November 25, 2017 • 37 mins
In this week's SYSK Select episode, tune in as Josh and Chuck take a detailed look at organ donation -- from the earliest organ transplants to the organ black market.
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Episode Transcript
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Speaker 1 (00:00):
M Hey everybody, it's me Josh and for this week's
s Y s K Selects, I've chosen January two thousand
ten episode called How Organ Donation Works. We get into
the ins and outs of organ donation, that what you
can do and what you can't, and we also talk
about the black market for organs um, which is something
(00:22):
that's been in the news recently. There has been a
huge Reuters expose on the secondary organ donation market for
profit market, which is worth reading too, especially if this
episode floats your boat. So I hope you enjoy How
Organ Donation Works. Welcome to Stuff you Should Know from
(00:50):
House Stuff Works dot com. Hey, and welcome to the podcast.
I'm Josh Lark with me as always as Charles W.
Chuck Bryant, who I assume has two functional kidneys. I do,
but I would give one up for you, brother. Wow,
(01:12):
would you really? Maybe? I think I think that three
Chuck as a living donor maybe not? But if I died,
then sure you get thanks. Man. What about your liver,
because I'm pretty certain I'm gonna need somebody's livers. I
don't know that you would want mine either, to be honest.
Oh yeah, that'd be like getting Mickey Mantle's liver. I
need like a we need a virginal liver, don't. Yeah,
so I can just start over again, wash it in vodka.
(01:35):
So what are we talking about, Josh? We're talking about
organ donation, Chuck perfect, which I find absolutely fascinating. UM.
Back in nineteen fifty four, let me take you back
a little bit here, the first successful living human to
human organ donation took place. It was a kidney. Yeah,
(01:56):
it was a great story. Kidneys actually remained the most
commonly donated and UM received organs. But this was actually
a couple of twin brothers, one of whom was dying
of chronic nephritis. Yeah, Richard and Ronald Herrick. And Richard
(02:17):
was the one dying, and Ronald was in good shape, right,
and Ronald said, well, you know what, you're my twin brother,
and I don't really want you to die young, so
I'm going to give you one of my kidneys. And UM.
There have been uh some other transplants before that. They
didn't work out though, well some of them did, but
it wasn't live human to human UM like for example,
the first I think the first organ, the first donation
(02:41):
or transplant that ever took place was way back in
sixteen sixty where they fused part of a dog's skull
under human's head and that graft worked. H We have
taken testicles from monkeys and successfully in playing them into humans.
A pig kidney was successfully transplanted into a human vein transplants, uh,
(03:03):
And a lamb kidney was put into a recipient in
nineteen twenty three and that person lived for nine days.
But nineteen fifty four finds the first time a living
person donated an oregan to another living person, and it
was successful. And the reason why, they think was because
they're twins, there was a very low chance of rejection, right. Yeah.
(03:25):
And the story is great because Richard, you know that
the dying brother had a moment, a clear moment where
he literally, like the day before, said don't do this. Man,
get out of here right now. And the brother said, no,
I'm gonna give you my kidney like it or not, chump,
and he did. And it was a great story. Yeah,
And they actually both lived to ripe old ages reproduced,
so they fulfilled their destinies humans. And since then, Josh,
(03:48):
there have been more than a half a million of
these organ transplants performed. Right, We've gotten a lot better
at it. Um. As I was rambling off that list
of stuff that took place before nineteen fifty four, we
have and exponentially better. Uh. In two thousand three, we
successfully transplanted a tongue. Yeah, I saw that, which I
could use a tongue transplant. A slightly thinner tongue would
(04:09):
would do me a lot better. I think you had
a fat tongue. Yeah. And do you remember the um,
what do we do the face transplant? Huh um. That
woman actually remember she got her face from a suicide victim.
That was in two thousand five and in two thousand six,
so I know it's coming. A cadaver's penis was transplanted
(04:30):
onto a living humane and that man gave it back. Yes,
and I love The reason they gave was because of uh.
It caused psychological problems between the man and his wife,
which I can imagine. Let your imagination running with that one. Yeah, yeah,
that's just uh. I would say the same thing would
happen to my household. So thanks to m A better
(04:50):
understanding of how the human body works of blood type,
of the development of anti rejection drugs like Chuck said,
we've hit about half a million transplant surgery so far. Right,
So Chuck actually is hot and heavy, uh to to
give out a stat and this is a very special
stat because it's actually most likely going to change by
(05:12):
the end of the podcast. Yes, these are taking away.
These are current stats. If you go to the website
u n O s dot org, the United Network for
organ Sharing, they actually have up to the minute statistics
on who needs what and who's giving what and what
operations are being performed. And I didn't realize this, but
it's up to the minute because earlier in the day
(05:33):
I checked on kidneys and the number actually dropped by
three about an hour later on the waiting list, So
three people got kidneys in that like half hour span.
So I'm just gonna read a couple now and then
we'll check back in for fun in twenty minutes and
see if that's changed at all. Okay, I'm gonna write
this down to Chuck because we'll never remember it. This
is the first time we've ever used a laptop in
the studio and a pen usually just us in our mouths. Uh. Total, Josh,
(05:59):
we got one five hundred and five thousand, two people
are waiting for organs, and we'll do kidney because that's
the most popular. Eight three thousand and twelve people are
waiting for a kidney as of two oh three pm.
All right, and we'll check that in twenty minutes and
hopefully those numbers have gone down. Yeah, because that will
(06:20):
mean that either the people on the waiting list have
died or they received a transplant. I guess we could
put those two, we could compare against one another, and
maker we could surmise for So, Chuck, what are organs? Yeah?
I had a feeling you're going to ask me that, Josh,
go ahead, No, okay. Organs are systems of cells, Josh
(06:42):
and tissues, and they all are in our body for
a very specific reason, each one. And what I like
about the organs is that they are all over equipped,
which is what you're looking for in an organ. You
don't want like the heart to be like boy, if
it beats one beat less, you're really screwed. So um
our art. Actually, a twenty year old's heart beats pumps
(07:03):
about ten times more than the amount of blood we need.
