved in a situation concerning a public plea for donation of deceased donor organs to a specific individual, the Board recommends that the member reinforce to the candidate and/or donor family that the OPTN system is designed to allocate organs equitably according to the greatest need and/or benefit of all candidates. Should the candidate or donor family persist in their wishes, the member institution should act foremost to ensure equity within the transplant system, with additional consideration of relevant medical facts, ethical guidelines, and applicable laws and allocation policies.

The Organ Procurement and Transplantation Network (OPTN) is operated under contract with the U.S. Department of Health and Human Services, Health Resources and Services Administration, Division of Transplantation by the United Network for Organ Sharing (UNOS). The OPTN brings together medical professionals, transplant recipients and donor families to develop organ transplantation policy.