Surgery: Double Transplant

In a seventh-floor room in New York City’s Mount Sinai Hospital, a 49-year-old man with incurable brain disease lay in a coma one day last week. Alerted that death was hours away, a team of 16 doctors who had been standing by for 48 hours quickly readied two other patients for kidney transplants. First they removed the diseased kidneys of a 16-year-old Manhattan boy and kept him anesthetized on the operating table, the incision in his groin covered with a plastic drape. At the same time, they gave presurgery sedatives to a 48-year-old New Jersey housewife who had lost both kidneys to nephritis three months ago. At 5 a.m., the brain-disease victim died; surgeons quickly removed his kidneys, rushed one to each of the operating rooms. By 8 o’clock, they had implanted a new kidney in both waiting recipients.

There is nothing unusual about kidney transplants these days, although last week’s “doubleheader” operation was a kind of surgical economy seldom arranged. While doctors would prefer to use kidneys from close relatives to lessen the chances of natural rejection of foreign tissue, such donations cannot often be arranged. Those willing to donate organs are often not healthy or else are incompatible donors, and those able to donate are often not willing. The next best source is cadavers.

Trouble is, the kidneys of the dead are just about as hard to obtain as those of the living. Sustained by artificial-kidney machines, 50 to 100 victims of kidney disease are waiting in line for potential donors in New York City alone. Thousands more in other cities are biding their time for the same reason. Often the obstacle to donation is not the delicate task of asking the dying patient to donate his kidneys. In appealing for greater posthumous largesse, Mount Sinai’s Dr. Lewis Burrows also addressed families of the dying—because, under laws in many states, once a patient dies his organs become the property of his estate and can be removed only with family approval.