And uh, we we have this reserve capacity in all
of our organs. As young lads and lasses. Right. But
as Tom Chief, who you know as my bff who
wrote this article, he points out that the corneas, when
you talk about eye transplants, they're talking about corneal transplants. Um,
(07:25):
they actually don't necessarily deteriorate like all the other organs. Yeah,
that's pretty cool. Um, So the corneas of seventy five
year old donor are just as good, considering you know,
there's not more wear and tear than say a twenty
year old. Yeah, you could put a seventy year old
person's cornea inside of a young person and there would
be no difference. Right. But for organs, they deteriorate with age.
(07:48):
Well that's the bad news, right, Um, so eventually you
may need one, right, Well, yeah, because what happens is,
let's say one organ can deteriorate while the rest of
your body remains pretty healthy. That's actually best case scenario,
as weird as that sounds, because that means you can
just swap that sucker out and you'll be fine again. Right. Well,
that that's in a very ideal utopian world. That's exactly
(08:11):
what happens. The problem is, there is a lot more
people in need of organs than there are organs available
right right, there's um a waiting list. Some aren't so bad.
I think kidneys go pretty quick, as you're you're talking
about earlier. The longest wait I found, um was the
old heart lung combo. That median wait time was six
point seven years. It's a long time to wait for
(08:32):
a heart and a long if you need it. Yeah,
a long time because nobody goes I'm probably gonna need
a heart and a long combo. Eventually, I'll just put
myself on the waiting list. Now you need it, like
the moment you go onto that waiting list and you
have to wait six point seven years until you get it, right, Yeah,
and that's why. Um, the mortality rate while waiting for
a heart, which is that's not as bad as I
(08:54):
would I would be, like the lungs are, and um,
the ever actually is the worst good Yeah, sorry, um.
There's two ways you can get organs from a live
person or a dead person. Yes, Traditionally we don't take
organs like the heart from a live donor because they
(09:15):
would be a dead donor. After that, you can take
things like uh, the liver pancreas uncommonly, but it can
be done a portion of the intestine, um, blood, blood,
stem cells, bone, marrow, bones, all and bones. Yeah, which
giving up a bone that's really something like, I mean
(09:37):
after that, you just kind of have this floppy arm,
but somebody else has a bone, you know, I mean,
that's pretty nice. You Know. What I thought was interesting
about the kidney deal, like why you can give up
one kidney and still be okay, is that most of
the times when your kidneys are affected, they are both
affected at the same time, so it's one's never gonna
go down and you'd be like, oh, I wish I
(09:58):
still have my healthy kidney because they both would have
been unhealthy. And uh, all right, I think we've arrived
at the liver Chuck. This is fascinating to me. It
is where where should we start? Well, let's just start
by saying that the liver can grow. It's like the
starfish of oregans. Yeah, it can regenerate itself, which is
just freaking amazing. Sure. Um, So, for instance, let's say
(10:23):
you wanted to split your liver in half and transplant
that into two different people. You could do that. You
could and actually, if you're an adult donor, they can
cut off a portion, a child sized portion, UH, which
is I think the same as like a child sized
meal where you get like three chicken nuggets from UH
and give it to a kid and chuck, this is
(10:46):
so great. It grows along with the kid right to
a full size liver once again, but in step with
the kid's maturation. Right, that's just mind boggling. Let's say
you needed a piece of your liver. Let's say you
needed liver replace and I cut half of my liver
off and gave it to you. My liver would eventually
grow to full size once again. Yeah, if I live
(11:07):
that long, so mine would grow and yours would grow.
And the cool thing is with the liver, you don't
even have to take out the old liver. You can
just put in the new one. It's like the best
organ on the planet. It really is, and our favorite
organ because of the function that it serves. So Chuck,
Like I said, you can neither be a dead donor
or a living donor. A dead donor can donate anything, right,
(11:27):
including your yeah, and your eyes, um, heart, lung, all
that stuff that you can't really take from a living donor. Um.
But there are some exceptions. If you have HIV or
disease causing bacteria in your blood stream or tissue. They're
not going to be taking your organs. Um, And if
(11:49):
you are a practitioner of the Shinto religion, there's not
gonna be a lot of organ donation going on there either, right. Yeah,
not only that, but if you are Amish, they might
support your donation if there is a certainty relative certainty
of success, but they're more reluctant if it's uh less
probable of success. Right. And Tom actually mentioned why the
(12:10):
Gypsies don't agree with the organ donation. They believe that, um,
you need your body for the first year to get
around the afterlife. Apparently after that you got it down
pat and you don't really need it any longer. Um.
But he didn't mention Shinto, but I looked it up. Uh.
They believe that the corps is impure. The body becomes
impure after death. So would be like, here, take this
(12:31):
rotting piece of flesh that will save your life, but
you're going to be impure while you live. Interesting, So,
as a result in Japan, uh doing donation rates are
like really really low like the USA. Yeah, and Jehovah's
witnessed we should cover them because we're we always like
to talk about them. Uh, they're not opposed to it,
but they have one rule which I thought was interesting.
(12:52):
You can donate your organ as long as they drain
all of the blood out of the organ first before
giving to someone else. So I guess we're not big
on translusions. I don't think so, that'd be my guess. Yeah, okay, Um,
(13:24):
how do you register Chuck? Well, it's pretty easy. Actually
in most states, you can do it at the d
m V, which I always found interesting. Yeah, you can
do it right with there when you're getting your new
driver's license. And uh here in Georgia, actually we used
to have the one of the highest donor rates, or
I should say one of the most expansive donor registries
in the country. And the reason was when you went
(13:46):
to go get your driver's licenses. I'm sure you remember, Um,
they'd knock seven bucks off of your driver's license. I
love that. So you were an idiot if you didn't
sign up. The problem is that there's not supposed to
be any kind of compensation whatsoever for being even though
this was legal under state law. Um. The Georgia Organ
(14:08):
Procurement organization, which we'll talk about a minute. Um, they
were very hesitant to draw from the Georgia donor list
because they weren't sure if the person was just looking
for the seven bucks off or else if they really
wanted to be an organ donor. So actually, the contribution
rates were very low in comparison of the size of
(14:29):
the registry in Georgia until two thousand five when they stopped.
