Drumming Up Donors   

Laurence Swasey, community education liason for the New York Regional Transplant Program, says he's always looking for ways to help reporters find a fresh angle on organ stories.

The tale of a family struggling to pay for a child's operation isn't always the big story it used to be, he says, because insurance companies, Medicare and Medicaid in many states are more likely now than in the past to cover transplant costs (typical heart transplant: $148,000). So it's a question of drumming up organ donors, who are perennially in short supply.

About 10,000 to 15,000 cadavers--each with up to eight harvestable organs--go to waste every year because they haven't been donated. Swasey's goal is to raise awareness and get people to sign their donor cards. Unfortunately, he says, "in general the media has gotten a bit bored... It's only 34,000 people [waiting for organs] nationally, and compared to other diseases it's not much."

One solution: Rather than have parents peddle stories about cute kids in need, have cute kids peddle stories about their needy parents. After one little girl called a New York television station to say her mother was waiting for an organ, a reporter followed up with a "waiting and hoping" story on how many adults, including this woman, die because there are never enough organs to go around.

"Sure we want to concentrate on children," Swasey says, referring to the media's traditional interest in photogenic subjects. But now "because transplant works, it's a tragedy to lose anyone."

Transplant professionals insist that coverage of individual cases doesn't influence how quickly a potential recipient will get an organ. Swasey disputes suggestions that Pennsylvania Gov. Robert Casey received favored treatment last year when he had a heart and liver transplant within 24 hours of announcing he needed one. Casey lucked out, Swasey says, because he was close to death, which gave him priority points; he needed two organs, which also gave him points; and donor organs with the right blood type, tissue type and size were available.

The point system is an outgrowth of the 1984 National Transplant Act, which was aimed at creating a centralized waiting list for organ recipients and introducing some fairness into a system that had been disjointed and arbitrary. The law prohibits the sale of organs and authorizes regional organ procurement agencies to help hospitals line up organ donations.

According to the new book "Defying the Gods," by Wall Street Journal reporter Scott McCartney, the 1984 law has been undermined by a quiet shift in policy at the United Network For Organ Sharing (UNOS), the nonprofit group under contract to the Department of Health and Human Services to maintain the computer list. According to McCartney, in 1991 UNOS--acting on the advice of transplant surgeons with a clear conflict of interest--decided to allow the nation's 275 organ transplant centers to start their own waiting lists. The centers get first crack at organs obtained by the nearest regional procurement agency.

This arrangement has led to a strange dilemma for patients, McCartney suggests. They can sign on at a popular organ transplant center like the one at the University of Pittsburgh, where success rates are high, and risk dying while slowly moving up a very long waiting list. Or they can opt for a lesser known center, where the surgeons may be less experienced--but the competition for organs much less keen.

Swasey says no matter where the procurement agencies are located, their PR people ought to be out glad-handing the press. Many are leery of the media, he says, and that's too bad, because the problem is no longer inadequate medical science but inadequate organ supply. "That's the message I want to get out," he says.