Will court ruling change conversation about paying for organs?

Taking payment for an organ or tissue donation is illegal under federal law.

In December, a U.S. Appeals Court carved out a narrow exception to that rule by allowing some stem cell donors to be paid.

The Flynn v. Holder decision allows payment for stem cells gathered by apheresis, a process that filters them out of the blood rather extracting them surgically through the bone marrow. It is safer and much less invasive than solid organ donation, but the decision to allow payment for the cells, which are used to treat cancer and other diseases, still has critics.

“From a transplant perspective, it’s rather idiotic,” said Dr. Nancy Bunin, head of blood and marrow transplant at the Children’s Hospital of Philadelphia.

She said aside from ethical considerations — such as whether donors would lie about their medical history for the money — there are practical reasons that paying for donation is a bad idea.

“Donor matching for blood or marrow transplant depends upon a very complicated system,” Bunin said. “So you can say, ‘Gee, I’d like to be a donor and get my $3,000,’ but the chances of you actually being selected for a patient who needs a transplant are extremely small.”

Those who argue for compensation say it could encourage donation and alleviate shortages, especially among minorities, for whom marrow matches are harder to find.

Attorney Jeff Rowes, with the nonprofit The Institute for Justice, successfully argued for compensation in the federal court case.

“What we want to do is run a simple pilot program that would offer strategic, non-cash incentives like a scholarship or a housing allowance, or we would make a charitable donation to the bone marrow donor’s favorite charity,” Rowes said. “We want to determine empirically if using strategic incentives works.”

Rowes is waiting to see if the decision withstands possible appeals before starting the pilot program.

More broadly, Flynn v. Holder also is serving as ammunition for those who support compensation for solid organs donors.

Jan Weinstock of the Gift of Life program, which coordinates organ donation in Eastern Pennsylvania, South Jersey and Delaware, staunchly opposes flat-out payment for organs. But she is glad the court decision is highlighting the need to encourage donation in ways that won’t corrupt the system.

“I do think it is worthwhile to discuss what types of incentives would be both ethical and… meaningful to allow everyone to move ahead and be an organ donor,” Weinstock said.

Eighteen people die each day waiting for an organ in what Weinstock calls a public health crisis.

Lawyers, doctors and other health professionals will examine the possible repercussions of the Flynn v. Holder ruling on solid organ transplants at a conference organized by Drexel University Friday.