UNOS: Innovative Organ Exchanges Do Not Run Afoul of Law

An analysis provided by the general counsel of the United Network for Organ Sharing (UNOS) has concluded that it is legal to give priority to a person waiting for a kidney transplant whose relative or friend has donated a kidney for transplant to someone else.

UNOS, which operates the U.S. transplant network, requested the opinion to clarify whether arrangements known as Intended Recipient Exchanges and Paired Exchanges run afoul of Section 301 of the National Organ Transplant Act, which prohibits purchase and sale of organs.

Intended recipient exchanges occur in instances where a person in need of a kidney has a willing donor who is incompatible. In these cases, the donor gives the kidney anonymously for transplantation to another person on the waiting list, and the donor's intended recipient receives priority for a cadaver kidney.

Paired exchanges occur in cases where two persons in need of a kidney both have will donors that are incompatible, but where each donor is compatible with the other recipient.

A growing number of transplant centers have expressed interest in these kind of innovative exchanges. So-called "anonymous" donations of various kinds where the donor and recipient were complete strangers jumped to 55 last year compared to only six such donations three years earlier, according to UNOS.

So UNOS asked general counsel Malcolm Ritsch, Jr. to clarify the applicability of NOTA's one-sentence criminal provision outlawing the purchase and sale of organs to these types of emerging approaches to donation.

"Transplant professionals involved in these and other innovative living kidney donation arrangements have proceeded in the reasonable belief that these arrangements do not violate NOTA Section 301," Ritsch concluded. "NOTA Section 301 is legally and historically inapplicable to today's living donation arrangements."

Other Sources: UNOS