The Good Samaritan as Organ Donor
In 1999, 2 cases of extreme generosity, stranger-to-stranger living donor organ transplantations, captured the imagination of the public on both sides of the Atlantic. In August, 47-year-old Ken Schuler donated a lobe of his liver to 39-year-old Deborah Parker in Richmond, Virginia. Schuler was motivated by a televised appeal for an organ donor by Ms. Parker's father. About 3 months later, Ron Johnson, a caretaker in Northamptonshire, England, read about a 10-year-old Israeli girl, Lisa Ostrovsky, who was very ill with cystic fibrosis. Mr. Johnson flew to the United States to donate a lobe of his lung. Her mother donated a lobe of her lung as well, but the child died on New Year's day.

Organ transplantation from living donors is not a new phenomenon. In December 1954, Joseph Murray transplanted a kidney from a monozygotic twin into his brother. Because transplant immunosuppression was in its infancy, the success of this operation depended upon a perfect tissue match. As immunosuppression regimens were perfected, however, cadaveric organ transplantation became the gold standard. Steady advances in technology have made transplantation more successful and the demand for solid organs has increased dramatically.

Among a number of strategies being used more and more to increase the human organ donor pool is living donation, not only for kidney transplantation, but also for liver, lung, pancreas, and intestinal transplantation. Living donors can be either genetically related or unrelated to the recipient. Unrelated donors may be emotionally related (ie, spouses, close friends), or they may even be complete strangers. Although the number of living-related donors far exceeds the number of living-unrelated donors, the rate of living-unrelated kidney donation increased by 46% annually in the United States between 1993 and 1996.