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Encore Presentation: Body Parts
Aired June 4, 2006 - 20:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
ANNOUNCER: CNN PRESENTS, winner of the International Documentary Association's distinguished award for best continuing series.
ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT (voice-over): Every week, more than 100 people dial waiting for an organ.
UNIDENTIFIED MALE: Kidneys here.
COHEN: Cadavers don't begin to meet the need. So doctors need people like this woman.
KATHLEEN SAMPSON, KIDNEY DONOR: It's a gift. And this is my gift that I'm giving to someone.
COHEN: So generous, she's giving an organ to a complete stranger.
UNIDENTIFIED MALE: They realize that hey, I've got two kidneys.
COHEN: But what about when something goes wrong for the donors?
UNIDENTIFIED FEMALE: I had no idea that Mike wasn't doing well until he started coughing up blood the Sunday afternoon, he died.
COHEN: Who's looking out for them?
UNIDENTIFIED MALE: I've seen anorexics with give organs, I've seen people who are clearly depressed give organs.
UNIDENTIFIED FEMALE: What I have found is that the transplant community is accountable to no one.
COHEN (on camera): You're about to learn about a growing problem -- more and more people are donating a kidney or a section of their liver to patients who would die without them. Most of the time, these stories have a happy ending.
But there's another side to the story you may not have heard before. I'm Elizabeth Cohen. CNN PRESENTS teamed up with "St. Louis Post-Dispatch" reporter Deborah Shelton who spent two years investigating organ donation. What we found is that too many donors end up feeling used and forgotten. Like a bag of spare parts.
UNIDENTIFIED MALE: Where we all take a moment to extend our hand towards our sister Kathleen.
COHEN (voice-over): In the depths of winter, a woman prays. In the midst of summer, her prayers are finally answered.
UNIDENTIFIED MALE: Lord, we ask you to be with her every day of her life but most especially this Tuesday.
COHEN: Tuesday is the day Kathleen Sampson (ph) has been praying for.
UNIDENTIFIED MALE: Amen.
UNIDENTIFIED FEMALE: Might feel a warm sensation going up your arm.
COHEN: After months of testing, she's giving her kidney to someone who would die without it, someone she's never met.
UNIDENTIFIED MALE: Great.
SAMPSON: Basically, here's my kidney, do with it, you know, whatever's best to give it to the best person and this is just something that I want to do, and I'm hoping that it will have great results.
COHEN: She's not alone. There are 78,000 living donors and nearly 400 of them are like Kathleen, giving to complete and total strangers.
DR. ROBERT MONTGOMERY, JOHNS HOPKINS: They realize that hey, I've got two kidneys, and really my body will function perfectly well with one kidney.
COHEN: Dr. Robert Montgomery will be performing her surgery at Johns Hopkins in Baltimore.
MONTGOMERY: It's a great privilege to meet someone like you.
COHEN: Oh, gosh. I feel privileged to be able to do this.
MONTGOMERY: You're a very special person.
COHEN: Kathleen's always been a generous person, working for the Red Cross.
UNIDENTIFIED FEMALE: Come on, Erica.
COHEN: Volunteering at the Special Olympics. But this, this is different. She's about to give up a kidney.
UNIDENTIFIED MALE: Take another deep breath in and hold it in, please.
COHEN: Why is she doing it?
SAMPSON: It's a gift. And this is my gift that I'm giving to someone is to give them a better shot at life. What I keep thinking of is what if there was a way that Connor could have been saved and no one stepped forward. You know what if.
COHEN: Kathleen's son Connor died several years ago when he was five.
Her family gathers every year on the anniversary. His death haunts her entire family. No one is more haunted than Kathleen. Connor was playing outside when she ran inside to make a bottle for his baby sister. Then she heard screaming. He had been hit by her neighbor's car.
SAMPSON: I said Connor, just tell me where it hurts, tell me where it hurts and he looked at me and he said everywhere. And then he went into shock or his eyes rolled back. And then they made me get out of the ambulance and that was the last time I saw him.
COHEN: Connor died at Johns Hopkins hospital. Kathleen is now here to give life where she lost it.
Thousands of people would love to get Kathleen's kidney. Some are so desperate, they beg on Web sites. This huge demand has some people worried. In the rush to help those who need organs, will doctors be too quick to take them from generous people like Kathleen?