They stopped it, I think to actually give you a
T shirt too that says I sold my lungs for
seven dollars. That's illegal, and all I got was this
lousy T shirt. Yeah. No, under UM law, you can't
have any valuable compensation for organ procurement, right what we'll
get to that too, the whole black market deal. Okay,
(14:50):
So Chuck, if you're a dead donor, how do you donate?
There's two ways, right? Uh? Two ways, sure, two ways
of death. Brain death and cardiac death. Is that what
you mean? Obviously? Cardiac death is um a little trickier
because you only have a certain amount of time to
get the organs from the body. Brain deaths a lot
(15:11):
easier in one sense, because um, there could be is
you know, weeks to find a match and to prepare
the organ for donation and get it carried out. But
there's a wrinkle there. So there's a lot of wrinkles there.
Let me let me say something about cardiac death first, right,
Um this there are there are no laws really governing
(15:33):
organ procurement. It's not a case by case basis, And
basically everybody involved in the organ procurement process does their
best to walk a very cautious line while harvesting organs
to try to save other lives, right, yeah, because there's
families involved grieving obviously. Um. With cardiac death, there was
(15:54):
a board I think out of Harvard in the late
nineties that established a five minute wait time from the
cessation of a heartbeat. Right, so, you you take somebody
off a life support, wait for the heart to stop beating.
Five minutes after and while this this the heart's winding down,
you're prepping the patient for surgery. Five minutes after, Uh,
(16:14):
somebody pronounces the person dead and they cut them open
and take the organs. But in five minutes the heart
is useless pretty much at that point. Some of the
other organs, like the liver, the kidneys, maybe the lungs
can survive that five minutes, but the heart's gone. So
if you have a cardiac death, you have a useless heart,
even though the heart might have been perfectly healthy. Five
(16:34):
minutes again right, So there was this doctor in Colorado
that said, you know what, there's no law whatsoever that
says I have to wait five minutes. This guy did
a lot of research and found in the medical literature
the longest duration between the cessation of a heartbeat and
the spontaneous regeneration of a heartbeat ever recorded was sixty
(16:54):
five seconds. So he started a sixty five second rule,
got the pants suit off of them. It was an
unsuccessful lawsuit, and now all of a sudden, the president
has been set and now there's a sixty second rule
out there that some people adhere to. That is how
organ procurement has been established in the US. Somebody pushes
the envelope, they get sued. They if the cases uh
(17:17):
isn't one by the by the plaintiff, then you have
a new rule. Isn't that weird? There's like zero guidance
for organ procurement except that the person has to be dead.
We don't have any real definition for death. Well, that's
where brain death gets really really true. Exactly. Take it, Chuck, Well,
I don't. I mean, you're the you're the expert here.
(17:38):
I don't. I can't weigh in morally because I don't
know what I think. Really Nah. I mean, I know
what I might believe for myself, but I don't know
about establishing guidelines for others. But we need them, though,
don't we? Yeah? But I don't want to make up
those rules, do you know? And apparently the federal government
doesn't either. Um. Every once in a while, I think
Carter assigned a panel to create a white paper on this,
(18:01):
and I guess George Bush did right before he left office,
because there was one that came out in two thousand
and eight. Either Bush did right before he left office
or it was like the first thing Obama did when
he came into office. But there was a very recent
white paper that came out that said, Okay, here's how
we feel about brain death. Right, here's the problem. Back
in the fifties, I think we came up with this
(18:23):
thing called the ventilator. And with the ventilator, you can
keep somebody who for all intents and purposes dead, you
can keep their organs functioning. So you're masking death. We
have no idea what would happen if that ventilator wasn't there,
would the person die? And if the person does die,
how long do we have to wait until we say
that that person is dead? Right? So the the ventilator
(18:46):
made it so we could procure organs more easily in
brain death because we can keep them alive. At the
same time, it blurred the line between life and death. Well,
now they came out with this recommendation that said brain
death is disengagement of no the um end of meaningful
engagement with the rest of the world, which really widened
(19:06):
the scope of who exactly is dead. And so when
you have a brain dead patient and you procure their organs,
what what you actually do is you have to run
them through this battery of tests where you are um
shining lights in their pupils. Uh, there's an ice water
injection into the ear canal to see if you move
toward or away from the stimulus um And there's this
(19:28):
battery of tests to establish brain death. And then here's
the clincher. They do an apneus test where they take
you off the ventilator for two minutes and see what happens,
and see what happens. Inevitably, the um, the heartbeat is
going to slow down. And then after two minutes they
put the ventilator back on. But that two minutes where
(19:49):
your brain was starved of oxygen was enough to to
create real brain death if you weren't before. Wow, think
about that. This is why they call you supplementary research man. Right,
that's why that's your superhero. Can you hear like people
fast forwarding through to get through this, partners, It's like Josh, Josh, Josh, Josh. Okay,
(20:09):
So we have this, we have this new definition of
brain death. And when the second apnea test happens and
you're declared brain dead, what they anesthetize you, they inject
you with anti paralytics. Will you into that hospital room
and they harvest your organs, so you actually die from
a lack of organs present in your body. So that's
(20:34):
that it's a ghoulish matter. And this these people who
are in charge of making sure that people donate and
keeping the image of organ donation is a gift of
life alive, have to battle with this, the fact that
it's a very ghoulish process. So who's who's in charge
of this stuff, by the way, for what for that
(20:56):
whole soap op spiel anytime, buddy, Yes, Josh. That would
be called an O p O, which is an organ
procurement organization and they are federally designated nonprofits and they
are local all over the country. There's usually UM one
in the central location of a state and then different
satellite office is obviously because you need to be close by.
