COMMENTS: Toddler Bait, Organ Switch

John McKenzie filed an interesting account of the proposal by Arthur Matas, a kidney transplant surgeon at the University of Minnesota, for ABC's A Closer Look. Because of the shortage of kidneys--17K donated each year for a waiting list of 74K--Matas suggests that a $60K pay-per-organ program would create a supply, with living donors undergoing a full physical and psychological evaluation and being offered free longterm healthcare. Matas argued that already human sperm, eggs and blood are legally for sale. Why not kidneys too? To which McKenzie pointed out that having one's kidney removed is "major surgery."

It is a routine convention of medical reporting to start with a human interest hook: personalize a problem by profiling a patient before proceeding to the broader abstract point of the story. So McKenzie accommodated by introducing us to kidney dialysis patient Dominik Lawson, who may have to wait five years for a donor "if he survives that long." But in truth McKenzie spoiled the story by using Lawson. Dominik turns out to be just 24 months old. Even if Matas' pay-per-kidney scheme goes into effect, it is unimaginable that participants would include children, those with a kidney small enough to save a toddler's life. So McKenzie showed us the sick child merely for emotional manipulation, with no journalistic justification.

UPDATE: Dominik Lawson's mother Kelly leaves a correction in Comments. She states that "the perfect kidney donor for Dominik is a healthy ADULT!!!"--in which case McKenzie's reporting turns out to be justified journalistically after all and my comments about "emotional manipulation" out of line. Researchers at Stanford University (see Comments) seem somewhat cautious that adult-to-toddler transplants are "perfect" but even with that caveat my "unimaginable" was plain misinformed. I retract that and apologize.


My dear Andrew--Where do I start or should I even waste my time trying to explain the transplant process to "people like YOU"! I am Dominik Lawson's mother, the person who takes him to dialysis 4 days a week, 5 hours each time. The women who watches her son's health deteriorate because he has a slim chance of finding a kidney donor match. Dominik was not "bait" in any way, shape, or form. The perfect kidney donor for Dominik is a healthy ADULT!!! They do not use living children as organ donors. So please before you say that my sick son was "used" for emotional manipulation check the facts reguarding living donors. It you would like to do something helpful, positive and informative write about how my son's life could be saved if their were more adult's who would consider being an organ donor. With much appreciation--Kelly Lawson, Dominik's mommy.
Kelly --

Thanks for the correction. My criticism of John McKenzie's journalism was not intended to imply that more adults should not consider being organ donors. Of course they should.

You correctly point out that I was not aware that the "perfect kidney donor" for your son is a "healthy ADULT!!!" I checked this out online. The Mayo Clinic explains what I did not understand: "Kidney transplantation involves surgically placing another person's kidney (the donor) into a child's lower abdomen, usually on the lower right side. The transplanted kidney is placed in the pelvic area, not where the original kidneys are…The child's own kidneys are usually not removed."

A caveat comes from the Lucile Packard Children's Hospital at Stanford University: "The leading difficulty with transplanting an adult-sized kidney into an infant or small child is supplying it with adequate blood flow. The child's smaller heart, blood volume and vessels are insufficient to satisfy the blood flow demand of an adult-sized kidney on their own. Blood pooling in the transplanted kidney clots, and the kidney stops functioning."

Good luck to you and your son.

Dear Andrew--Please know how much I appreciate your willingness to abjure your previous statement. My hope is that people will learn how the donor and transplant process work so they can make informed decisions. I think it is important that adults know that children are in dire need of being transplanted in order to "live" and that "they" may be their only hope. Thank you again---Kelly Lawson.
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