Our investigation found that surgeons have approved donors who some believe were highly questionable, children as young as 10, drug addicts, even people who were mentally ill.
ART CAPLAN, PH.D, UNIVERSITY OF PENNSYLVANIA SCHOOL OF MEDICINE: I've seen anorexics give organs, people who are clear little depressed give organs, I've seen people come who have been accepted in programs who are morbidly obese. I've seen people come to programs who have had a long history of drug and alcohol abuse.
COHEN: Art Caplan is a bioethicist at the University of Pennsylvania and one of the leading authority on the ethics of organ donation.
UNIDENTIFIED MALE: That's the kidney right there.
COHEN: He and others say even though centers are supposed to screen donors for psychological problems, some centers do a poor job.
DR. BENEDICT COSIMI, AMERICAN SOCIETY OF TRANSPLANT SURGEONS: There are no written hard and fast rules as to how individuals should be worked up. And obviously, it varies from institution to institution.
COHEN: Dr. Benedict Cosimi is president of the American Society of Transplant Surgeons.
COSIMI: I don't think that there's a crisis out there that needs to be fixed by some new series of legislative events because abuse of individuals is going on rampantly.
COHEN: But should drug addicts and alcoholics really be allowed to give organs?
COSIMI: Why not? An individual may have what, by written guidelines is alcoholism but is a functional individual and can make a decision and wants to give an organ to a family member or a loved one. And I think they should be allowed to do that.
COHEN: While most donors make it through the surgery fine there are reports of some who have suffered regrets. Depression, even suicide.
UNIDENTIFIED FEMALE: Have you ever had surgery before?
COHEN: Kathleen had a psychological screening but there's something she didn't fully share with her doctors.
SAMPSON: We'll both just move out and go our separate ways.
COHEN: She and her husband are about to get a divorce.
UNIDENTIFIED FEMALE: Hi, baby.
CAPLAN: I'm nervous about anybody giving an organ eight time when they're in the middle of a separation or divorce.
UNIDENTIFIED FEMALE: Hi, baby. Oh.
CAPLAN: I'm about somebody doing it who's had a loss and is in the middle of grief.
UNIDENTIFIED FEMALE: Love you, baby.
COHEN: Kathleen's not worried, she believes her son Connor is protecting her from above. Have you talked to Connor about your kidney donation that's about to happen?
SAMPSON: He is like the director behind this whole thing.
They're talking about having the surgery on the 26th of July. And that would be the two-year anniversary of Connor's funeral. That is the day that he was buried. And if that's not him showing off, he's making it clear that he's involved in this, and he's working things out.
COHEN: As Kathleen prepares for her big day, she knows there are risks, risks she's willing to take. About 10 percent of live kidney donors suffer complications and up to 30 percent of liver donors. Some have even died. Now some are asking if the price for this act of altruism is too high.
UNIDENTIFIED FEMALE: My husband was just a receptacle with an organ in it and that's how he was treated.
COHEN: Vickie Hurwitz's (ph) husband Mike died three days after donating a section of his liver to his brother. She says that's because once the surgery was done, the doctors forgot all about Mike.
When CNN PRESENTS returns ...
UNIDENTIFIED FEMALE: The cadavers get better care than living donors. Some of them feel that way.
COHEN: What will happen to Kathleen when she donates her kidney, what will happen to her when she gives the gift of life?
COHEN: At 6:00 in the morning, Kathleen Sampson arrives at Johns Hopkins hospital. She's here to give her kidney away to someone she's never met.
UNIDENTIFIED FEMALE: I love you.
COHEN: She decided to do this nearly a year ago. And over time, her mother and aunt have come to terms with it. But still, this is a difficult morning.
UNIDENTIFIED FEMALE: I'm sorry.
COHEN: After all, Kathleen is a healthy person and there's no medical benefit for her. Kathleen leaves her family and prepares for the surgery. Her surgeon, Dr. Robert Montgomery, warns them it won't be easy.
MONTGOMERY: Tonight, she'll feel like she got hit by a bus.
UNIDENTIFIED FEMALE: Oh.
MONTGOMERY: The main risk is bleeding. OK? And when that happens it, happens about one or two times out of 100. So that's pretty unusual.
