Despite serious ethical concerns, the brave new world of Internet-based organ donor matching dawned in Denver last week.
A kidney transplant at Presbyterian/St. Luke's Medical Center was the first involving a match made on the Web site, MatchingDonors.com. The site does not attempt to prioritize cases based on patients' needs, location or length of time they have waited for an organ.
The planned surgery came after a doctor postponed the procedure over questions about the matching practice.
The idea behind MatchingDonors is that people who don't want to wait their turn on donor lists such as the United Network for Organ Sharing can list their need and see who turns up with a matching organ.
The organ recipient, Bob Hickey, 58, says he first learned about MatchingDonors in January. The Web site, based in Canton, Mass., charges varying fees-sometimes $290 per month-to post profiles of people looking for live organ donors.
Within three months of his posting, Hickey received 500 offers for donations, which he eventually whittled down to Rob Smitty of Chattanooga, Tenn., a 32-year-old part-time photographer and food distributor. The two had never met.
Hickey says his agreement with Smitty is legal. He is paying Smitty for his family's trip to Denver and lost wages. He estimated the total cost at $4,800 to $5,000.
Igal Kam, the surgeon set to perform the transplant, at first balked after learning where the kidney was coming from.
The hospital's clinical ethics committee met earlier in the week to evaluate Kam's concerns about the transplant, including whether either Hickey or Smitty stood to profit from the arrangement. The panel later advised the hospital to make a "compassionate exception," once both men had signed statements indicating that neither would benefit financially.
"Certainly, we know this was very difficult for Mr. Hickey and Mr. Smitty, and our first concern has always been for them," says Mimi Roberson, chief executive of Presbyterian/St. Luke's. "We're pleased we were able to resolve this quickly with a compassionate exception. But it's also important to note that organ donations continue to be the topic of a broader national debate and more answers are needed."
Roberson says the exception in this case was not to be construed as an endorsement by the hospital of MatchingDonors and said officials would give greater scrutiny to such arrangements in the future.
The United Network for Organ Sharing, which matches organ donations based on regional availability and patient need, has come out against the Web site, saying it takes advance of vulnerable transplant candidates and donors and subverts the equal allocation of organs.
Mark Yarborough, director of the Center for Bioethics and Humanities at the University of Colorado Health Sciences Center in Denver, says he's concerned about the Web site's fairness and potential lack of oversight by medical professionals. "This kind of system potentially may make the overriding criteria (to receive an organ) the ability to pay," he says.
Yarborough says the Web site also could lead to people picking the recipient of their organs. Society benefits when there are procedures to ensure that everyone gets a fair and ethical chance for a transplant, he says.
Neverland? Nope, see you in court
This isn't a fairy tale you would want to read to your child.
Walt Disney Co. faces the possibility of court action over alleged infringement of a British hospital's copyright of the Peter Pan tale. The company is already in court over a shareholder suit filed against a $200 million payout to former President Michael Ovitz.
London's Great Ormond Street Hospital is investigating whether Peter and the Starcatchers, what's been described as the "prequel" to the play Peter Pan, violates its copyright. The new story was penned by syndicated humor columnist Dave Barry and crime-novelist Ridley Pearson and published by a Disney subsidiary, Hyperion.
J.M. Barrie, creator of the boy who never grew up, gave the copyright to the children's hospital in 1929. The hospital disputes Disney's claim that the copyright expired in 1998 and says it was extended to 2023 through a U.S. law passed that year, the Copyright Extension Act.
Peter and the Starcatchers has been on the New York Times best-seller list for the past six weeks.
Despite the threat of the lawsuit, the hospital doesn't want to totally slight Disney.
"The matter is in the hands of the hospital's lawyers," the hospital said in a news release. "It is important to stress that the hospital has always worked well with Disney in the past and believe there must have been some misunderstanding, which we hope to be able to resolve quickly."
Obvious Conclusions Department
Once again, serious medical researchers have spent time finding out what everyone already knows, in this case that exposure to heavy traffic increases the likelihood of having a heart attack.
In the Oct. 21 edition of the New England Journal of Medicine, German researchers who studied data from a registry of myocardial infarction in southern Germany found that of 691 survivors who could report their actions, many had spent part of the hour before the onset of symptoms in cars, on public transportation or on motorcycles or bicycles.
Their conclusion? "Transient exposure to traffic may increase the risk of myocardial infarction in susceptible persons."
We can save on future research costs by adding that transient exposure to loud cell-phone users, political candidates, cable television pundits and Internet pop-up ads also increases risks, in persons susceptible and otherwise.