(21:19):
You know, you can't be hopping all over the country
to get these organs, although that happens as well. And
they basically responsible for awareness, recruitment, evaluation, UM organ removal,
and transportation. So they're the people that's standing there with
a cooler waiting to drop your organ in there and
rush it to the recipient. They're also the people that
talk to the family generally. Well. Sure, so anytime somebody dies,
(21:42):
you the hospital is legally obligated to notify the organ
procurement organization, right and you know this this is a
good point to bring this up. If you want to
be an organ downer or if you are, you really
need to tell your family the stuff, and you should
have it all in your living will because things can
get a little ugly. UM for instance, let's say you
are from a very strict religious background. Maybe your family
(22:07):
doesn't want you cut up. They think that would be
a bad thing, but you want it. You gotta have that,
you know, in paper on paper, in writing, right, you
need and if you have a documented um in a
lot of cases, even if you if your family is like, no,
we don't want to donate the organs, the organ per
human organization will say, you know what, ts sorry, he
want he or she wanted to be an organ owner.
(22:28):
And the last thing you want after you die is
for your spouse, let's say, to have to mountain this
campaign against your family like a tug of war like that.
You gotta have it all spelled out nice. Um. So
where are we? The United Network of organ Sharing that's
another group. This is where that's where you got the
kidney statistics. We're gonna go back on and look at right. Yeah,
they're in Richmond, Virginia, and they are responsible for placing
(22:50):
donated organs um and maintaining the waiting list like you
just said. And they never close No. Seven three sixty five,
which is how it should be. Obviously, we should calling
them right now to see if they're open now. Let's
not do that. I'm sure they're open. And then Chuck,
there's the Scientific Registry of Transplant Recipients, right, Yes, the
s R t R. And they basically maintain like every
(23:12):
amount of data you could possibly want on transplants, right
for like policy makers and doctors and drug makers and
that kind of stuff. Yes, And there was one more
called the ORGANS sorry, the Organ Procurement and Transplantation Network,
and they're they're just another network that matches people with
recipients and has waiting list that kind of thing, right,
(23:33):
So this is actually a pretty um lean, mean streamlined machine. Yeah,
the Procurement and Donation Network. It has to be right, So, Chuck,
you were saying like they can't be hopping all over
the country, but they have to sometimes. So what happens
with like, let's say somebody dies in Sacramento and they
have the perfect heart that somebody in Tampa needs. What
(23:56):
happens while they will put it into a cooler and
fly to uh what was the destination? Tampa? Tampa? They
fly to Tampa. Apparently like the hospital in Tampa. Those
people will go fly to Sacramento, take possession of it,
and then fly it back unless there's somebody in the like, like,
let's say somebody in Sacramento needed it and somebody at
(24:17):
the Sacramento General Hospital died. That's when that cooler comes in.
Which have you seen the one that's at the office.
We have an organ transplant cooler. Yeah, it's pretty cool,
roxane keeper tab in its. Uh. You know what I
thought was really cool is if you were on the
organ donation list as a living donor, you are actually
(24:39):
given consideration if you need an organ transplant yourself. And
they said that they won't like bump you to the
top of the list, but they will give that a
little bit of extra weight, which I think is that's
only right. Did you also see that? Um, if you
are a living donor and you usually your insurance company
won't raise your rates after that, but move to another
(25:01):
insurer change like plans, they'll hit you with a pre
existing condition. That's how evil. Seriously you sign up for listening,
I will give someone my kidney as a living human
and the insurance companies are like, oh, well, you might
have to charge a little extra for that. Don't you
think we should start publicly executing CEOs of insurance companies?
It should be part of the healthcare reform package. Right,
(25:23):
of course we don't mean that, right, Thanks for the
Ceoh so chuck. When when you're talking about people running
around with coolers and all that, it kind of creates
this harried pace right in your mind. Um, and that's
very much true. You have a very short amount of
time for an organ to survive. Remember I said, like
even five minutes can kill a heart once it's deprived
(25:44):
of oxygen, which it stops beating, right. Um. What happens
when you die too, The body undergoes all these huge changes. Um.
That happened almost immediately, Like, um, there's this uh, parasympathetic
flow of chemicals right um, which is like kind of
fight or flight on steroids. So I guess it's a
(26:07):
sympathetic flood. Like dopamine levels increase eight hundred percent, epinephrin
levels increase, nor EEF levels increase. So all these chemicals
that are meant to like either speed you up or
slow you down or just flooding fro the body. That's
why you have to take the drugs right most times, Well, no,
this is when you die. So when they're trying to
(26:29):
harvest these organs, they're like trying to get them out
of the body before this flood just damages these things
I thought you meant as a recipient that would happen. No,
that'd be pretty awesome though, to have your dopamine levels
raised eight percent, right, But it's not as easy as
just throwing the new heart in there either and sewing
you up and say good luck with your life. No, no,
it's not you. And uh, there's also some expectation that
(26:52):
you lead a very healthy life after that. You're not
supposed to be drinking or smoking or swearing, and um,
you have to stay away from call girls and things
like that. Yeah, you shouldn't get a new liver and
then like dive into the vodka bottle. You're you're pretty
much signing a contract to become ned Flanders after you
get your organ donation. Yeah. Actually, just over Christmas heard
(27:13):
of a friend of a friend of a family member
that was a candidate for I think a liver transplant
and they would not do it because he wouldn't enter
um rehab. Really yeah, wow, so that's hardcore. Yeah, that
guy's dedicated to the booze, isn't it. Yeah, pretty much. Um,
(27:35):
And also you're if you are a recipient, there's some
expectation that you pay, like for the lodging and travel
expenses of the person who donated. Yeah, it's kind of
an unwritten rule from what I understand well and have
to be real, you know, it's kind of against the
law really well, but it makes sense though, because if
you're let's say, you want to donate a kidney to
someone that lives across the country and you're spending money
(27:57):
off from work and flying out there and putting yourself
all right, it's gonna cost you some dough and a kidney. Yes,
you'd have to be a really nice person to be
an an anonymous Yeah, that'd be cool. All right. So, Chuck,
(28:35):
you want to talk about the black market? Yes, the
black market does exist. Isn't that crazy? Um? Yeah, but
not surprising. No, but it's pretty interesting. Um. It obviously exists, Um,
typically outside of the United States, although there have been
some cases inside the United States. Usually it's like, and
(28:56):
this is what's so said. Usually it's impoverished nations, And
what happened is that will be a couple of countries involved.