COHEN: About 10 percent suffer complications from this surgery. Three out of 10,000 donors will die. Kathleen isn't fearful of the risks and she signs the consent forms. While Dr. Montgomery gives her family one last reassurance.
MONTGOMERY: Your little girl, don't worry.
UNIDENTIFIED FEMALE: Thank you.
MONTGOMERY: Don't worry.
COHEN: With just 15 minutes to go before the operation, her family gathers in prayer.
UNIDENTIFIED MALE: Commit her into your care even now, Lord and we do that, father. We just pray that you'll watch over everything that's about to transpire and you'll be with the doctor, the surgeon, all the technicians. UNIDENTIFIED FEMALE: Love you.
COHEN: Kathleen gets one last kiss from her mother and she's on her way to the operating room.
UNIDENTIFIED FEMALE: Love you, Kat.
UNIDENTIFIED FEMALE: Love you.
COHEN: Here's what Kathleen doesn't know. After surgery, the man who receives her kidney will be watched and tracked by doctors for the rest of his life. No one from the transplant center will be watching Kathleen for the rest of her life. And that makes Donna Luebke very angry, she's a nurse and a kidney donor to her sister 11 years ago. She sits on the boards of the United Network for Organ Sharing the national organization that oversees transplantation. Luebke says she's horrified by the fact that no one systematically tracks organ donors long-term.
DONNA LUEBKE, UNITED NETWORK FOR ORGAN SHARING: I don't want to increase the number of living donors until we have safeguards in place. And there are no safeguards. There are no regulations. There is no oversight. There is no monitoring. And that really concerns me. We have to have proof that we're providing high quality care for them. And we have no proof.
CAPLAN: We really don't know how risky this is. What if we actually knew that people who tend to do this after five years, 10 percent of them say they're sorry they did it?
COHEN: But Dr. Cosimi says a number of centers have followed their living donors for up to 25 years.
COSIMI: Looking at not only their physical rehabilitation and possible complications but also their psychosocial, and very, very rarely does one find an individual that says I wouldn't do it again.
COHEN: But that is the way Jane Slat (ph) fees. She allowed one of her daughters to sacrifice for the other.
UNIDENTIFIED FEMALE: I'm broken. I feel that I have failed to protect my own girls.
COHEN: Stephanie Slat (ph) was a healthy college senior when her sister (ph) Sara's kidneys started to give out. Sara who's 24 was born with severe kidney and brain damage and had to go on dialysis and feed at some point to get a new kidney. Stephanie was the only family member who matched so she volunteered.
UNIDENTIFIED FEMALE: It was like kind of my sisterly duty, you know, I'm going to take care of my sister, if I can.
COHEN: Her mother tried to talk her out of it.
UNIDENTIFIED FEMALE: She tried to stop it. She said she wanted to but I got really mad at her. COHEN: Stephanie says doctors mentioned the risks but emphasized the positive.
UNIDENTIFIED FEMALE: I was led everything was going to be fine. It was going to work, I was going to be OK and be home.
COHEN: But it didn't turn out that way. Donating to her sister, an act of kindness became a nightmare. For months and months, Stephanie suffered the consequences. The first night home from surgery, she developed a fever and immediately caused her surgeon.
UNIDENTIFIED FEMALE: They told me just to take some Tylenol and just to go to sleep and maybe you know, it will go away.
COHEN: Then she felt a strange sensation near the wound where her kidney had been removed.
UNIDENTIFIED FEMALE: I just kind of felt it was like a tidal wave coming out of my stomach. I could feel it pouring out of my stomach and down my sides, warm, warm, warm fluid.
COHEN: Doctors at Geissinger Hospital (ph) where the surgery was done declined to go on camera, but issued a statement saying they treated Stephanie's infection appropriately. They told her to keep packing the wound with gauze to absorb the fluid. She did, but it didn't help. So Jane took Stephanie to another hospital where they performed emergency surgery.
UNIDENTIFIED FEMALE: They found a pocket, an abscess that was full of MRSA staph infection.
COHEN: MRSA is called the super bug. A bacteria so strong, it resists many antibiotics. Five months after her surgery, Stephanie had to spend two hours a day hooked up to this IV, receiving a special antibiotic called vancomycin through a line implanted it in her chest. She also wore a pump to vacuum away the excess fluid from her wound and had to wear it every day. Even at her graduation.
