Kidney transplant turns doctor into activist

Financial incentives would help curb organ shortages, she says. Others fear backlash against altruistic donations.

By Kevin B. O'Reilly, AMNews staff. July 17, 2006.

In 2004, Sally Satel, MD, was diagnosed with end-stage renal disease. She has no siblings, and friends didn't pan out as potential kidney donors. Eager to avoid dialysis, the psychiatrist and conservative author turned to MatchingDonors.com. She even considered a black-market kidney before concluding it was too risky.

After a lead from the Web site fell through, an acquaintance -- Atlantic Monthly writer Virginia Postrel -- heard about the physician's predicament and agreed to donate a kidney.

The March 2006 transplant has so far been a success for recipient and donor, but Dr. Satel hasn't left the issue behind. Instead, she has agitated to improve U.S. organ donation rates.

Dr. Satel has criticized what she sees as an overly timid status quo unwilling to test alternatives such as presumed consent, mandated choice or financial incentives to increase donation rates. But bioethicists and most of the transplant community says such alternatives are unproven and could lead to a backlash that harms overall donation rates.

The reality is both sad and well known. There are more than 92,000 people on the United Network for Organ Sharing waiting list. The list is growing by 5% a year, and 17 of those waiting die every day.

As the organizer of a June conference titled "Buy or Die: Market Mechanisms to Reduce the National Organ Shortage," hosted by the American Enterprise Institute in Washington, D.C., Dr. Satel has used her transplant story and media savvy to bring greater attention to the organ shortage.