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June 10, 2004
UK To Throw Out Viable Transplant Organs?

With the First Mate receiving her new kidney this week, organ-transplantation stories catch my eye rather easily. Unfortunately, this disturbing story from today's London Telegraph clashes with the buoyant joy we've all felt from the FM's success:

Shortages of consultants are threatening a crisis in transplant surgery with the possibility of donated organs having to be discarded. Senior consultants met officials from the Department of Health and the NHS yesterday to call for changes to working conditions to encourage more young doctors to go into transplantation.

The problem is particularly acute in renal medicine, and there are fears that it is only a matter of time before viable donated kidneys have to be discarded because no-one can be found to perform an operation.

While to Americans the notion of throwing away life-saving organs seems utterly ludricrous, especially after years of public-service announcements supporting organ donation, the crisis in the UK is far too real. Doctors do not go into transplantation, which this article blames on the long hours required for specialists. After all, organs come available at all times of the day and night, and in order to get the best possible use of the transplant, surgeons should get the organ into the patient as soon as possible. However, especially for kidneys, it doesn't have to be immediate -- we were told that we needed to be available at all times to confirm our readiness to receive a kidney from the list once one matched, but that the surgery itself could be conducted within 24-36 hours after the kidney was harvested.

I suspect that the true reason that British doctors show so much reluctance to specializing in renal transplants, and transplants in general, is that the socialized health system doesn't incentivize them to do so. If doctors receive no better compensation for transplantation than normal surgery, especially elective surgeries, then why go through the extensive extra training required for it? Transplants require extra work in the operating room and a great deal of follow-up care on behalf of the physician. Other surgeries require much less training and follow-up care, and as the article states, more regular hours in most cases.

If the UK destroys perfectly viable kidneys due to a lack of resources, then the NHS should be ashamed of itself for allowing their medical care to deteriorate to such a state. Americans should consider this when debating the benefits of socialized or "single-payer" medical systems. Wage and price controls invariably reduce choice and opportunity on all sides of the market -- and health care is no different. Only deadlier.

Addendum: Just so you understand the issue from my perspective, in the US, there's an average five-year wait for a cadaver kidney from the list. If we hadn't had a friend volunteer to donate her kidney, the First Mate probably would not have survived to see her name come up on the list. To hear that the UK actually projects that life-saving organs will be tossed out like garbage simply because they don't have the capacity to do the surgeries outrages me, on behalf of all the people with kidney failure in the UK.

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Posted by Ed Morrissey at June 10, 2004 6:37 AM

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