Because of her medical condition, Stephanie had to live at home where her mother continued to care for her.
UNIDENTIFIED FEMALE: OK, just hop up here.
COHEN: And when mom wasn't caring for Stephanie, she was caring for her other daughter, Sara. When Stephanie gave her kidney to Sara, it failed and her doctors say they have no idea why. Because of that, Sara is on dialysis 11 hours out of every 24.
UNIDENTIFIED FEMALE: This takes the place of her kidneys now.
COHEN: And that's the part that hurts Stephanie the most. She gave up her kidney so her sister could get off the machine.
UNIDENTIFIED FEMALE: I picked the date, I wanted it before Christmas.
COHEN: Why did you want it before Christmas?
UNIDENTIFIED FEMALE: Because I wanted her to be able to get up and see the Christmas tree.
COHEN: Stephanie had even picked out a Christmas present for her sister, a bath set, thinking she would be off dialysis.
UNIDENTIFIED FEMALE: They went and they bought it for her. Because they thought she would be able to take a bath.
COHEN: Now Sara waits for another kidney. And Jane Slat continues to think about her decision to let one daughter sacrifice for the other.
UNIDENTIFIED FEMALE: Stephanie's kidney is not functioning in Sara. Stephanie is minus a kidney for the rest of her life. I hope physically she'll come through this. Emotionally, I don't know if she'll ever overcome it. I don't know if I'll ever overcome it.
COHEN: When CNN PRESENTS returns, Kathleen's in surgery. What future awaits her?
COHEN: Kathleen Sampson is in the middle of surgery to remove her left kidney and give it to a complete stranger out of the goodness of her heart. Kathleen has never met this man.
But they have something in common, Barry Mendez is also doing something most of us would never dream of, giving a kidney to someone he doesn't know. But Barry's inspiration is different from Kathleen's.
UNIDENTIFIED MALE: It's a comment about Jesus. It's the Gospel of John in picture form.
COHEN: He's a member of a religious group where most of the members have given kidneys. His case and others like it raise a question. Is the need for organs so desperate that hospitals and doctors will take donors they shouldn't? Barry and his group, the Jesus Christians, travel the world in trailers preaching the Gospel.
UNIDENTIFIED MALE: We're just a bunch of Christians who just live together like the early Christians did.
COHEN: Out of the 28 Jesus Christians worldwide, 15 have given kidneys. In Australia where the group was founded, the government for the State of Victoria is so suspicious of the Jesus Christians, they're banned from donating to strangers. Many European countries also ban or make it very difficult for so-called Good Samaritan donors. So the Jesus Christians come to the U.S.
UNIDENTIFIED MALE: I beseech you therefore, brethren, by the mercies of God that you present your body as a living sacrifice.
COHEN: Barry says the decision to give his kidney away was his, that his fellow Jesus Christians had nothing to do with it.
UNIDENTIFIED MALE: I've done something to help someone and that is the message of love basically that what from my understanding what Jesus was trying to teach us.
UNIDENTIFIED FEMALE: Now to a bizarre cult targeting young Australians.
COHEN: The Australian press refers to the Jesus Christians as the kidney cult charging that the leader David McKay coerces members into donating like he did in 2003.
DAVID MCKAY, JESUS CHRISTIANS LEADER: I consider it a privilege. I've been struggling to get in there into the queue and get it over with, you know, so I can feel that satisfaction that if I died afterwards that at least somebody's going to live on with my kidney.
COHEN: McKay says the Jesus Christians are not a cult and he's never coerced any of them into donating a kidney.
MONTGOMERY: How are you doing?
UNIDENTIFIED MALE: Good.
COHEN: Dr. Robert Montgomery knows Barry is a member of the Jesus Christians. In fact, his hospital, Johns Hopkins has taken kidneys from members of this group before.
MONTGOMERY: We're going to divide the blood vessels right there. Any questions about anything?
COHEN: After hearing about the risks, Barry signs the consent forms.
UNIDENTIFIED MALE: I've read all the literature, went through the issues and I'm fully aware. Yeah, it's just a risk.
LUEBKE: I think it's highly coercive that these people are forced to donate.