You'll take someone out of a really poor country offered
them like five thousand dollars for their kidney, and then
the middleman will get, you know, a hundred thousand dollars
for that kidney. And you know, it's not like these
are done in professional surgical rooms. It's a lot of time.
(29:16):
It's it's the back room, if you know what I mean.
And that's actually exactly what happened in two thousand three
in South Africa. Yeah, they were importing people from uh I,
guess the City of God in Brazil. Yeah, slums of Brazil. Yeah,
and um giving them five grand for their kidney and
then turn around selling it for a hundred k yep.
(29:37):
That's nuts, yep. And uh where else did it happen?
Villagers in India so that they were getting they weren't
getting nearly. They were getting about eight hundred dollars for
their organs, which is just unbelievable. And at one time
the Israeli organ brokers were obtaining these from Soviet Bloc
nations and doing the operations in Turkey. And this one
(30:00):
guy made a middleman, made about four million dollars before
he was caught, which is not bad harvesting organs, although
I imagine being an illegal organ broker is a fairly
stressful job. Yeah, and it happens in the US too,
although customarily it's um an organ broker and a nefarious
funeral director who harvest organs before cremation. Did you know
(30:22):
this happened? No? I didn't either, and I saw all
the six ft under of course you did. Uh. Did
you see the movie Thererista's No, that wasn't very good.
That was the the deal there though kids are like
captured in the jungle. No, but it was like an
Eli Roth movie. It was like hostile, except they were
(30:43):
harvesting organs basically instead of just blind torture. Uh. And
speaking of that Thereristas. That actually does happen in the world.
It's not just old wives tales. Poor Mohammed legend kidney
theft does happened. It really does, Mohammed. What do you say?
(31:04):
His name was Selim Khan. Yes, he lived in Delhi, India,
and he was looking for a day's work and agreed
to go to a house under the premise that he
would get about four dollars a day for performing uh work.
Their construction work. All is on the up and up
so far then, he has held at gunpoint for several
days along with two other day labors. They were taken
to an operating room drugged and they awoke with a
(31:28):
horrific pain in their side and minus one kidney. And
when they took him to the hospital. When he went
to the hospital, he checked him out and he had
indeed been down one kidney. Not an urban legend. That
really happens, although it makes me wonder if the urban
legend gave rise to the actual practice. Oh yeah, you know,
maybe so. And Josh, the one US case that was
(31:49):
in here was really interesting too. Yes, Michael Master Master Marino.
There's an oral surgeon in New York and he opened
a company called Biomedical Tissue Services with an embalmer, which
should have been a real red flag that he partners
up with an embalmer. And this is in the year
two thousand, not even that long ago. Actually it was
ten years ago. I'm old. Uh. For many years though,
(32:11):
they harvested human tissue provided by funeral homes and sold
it to research facilities. And one of those bodies belonged
to who Alistair Cook Alistair Cook, famous host of Masterpiece Theater.
So he was chopped up and given to unwitting well,
I don't know about recipients. They did harvest some of
his tissue. Yeah, yeah, how about that? It's pretty awesome.
(32:34):
So where are we now? We are I think we're
at the point where we check those stats. I have
them written down here as of two oh three pm.
What time is it now? Chuck's got to get out
of his h Okay to thirty one. I gotta telling
any disappointed if this number hasn't gone down, I think
all of our listeners will be too. So we started
(32:57):
out Chuck with a total of one five thousand two
on the waiting list. What are we at one oh five? Okay,
nothing has changed in twenty minutes with the kidney. We
are at three thousand twelve. Well, it would be the
same because that was the master stat. So the kidney
didn't change either. Let's just hope Jerry didn't put a
(33:18):
drum roll in anywhere, right. But I will say, though,
don't be disappointed, because, like I said earlier this morning,
um three people received kidneys that were in searches. Yeah,
let's let's like to think the other scenario hand out.
Are you a donor? I don't remember I was. At
one point in time I was seven bucks off, But um,
(33:41):
I think I'm going to go ahead and do it. Yeah,
this article inspired me because I'm of the belief that
the human body after you die is like worm dirt,
So I have no problem with donating my entire body
or all my organs, none of that. Yeah. Well, if
you want to learn more about oregan donation, you can
(34:02):
read Tom Sheeve's article on how stuff Works dot com. UH.
You can also check out the UM what is It
Chuck the Organ Procurement Network UM for their side of
the story. But I think you should also check out
the Life Guardian Foundation. They have a very much opposing
view of organ donation. So such a controversial topic should
(34:23):
probably um get all of the facts before you make
the very um important decision of whether or not you're
going to be a dead donor. And if you decide
that you want to be, like Chuck said, let everybody know,
tell everybody, tell strangers on the streets. Just anytime you
meet a doctor, go I'm going to be an organ door.
And you may want to make the decision with your
loved ones as well, sure, even though ultimately it is
(34:46):
it is your call. So good luck with being a
rag doll in the afterlife, which leads us, of course
to listener mill. Yes, Josh, I am going to call
this U interesting cleptomania story from Sarah Okay um Hi, Josh,
Chuck and Jerry. And she even spelled it correctly. Wow.
(35:08):
I think that deserves a T shirt, don't you. Oh?
Actually she didn't. Sorry to ours Okay close though. Uh.
