Kidney donor
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Kidney donor

The need, the process, and legislation

There are 80,729 people in the United States on waiting lists for a kidney (2,723 in New Jersey). Although the number of living donors has increased in recent years, the rate of donation does not keep up with demand and many people die while waiting for a kidney. There are approximately 6,000 live kidney donations per year in the United States, representing about 45 percent of all kidneys donated (the rest are from deceased donors). In New Jersey, living donors have actually eclipsed deceased donors; in the last 10 years there were 1,472 living kidney donors, compared with 1,297 deceased donors.

The process of matching initially involves blood typing of the donor and recipient to determine if they are compatible. In addition, crossmatching and antibody screening tests are done to see if the potential recipient’s immune system will reject the donor organ. If the recipient has antibodies (proteins that bind foreign substances in the body and fight infections) that react to the donor organs, a new process called plasmaphoresis can sometimes be used to remove the harmful antibodies from the recipient’s blood. This can increase the chance for the kidney to be accepted.

Chaya Lipshutz, who arranged Rabbi Ephraim Simon’s donation, considers herself a kidney matchmaker. In 2005 she donated her own kidney to a stranger, and was inspired by that experience to start an organization to match other donors to people in need of a kidney. (Her brother later donated a kidney as well.) Lipshutz explained that she does not get paid for running this program. More details can be found at www.kidneymitzvah.com.

Neither do donors get paid; the 1984 National Organ Transplant Act, or NOTA, prohibits payment for organ donation, with the exception of medical costs, and costs of travel, housing, and lost wages related to the donation. NOTA also established the Organ Procurement and Transplantation Network, a national registry for organ matching, mechanisms for the oversight of organ procurement and transplantations, support of such organizations, and research related to transplantation.

There has been federal as well as state legislation to provide incentives for organ donation. Federal law provides federal government employees with up to 30 days paid medical leave for organ donation. New York state law also provides its employees with paid leave for time lost due to organ donation.

New York State has also passed legislation providing up to a $10,000 tax deduction on state taxes for travel, lodging, and lost wages related to organ donation. Similar bills have been proposed in New Jersey but have not yet passed the legislature. A federal bill is pending to provide up to a $5,000 tax deduction for unreimbursed expenses related to organ donation, including lost wages.

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