COHEN: Donna Luebke is fighting for stricter rules for screening donors.
(on camera): You feel like there is coercion?
LUEBKE: Yeah. I think their leader is coercive of the followers. And is this their means to salvation by making a human sacrifice of themselves? And the transplant community is participating in that.
I think there needs to be an investigation into what centers are doing those surgeries and to really look at the coercive nature of that cult or that religion, whatever you want to call it. But it really concerns me that these surgeons know who they are and are still doing these surgeries.
COHEN (voice-over): This doesn't worry Hopkins or the Mayo Clinic or other hospitals that have taken kidneys from Jesus Christians. Surgeons like Dr. Montgomery don't believe they're coerced.
MONTGOMERY: Are the marines a cult? You know? Are they being coerced? To go over to Iraq?
As far as I know, what they've done is done good for other people. Just because a large number of people in a group have done a good thing doesn't mean that they're crazy. I mean just think of the cynicism in that, thinking that they're crazy, they're a cult, you know? I don't know what they really are, but I know that they've done a good thing.
COHEN: But some are concerned that transplant surgeons have a conflict of interest when it comes to watching out for donors.
CAPLAN: They're not thinking about the donors first and foremost. They're thinking about the recipients, they're think about what that means to save lives which it why they do this, what it means to keep them financially going which is done by transplanting people. You're out of business if you don't have the organs.
And that's the first and the second order of business. Kind of down at third or fourth, donor advocacy, donor protection.
COHEN: Dr. Benedict Cosimi, chief of transplantation at Harvard Medical School disagrees.
COSIMI: I think if anything, the living donor receives as much scrutiny and care and consideration as does the recipient and it's kind of irritating actually for someone to claim that transplant surgeons are such out there trying to do as many cases as possible and ignoring the needs and the care of these individuals.
MONTGOMERY: It went beautifully. Took a little time. He did very well.
COHEN: Immediately after surgery, Barry is joined by fellow Jesus Christians, some of them kidney donors themselves.
Which parts of the scripture inspired you to give away your kidney?
UNIDENTIFIED MALE: Well, there's one in Romans 12, it says basically, our bodies are living sacrifices. I'm sharing one of my kidney. I have two, he has none. Why not?
COHEN: Three days after surgery, Barry leaves Hopkins. At the hospital's expense, he'll move out of camper and spend 10 days in a hotel. Meanwhile, Scott Keller who received Barry's kidney is able to get off dialysis for the first time in 16 years.
UNIDENTIFIED MALE: Words will never be able to express the thanks that I have for him.
COHEN: Coming up, Kathleen comes out of surgery while her family waits anxiously.
COHEN (voice-over): After waiting anxiously for hours, Kathleen Sampson's family finally gets the news.
UNIDENTIFIED MALE: We're just closing up. It went very smoothly. No problems at all. Very little bleeding. But not all living donor surgeries end this way.
COHEN: Who was looking out for your husband?
RHONDA BOONE, WIDOW: Me. No one was looking out for my husband except for me.
COHEN (voice-over): Danny Boone was 41 when he gave a section of his liver to his brother, who would have died without it. A liver donation is far riskier than kidney donation. According to the federal government's Advisory Committee on Organ Transplantation, up to one-third of donors suffer complications. Immediately after the surgery, Rhonda Boone noticed something was very wrong.
BOONE: When I took one look at him, he didn't even look like a human being. He was swollen from his head to his toes. He was unrecognizable.
The first words I said to the nurse that was taking care of him, I said do all of the transplant patients look this way? She said I don't know. This is the first time I've ever taken care of one. I thought, oh, no. That's not a good sign. And let me tell you, it went from bad to worse right there.
COHEN: Danny was in liver failure. And ironically, he now needed a liver transplant. Over the course of three weeks, surgeons operated on him five more times.
BOONE: By the time they put him on the transplant list to receive the liver transplant himself, it was the day before he died. And it was only a token.
COHEN: Danny Boone died July 16, 1999. What his widow learned later made her furious.
BOONE: My husband's death was very preventable, very preventable. Post-op care was horrible. It was a nightmare. The list of complications Danny suffered are so numerous.