Here's a story that I always think of when you
hear anything about kleptomania. A while ago, I was working
in a large independent bookstore that had been a city
institution for years. Like any retail establishment, they had experience
about ten theft loss a year, nothing too unusual. However,
(35:30):
one day in the late eighties, they received a thick,
densely written journal which detailed to the day, our moment,
weather condition, et cetera, every single book this person ever
stole from the bookstory but this guy turned it in. Uh.
They showed it to us in sales training. It was
written in a cramped hand, all pages front and back,
which is really creepy. When you're writing on the front
and back, you're either really green or you're like a
(35:53):
serial killer. That's what I think. Uh. Sometimes a clipping
or a picture from one of the stolen books is
taped to it. So of course the bookstore said, huh,
maybe we should prosecute since they confessed basically to stealing
over a period of twenty years, adding up to thousands
of dollars. Whose recognis They contacted the people that returned address,
and it turned out the person who wrote in was
(36:13):
a son or daughter the very prominent local family, active
in politics and big charities and the like, the kind
of family they named Wings of Hospitals after hot sarahs
So of course they didn't want their good name drafted
the mud and apparently settled out of court for an
undisclosed Some money can do that. I guess that journal
was something to behold though, So um, that's what Sarah says.
(36:35):
That is definitely a c. That's awesome. Yeah. Cool. Well,
if anybody's ever sent you a cryptic or disturbing journal
and you want to tell us about it, or if
you just want to say hi, you can send us
an email at stuff Podcast at how stuff works dot com.
(36:57):
For more on this and thousands of other topics at
how stuff works dot com. Want more how stuff works,
check out our blogs on the how stuff works dot
com home page. H
M Hey everybody, it's me Josh and for this week's
s Y s K Selects, I've chosen January two thousand
ten episode called How Organ Donation Works. We get into
the ins and outs of organ donation, that what you
can do and what you can't, and we also talk
about the black market for organs um, which is something
(00:22):
that's been in the news recently. There has been a
huge Reuters expose on the secondary organ donation market for
profit market, which is worth reading too, especially if this
episode floats your boat. So I hope you enjoy How
Organ Donation Works. Welcome to Stuff you Should Know from
(00:50):
House Stuff Works dot com. Hey, and welcome to the podcast.
I'm Josh Lark with me as always as Charles W.
Chuck Bryant, who I assume has two functional kidneys. I do,
but I would give one up for you, brother. Wow,
(01:12):
would you really? Maybe? I think I think that three
Chuck as a living donor maybe not? But if I died,
then sure you get thanks. Man. What about your liver,
because I'm pretty certain I'm gonna need somebody's livers. I
don't know that you would want mine either, to be honest.
Oh yeah, that'd be like getting Mickey Mantle's liver. I
need like a we need a virginal liver, don't. Yeah,
so I can just start over again, wash it in vodka.
(01:35):
So what are we talking about, Josh? We're talking about
organ donation, Chuck perfect, which I find absolutely fascinating. UM.
Back in nineteen fifty four, let me take you back
a little bit here, the first successful living human to
human organ donation took place. It was a kidney. Yeah,
(01:56):
it was a great story. Kidneys actually remained the most
commonly donated and UM received organs. But this was actually
a couple of twin brothers, one of whom was dying
of chronic nephritis. Yeah, Richard and Ronald Herrick. And Richard
(02:17):
was the one dying, and Ronald was in good shape, right,
and Ronald said, well, you know what, you're my twin brother,
and I don't really want you to die young, so
I'm going to give you one of my kidneys. And UM.
There have been uh some other transplants before that. They
didn't work out though, well some of them did, but
it wasn't live human to human UM like for example,
the first I think the first organ, the first donation
(02:41):
or transplant that ever took place was way back in
sixteen sixty where they fused part of a dog's skull
under human's head and that graft worked. H We have
taken testicles from monkeys and successfully in playing them into humans.
A pig kidney was successfully transplanted into a human vein transplants, uh,
(03:03):
And a lamb kidney was put into a recipient in
nineteen twenty three and that person lived for nine days.
But nineteen fifty four finds the first time a living
person donated an oregan to another living person, and it
was successful. And the reason why, they think was because
they're twins, there was a very low chance of rejection, right. Yeah.
(03:25):
And the story is great because Richard, you know that
the dying brother had a moment, a clear moment where
he literally, like the day before, said don't do this. Man,
get out of here right now. And the brother said, no,
I'm gonna give you my kidney like it or not, chump,
and he did. And it was a great story. Yeah,
And they actually both lived to ripe old ages reproduced,
so they fulfilled their destinies humans. And since then, Josh,
(03:48):
there have been more than a half a million of
these organ transplants performed. Right, We've gotten a lot better
at it. Um. As I was rambling off that list
of stuff that took place before nineteen fifty four, we
have and exponentially better. Uh. In two thousand three, we
successfully transplanted a tongue. Yeah, I saw that, which I
could use a tongue transplant. A slightly thinner tongue would
(04:09):
would do me a lot better. I think you had
a fat tongue. Yeah. And do you remember the um,
what do we do the face transplant? Huh um. That
woman actually remember she got her face from a suicide victim.
That was in two thousand five and in two thousand six,
so I know it's coming. A cadaver's penis was transplanted
(04:30):
onto a living humane and that man gave it back. Yes,
and I love The reason they gave was because of uh.
It caused psychological problems between the man and his wife,
which I can imagine. Let your imagination running with that one. Yeah, yeah,
that's just uh. I would say the same thing would
happen to my household. So thanks to m A better
(04:50):
understanding of how the human body works of blood type,
of the development of anti rejection drugs like Chuck said,
we've hit about half a million transplant surgery so far. Right,
So Chuck actually is hot and heavy, uh to to
give out a stat and this is a very special
stat because it's actually most likely going to change by
(05:12):
the end of the podcast. Yes, these are taking away.
