An incredible gift from a Good Samaritan

I have just finished reading Catherine Carver’s book Immune. It is a plain English (and sometimes humorous) exposition of the micro-organisms that inhabit, and in many ways control our bodies. It is highly recommended reading for anyone interested in knowing more about what happens inside ourselves.

Today’s blog is taken from her fascinating chapter on organ transplants. It is an amazing story of how human generosity can go a looooong way to alleviating life threatening conditions.

There is a chronic shortage of organ donations in the world. There are many factors that contribute to this shortage.

The world has so many people and a growing number of them need new organs. The maths is mind-numbing. China used to have a steady supply of organs from prisoners on death row. Their organs were removed by state order. This practice continued until 2015, when China agreed to heed the protests of the human rights community. But before this macabre practice was discontinued, in 2011, one million people in China were in need of a kidney but only 5,253 received one. Similar statistics can be found in the UK,US, India, Pakistan and Australia.

Iran is the only country to legalise and regulate the sale of kidneys. Some people question the ethics of this market and no doubt there is abuse, particularly of those in the lower socio-economic communities. But Iran is the only country where there is no waiting list for kidneys.

We begin to appreciate the forces driving the black market in human organs.

Secondly, organs have a limited shelf life. Hearts and lungs last about four to six hours, livers a little longer at 12 hours. Kidneys are good for 36 hours.

Finally, finding the right match is important. Hearts and lungs have to be the right size as there is limited space in the chest cavity. The abdomen is more flexible.

Blood type is important as is tissue type. The available heart donors is limited because donors need to die in a specific way for the heart to be viable for transplant. Typically the donor needs to be brain dead with no trauma to the heart.

Now to the story of the Good Samaritan. This will blow you away.

Because matching is crucial, families are a good source of donations. But sometimes a loved one’s organs are not a match. This can result in beneficially mutual swaps.

For example, Betty needs a kidney and her brother Ben is prepared to donate his. But Ben’s kidney is not a match for Betty.

Across town, Paul needs a kidney and his mother Pam is prepared to donate hers but again it is not a match.

However, Pam’s kidney is a match for Betty and Ben’s is a match for Paul. So they organise a four party swap……not unlike the AFL draft.

Mutually beneficial donations can extend beyond 4 people if doctors need to search far and wide for a matching organ. Sometimes a mass swap may falter if the one matching organ cannot be found.

Let’s expand our field of vision. James is a Good Samaritan donor. He has a healthy kidney to donate but no particular person to receive it. Good Samaritan donations usually result in a mass swap of organs.

When a Good Samaritan organ becomes available the databases are scoured to kick-start a chain reaction of donations.

The longest chain of kidney transplants in the US (as of 2016) commenced by a Good Samaritan donation involved an amazing 34 kidneys being transplanted across 12 months and 9 states!

Such an incredible gift.