COHEN: An expert testified that based on medical records, too much of Danny's liver was removed. What's more, before the surgery, his doctors knew he had a condition called celiac stenosis, which restricts the blood flow to the liver. Rhonda says his doctors brushed it aside.
BOONE: Danny was told that would be no problem.
COHEN: Dr. Amadeo Marcos (ph) of the University of Pittsburgh has done more living donor liver surgeries than anyone in the country. He and many other liver surgeons wouldn't even consider taking a liver from somebody with Danny's condition.
UNIDENTIFIED MALE: To me that that is too much risk for the donor.
COHEN: Then Rhonda Boone learned even more. During the pre-op exam, medical records showed that Danny had indications of a fatty liver and enlarged spleen. But the surgery went ahead anyway.
BOONE: Danny had no idea what he was getting into.
COHEN: Dr. Marco says these conditions should have prompted the surgeons to do a liver biopsy before the surgery, routine for many surgeons. He gave a deposition on Rhonda's behalf.
COHEN (on camera) Do you think you have saved lives by doing biopsies?
UNIDENTIFIED MALE: Absolutely.
COHEN (voice-over): But Danny never had one.
(on camera): You must have felt so angry.
BOONE: I felt very angry when I found that out. Experts have told me any one of those three conditions would eliminate someone from being accepted as a donor.
COHEN: Why did they accept him.
BOONE: I felt like the surgeons were motivated by prestige and money.
COHEN (voice-over): The doctors from the hospital where Danny had his surgery declined to be interviewed for this story. They settled out of court with Rhonda. She and her son, Justin, now live on a farm in Boone, North Carolina.
BOONE: There's a lot of things that happened from the time you're 15 until you're 21 that you need your father for. And Justin didn't have that.
COHEN: How could this happen?
BOONE: What I have found is that the transplant community is accountable to no one.
COHEN: When CNN PRESENTS returns, who's responsible for making sure this doesn't happen again? What is the government's role? And will Kathleen meet the man who received her kidney.
SAMPSON: I'm hoping I get to meet the recipient.
COHEN: Three days after her surgery --
UNIDENTIFIED FEMALE: Thanks for donating.
COHEN: -- Kathleen Sampson has saved a life. It was a self-less act, but soon she'll be just another statistic. Johns Hopkins will see her here just one more time. She'll be back next week for a checkup with Dr. Montgomery and have lab work done six months later.
(on camera): Why not just give them a phone call every year and say, "how are you doing?"
MONTGOMERY: There's really no formal system of tracking donors.
COHEN (voice-over): So do they have long-term complications? Do they suffer having to live with just one kidney? Decades later, will they regret what they did?
The answer is no one really knows. One united network for organ sharing report found that 117 kidney donors ended up on a list looking for a kidney themselves years later.
UNIDENTIFIED FEMALE: I would not encourage people to be a living donor. We don't have enough data. We don't have enough information.
COHEN: Even Joyce Somsak (ph), from the division of the federal government that oversees transplantation, can't recommend living organ donation.
UNIDENTIFIED FEMALE: There aren't a lot of long-term studies of what the impact is.
MONTGOMERY: I walk the kidney out through that door.
COHEN: The federal law organ transplants doesn't address live donation. By and large, the government does very little to regulate it. One of the few things it now requires is short-term tracking for two years. But many hospitals don't do even that.
UNIDENTIFIED MALE: There it is. Could I have a light back here please.
COHEN (on camera): You want 100 percent follow-up. What percent do you have?
UNIDENTIFIED FEMALE: I don't know what that number is.
COHEN (voice-over): Our investigation found that hospitals lose track of one-third of their living donors over the course of a year according to the United Network for Organ Sharing. That's just not good enough for Rhonda Boone and Vickie Hurwitz (ph). Their husbands died because they donated organs.
Boone and Hurwitz have now become advocates for living donors. They get e-mails all the time from donors who have lost their health insurance and have nowhere to turn. These two widows simply want someone to keep track, to keep a long-term registry of how donors are doing.
(on camera): All the transplant surgeons we've talked to have said they want to see a registry and they've been saying that for years.
UNIDENTIFIED FEMALE: Why can't they get one?
COHEN: That's what I was going to ask you.
UNIDENTIFIED FEMALE: Ask them that.
MONTGOMERY: It's the right thing to do and what we should be doing as a transplant community.