These are current stats. If you go to the website
u n O s dot org, the United Network for
organ Sharing, they actually have up to the minute statistics
on who needs what and who's giving what and what
operations are being performed. And I didn't realize this, but
it's up to the minute because earlier in the day
(05:33):
I checked on kidneys and the number actually dropped by
three about an hour later on the waiting list, So
three people got kidneys in that like half hour span.
So I'm just gonna read a couple now and then
we'll check back in for fun in twenty minutes and
see if that's changed at all. Okay, I'm gonna write
this down to Chuck because we'll never remember it. This
is the first time we've ever used a laptop in
the studio and a pen usually just us in our mouths. Uh. Total, Josh,
(05:59):
we got one five hundred and five thousand, two people
are waiting for organs, and we'll do kidney because that's
the most popular. Eight three thousand and twelve people are
waiting for a kidney as of two oh three pm.
All right, and we'll check that in twenty minutes and
hopefully those numbers have gone down. Yeah, because that will
(06:20):
mean that either the people on the waiting list have
died or they received a transplant. I guess we could
put those two, we could compare against one another, and
maker we could surmise for So, Chuck, what are organs? Yeah?
I had a feeling you're going to ask me that, Josh,
go ahead, No, okay. Organs are systems of cells, Josh
(06:42):
and tissues, and they all are in our body for
a very specific reason, each one. And what I like
about the organs is that they are all over equipped,
which is what you're looking for in an organ. You
don't want like the heart to be like boy, if
it beats one beat less, you're really screwed. So um
our art. Actually, a twenty year old's heart beats pumps
(07:03):
about ten times more than the amount of blood we need.
And uh, we we have this reserve capacity in all
of our organs. As young lads and lasses. Right. But
as Tom Chief, who you know as my bff who
wrote this article, he points out that the corneas, when
you talk about eye transplants, they're talking about corneal transplants. Um,
(07:25):
they actually don't necessarily deteriorate like all the other organs. Yeah,
that's pretty cool. Um, So the corneas of seventy five
year old donor are just as good, considering you know,
there's not more wear and tear than say a twenty
year old. Yeah, you could put a seventy year old
person's cornea inside of a young person and there would
be no difference. Right. But for organs, they deteriorate with age.
(07:48):
Well that's the bad news, right, Um, so eventually you
may need one, right, Well, yeah, because what happens is,
let's say one organ can deteriorate while the rest of
your body remains pretty healthy. That's actually best case scenario,
as weird as that sounds, because that means you can
just swap that sucker out and you'll be fine again. Right. Well,
that that's in a very ideal utopian world. That's exactly
(08:11):
what happens. The problem is, there is a lot more
people in need of organs than there are organs available
right right, there's um a waiting list. Some aren't so bad.
I think kidneys go pretty quick, as you're you're talking
about earlier. The longest wait I found, um was the
old heart lung combo. That median wait time was six
point seven years. It's a long time to wait for
(08:32):
a heart and a long if you need it. Yeah,
a long time because nobody goes I'm probably gonna need
a heart and a long combo. Eventually, I'll just put
myself on the waiting list. Now you need it, like
the moment you go onto that waiting list and you
have to wait six point seven years until you get it, right, Yeah,
and that's why. Um, the mortality rate while waiting for
a heart, which is that's not as bad as I
(08:54):
would I would be, like the lungs are, and um,
the ever actually is the worst good Yeah, sorry, um.
There's two ways you can get organs from a live
person or a dead person. Yes, Traditionally we don't take
organs like the heart from a live donor because they
(09:15):
would be a dead donor. After that, you can take
things like uh, the liver pancreas uncommonly, but it can
be done a portion of the intestine, um, blood, blood,
stem cells, bone, marrow, bones, all and bones. Yeah, which
giving up a bone that's really something like, I mean
(09:37):
after that, you just kind of have this floppy arm,
but somebody else has a bone, you know, I mean,
that's pretty nice. You Know. What I thought was interesting
about the kidney deal, like why you can give up
one kidney and still be okay, is that most of
the times when your kidneys are affected, they are both
affected at the same time, so it's one's never gonna
go down and you'd be like, oh, I wish I
(09:58):
still have my healthy kidney because they both would have
been unhealthy. And uh, all right, I think we've arrived
at the liver Chuck. This is fascinating to me. It
is where where should we start? Well, let's just start
by saying that the liver can grow. It's like the
starfish of oregans. Yeah, it can regenerate itself, which is
just freaking amazing. Sure. Um, So, for instance, let's say
(10:23):
you wanted to split your liver in half and transplant
that into two different people. You could do that. You
could and actually, if you're an adult donor, they can
cut off a portion, a child sized portion, UH, which
is I think the same as like a child sized
meal where you get like three chicken nuggets from UH
and give it to a kid and chuck, this is
(10:46):
so great. It grows along with the kid right to
a full size liver once again, but in step with
the kid's maturation. Right, that's just mind boggling. Let's say
you needed a piece of your liver. Let's say you
needed liver replace and I cut half of my liver
off and gave it to you. My liver would eventually
grow to full size once again. Yeah, if I live
(11:07):
that long, so mine would grow and yours would grow.
And the cool thing is with the liver, you don't
even have to take out the old liver. You can
just put in the new one. It's like the best
organ on the planet. It really is, and our favorite
organ because of the function that it serves. So Chuck,
Like I said, you can neither be a dead donor
or a living donor. A dead donor can donate anything, right,
(11:27):
including your yeah, and your eyes, um, heart, lung, all
that stuff that you can't really take from a living donor. Um.
But there are some exceptions. If you have HIV or
disease causing bacteria in your blood stream or tissue. They're
not going to be taking your organs. Um, And if
(11:49):
you are a practitioner of the Shinto religion, there's not
gonna be a lot of organ donation going on there either, right. Yeah,
not only that, but if you are Amish, they might
support your donation if there is a certainty relative certainty
of success, but they're more reluctant if it's uh less
probable of success. Right. And Tom actually mentioned why the
(12:10):
Gypsies don't agree with the organ donation. They believe that, um,
you need your body for the first year to get
around the afterlife. Apparently after that you got it down
pat and you don't really need it any longer. Um.