COHEN (voice-over): But what they say and do are two very different things. Surgeons like Montgomery say they want a long-term registry but they also say it's too expensive and time consuming.
(on camera): Why not follow donors to see how they're doing, to see how they're living without a kidney 15 years later?
COSIMI: Because it costs money. It sounds simple enough. How hard can it be to follow 3,000 or 4,000 individuals a year that donate each year. But it requires a lot, and I don't know that we need to follow every donor for 25 years.
COHEN (voice-over): Vickie Hurwitz doesn't buy it. Her husband's surgery was in 2002. Initially, it seemed to go fine for Mike, but three days later --
UNIDENTIFIED FEMALE: Mike started coughing up blood at 1:00 on a Sunday afternoon. I notified the nurse right away. They never got a doctor in the room. Two hours later, he coughed up enough blood that he choked and died right in front of me.
COHEN: Looking back, she says there were signs something had gone immediately after he donated part of his liver but no one in the hospital noticed.
UNIDENTIFIED FEMALE: After Mike's death, the New York State Department of Health came into the hospital and did an investigation of his death, and the one of the findings was that he got woefully inadequate post op care. They noted there was one intern on the floor taking care of 30 patients.
COHEN: The New York Health Department issued 51 violations. The living liver donor program for adults at Mount Sinai Medical Center in Manhattan was closed down for two years after Mike Hurwitz's surgery. Since the program reopened, Mount Sinai says it has the most complete and thorough process to protect donor safety and that it's survival rates exceed national norms.
Hospital officials declined to be interviewed about the case because they said it happened years ago and most of the people involved have left. Vickie Hurwitz settled out of court with Mount Sinai. She was able to leave her job and buy a horse farm in North Carolina so she could live near Rhonda Boone and continue the fight for doctors and the government to take better care of people who give up organs.
UNIDENTIFIED FEMALE: It's an ethical thing to me, a principle, a moral thing. You don't ask people to do these surgeries and not take care of them. It's wrong.
COHEN: As she recovers from her surgery, Kathleen Sampson has little information about what the future holds. But she will get to meet the man who now has her kidney.
SAMPSON: Nice to meet you.
COHEN: And we'll find out what happened to Barry who also made such a huge sacrifice for a stranger.
SAMPSON: One, two three.
COHEN: Nearly one year ago Kathleen Sampson set out to help end another human being's suffering.
SAMPSON: Nice to meet you.
COHEN: And she did. Chuck Dohr (ph), a husband and father of two is off dialysis because of Kathleen's gift of her left kidney. Because of her generosity, he can get back to work and go on with his life.
SAMPSON: It's just beautiful. It's just a beautiful feeling. I feel fortunate enough to be a part of this because I was healthy enough to be able to share myself with someone else. It's just -- it's wonderful to see the results.
COHEN: Her donation is completed. But the controversy surrounding living donors will likely go on for a long time.
Taking a body part from one person and giving it to another has made people wring their hands from the first living kidney transplant in 1954 between twin brothers.
CAPLAN: People went morally bonkers. They thought this is really ethically questionable. Can you saw somebody's kidney out and give it to another person? Even if they consent, it violated the core principle of medical ethics, do no harm.
COHEN: Over time, it's become even more controversial. In 1954, no one could have anticipated the Internet. Here people offer up their kidneys and livers asking for nothing in return. (on camera): What's this one here, becoming a living donor mom of four toddlers.
(voice-over): These sites scare a lot of people. Especially Jane Slatt (ph) whose daughter Stephanie is still suffering after donating her kidney.
This online post is from a prospective donor, a mother of four who's thinking about donating her kidney to the husband of someone she met at church.
UNIDENTIFIED FEMALE: I have a five year old triplets and a four year old. My triplets all have special needs. But I am so longing to give the gift of life.
COHEN: Jane wrote back immediately.
UNIDENTIFIED FEMALE: I really feel under the circumstances, you being the mother of triplets with special needs, you have all you need to do right now. If you do decide to do it, that you must have back- up if it does go wrong. It can financially, emotionally devastate your life. It has mine.
COHEN (on camera): These are people who want to --
UNIDENTIFIED FEMALE: Good honest caring people.
COHEN (voice-over): The growing number of people who want to donate to strangers and the huge need for organs has forced some hospitals to make a controversial decision. The hospital at the University of Pennsylvania won't take these organs. In fact, it would have rejected Kathleen Sampson's kidney.
DR. ROBERT WEINRIEB, UNIVERSITY OF PENNSYLVANIA HOSPITAL: I think that most of us feel that the risks involved in being an organ donor are not insignificant. And if somebody has it in their mind that they want to give to the community in an altruistic fashion, I think most of us feel they can do that in other ways that are safer.
COHEN: Dr. Robert Weinrieb is a psychiatrist at the hospital of the University of Pennsylvania. People who want to donate to someone they don't know for nothing in return make him and the whole transplant team nervous.
WEINRIEB: What makes me uneasy is the possibility that these people are trying to fix something in themselves, that either they don't know is broken or that they do know is broken. And they may be very disappointed once they've done that and found that that thing they've tried to fix can't be fixed.
COHEN: Dr. Weinrieb is working on a study at the National Institutes of Health looking at liver donors and found something disturbing what happens after donation.
WEINRIEB: Something we're beginning to worry about is the longer term psychological effects. We are seeing depressions. There have been a few reported suicides.
COHEN: He says sometimes unexpected physical side effects of the surgery become emotionally devastating for the donor. Other donors become depressed because the recipient died. For others --
WEINRIEB: They are getting an awful lot of attention from their family members, from the transplant team, from the community at large before they donate. And once they've donated, people don't pay attention to them in the same manner because they get better and they leave for the most part. And I think that that for them is very hard
COHEN: None of this has been a problem for Kathleen. It's been more than a year since she first prayed to become an organ donor. That winter is over. Another has passed. Her gift, inspired by her son's death, took place five months ago. She's since left her husband and she her daughter Olivia have moved in with her brother.
SAMPSON: I feel good. And it's like a new beginning. And I just -- I feel really good about my life right now.
COHEN: Her scars are tiny.
SAMPSON: I have this one right here, I have one up here that is practically invisible.
COHEN: In retrospect, some things do strike her as a little odd about the transplant, like the fact that Hopkins only followed up with her twice after the surgery. That's routine if there are no complications.
(on camera): Who's taking care of you now?
COHEN (voice-over): And she says life after donation has taken some adjustment.
SAMPSON: First like everything revolved around the surgery and getting tested and now it's just over. I thought it was just a little bit strange that I didn't have like a follow-up with Hopkins or anything though I was just kind of like there you go, we have your kidney.
COHEN: As for the other people you've met, other lives affected by living donation, Barry Mendez is in good health for now. He's in Europe doing missionary work. Stephanie Slat is off her IV and her pump, but her health problems continue and she's begun to see a therapist for depression. Rhonda Boone and Vicki Hurwitz have turned the grief over losing husbands into action. Vickie attended a board meeting for the United Network for Organ Sharing where she spoke out against the latest regulations protecting living organ donors.
UNIDENTIFIED FEMALE: There is really nothing in them that would protect my husband from what happened to him or that would protect Danny Boone from what happened to him.
COHEN: Vickie and Rhonda succeeded in getting tougher rules in their home states of North Carolina and New York.
(on camera): Do you think there's something wrong when it takes two widows to shake up the transplant world?
BOONE: Definitely something wrong. Who is really in charge of living donation?
COHEN (voice-over): They want tougher more standardized rules about how donors are cared for during and after the surgery.
BOONE: Make the rules and see that they're followed.
COHEN: Dr. Cosimi actually looks forward to the day when surgeons won't need any human donors, when medical advances let doctors get organs from animals instead of putting human lives at risk.
COSIMI: This will be of historical interest only, and probably our students that we're teaching now will say gee, those guys were really dinosaurs to have used living donors when we have this beautiful source now.
COHEN (on camera): A scale of 1 to 10, how do doctors do.
CAPLAN: I'd say we're at a three. That is not acceptable for people doing some of the bravest most commendable things you can do in life.
COSIMI: I would give it an eight. I believe donors are very well protected.
COHEN: Still, Caplan and others worry without more rules, the care of donors will vary from center to center. And over time, there will be fewer Kathleens and Barries. Fewer people willing to risk their lives to give the gift of life.
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