But he didn't mention Shinto, but I looked it up. Uh.
They believe that the corps is impure. The body becomes
impure after death. So would be like, here, take this
(12:31):
rotting piece of flesh that will save your life, but
you're going to be impure while you live. Interesting, So,
as a result in Japan, uh doing donation rates are
like really really low like the USA. Yeah, and Jehovah's
witnessed we should cover them because we're we always like
to talk about them. Uh, they're not opposed to it,
but they have one rule which I thought was interesting.
(12:52):
You can donate your organ as long as they drain
all of the blood out of the organ first before
giving to someone else. So I guess we're not big
on translusions. I don't think so, that'd be my guess. Yeah, okay, Um,
(13:24):
how do you register Chuck? Well, it's pretty easy. Actually
in most states, you can do it at the d
m V, which I always found interesting. Yeah, you can
do it right with there when you're getting your new
driver's license. And uh here in Georgia, actually we used
to have the one of the highest donor rates, or
I should say one of the most expansive donor registries
in the country. And the reason was when you went
(13:46):
to go get your driver's licenses. I'm sure you remember, Um,
they'd knock seven bucks off of your driver's license. I
love that. So you were an idiot if you didn't
sign up. The problem is that there's not supposed to
be any kind of compensation whatsoever for being even though
this was legal under state law. Um. The Georgia Organ
(14:08):
Procurement organization, which we'll talk about a minute. Um, they
were very hesitant to draw from the Georgia donor list
because they weren't sure if the person was just looking
for the seven bucks off or else if they really
wanted to be an organ donor. So actually, the contribution
rates were very low in comparison of the size of
(14:29):
the registry in Georgia until two thousand five when they stopped.
They stopped it, I think to actually give you a
T shirt too that says I sold my lungs for
seven dollars. That's illegal, and all I got was this
lousy T shirt. Yeah. No, under UM law, you can't
have any valuable compensation for organ procurement, right what we'll
get to that too, the whole black market deal. Okay,
(14:50):
So Chuck, if you're a dead donor, how do you donate?
There's two ways, right? Uh? Two ways, sure, two ways
of death. Brain death and cardiac death. Is that what
you mean? Obviously? Cardiac death is um a little trickier
because you only have a certain amount of time to
get the organs from the body. Brain deaths a lot
(15:11):
easier in one sense, because um, there could be is
you know, weeks to find a match and to prepare
the organ for donation and get it carried out. But
there's a wrinkle there. So there's a lot of wrinkles there.
Let me let me say something about cardiac death first, right,
Um this there are there are no laws really governing
(15:33):
organ procurement. It's not a case by case basis, And
basically everybody involved in the organ procurement process does their
best to walk a very cautious line while harvesting organs
to try to save other lives, right, yeah, because there's
families involved grieving obviously. Um. With cardiac death, there was
(15:54):
a board I think out of Harvard in the late
nineties that established a five minute wait time from the
cessation of a heartbeat. Right, so, you you take somebody
off a life support, wait for the heart to stop beating.
Five minutes after and while this this the heart's winding down,
you're prepping the patient for surgery. Five minutes after, Uh,
(16:14):
somebody pronounces the person dead and they cut them open
and take the organs. But in five minutes the heart
is useless pretty much at that point. Some of the
other organs, like the liver, the kidneys, maybe the lungs
can survive that five minutes, but the heart's gone. So
if you have a cardiac death, you have a useless heart,
even though the heart might have been perfectly healthy. Five
(16:34):
minutes again right, So there was this doctor in Colorado
that said, you know what, there's no law whatsoever that
says I have to wait five minutes. This guy did
a lot of research and found in the medical literature
the longest duration between the cessation of a heartbeat and
the spontaneous regeneration of a heartbeat ever recorded was sixty
(16:54):
five seconds. So he started a sixty five second rule,
got the pants suit off of them. It was an
unsuccessful lawsuit, and now all of a sudden, the president
has been set and now there's a sixty second rule
out there that some people adhere to. That is how
organ procurement has been established in the US. Somebody pushes
the envelope, they get sued. They if the cases uh
(17:17):
isn't one by the by the plaintiff, then you have
a new rule. Isn't that weird? There's like zero guidance
for organ procurement except that the person has to be dead.
We don't have any real definition for death. Well, that's
where brain death gets really really true. Exactly. Take it, Chuck, Well,
I don't. I mean, you're the you're the expert here.
(17:38):
I don't. I can't weigh in morally because I don't
know what I think. Really Nah. I mean, I know
what I might believe for myself, but I don't know
about establishing guidelines for others. But we need them, though,
don't we? Yeah? But I don't want to make up
those rules, do you know? And apparently the federal government
doesn't either. Um. Every once in a while, I think
Carter assigned a panel to create a white paper on this,
(18:01):
and I guess George Bush did right before he left office,
because there was one that came out in two thousand
and eight. Either Bush did right before he left office
or it was like the first thing Obama did when
he came into office. But there was a very recent
white paper that came out that said, Okay, here's how
we feel about brain death. Right, here's the problem. Back
in the fifties, I think we came up with this
(18:23):
thing called the ventilator. And with the ventilator, you can
keep somebody who for all intents and purposes dead, you
can keep their organs functioning. So you're masking death. We
have no idea what would happen if that ventilator wasn't there,
would the person die? And if the person does die,
how long do we have to wait until we say
that that person is dead? Right? So the the ventilator
(18:46):
made it so we could procure organs more easily in
brain death because we can keep them alive. At the
same time, it blurred the line between life and death. Well,
now they came out with this recommendation that said brain
death is disengagement of no the um end of meaningful
engagement with the rest of the world, which really widened
(19:06):
the scope of who exactly is dead. And so when
you have a brain dead patient and you procure their organs,
what what you actually do is you have to run
them through this battery of tests where you are um
shining lights in their pupils. Uh, there's an ice water
injection into the ear canal to see if you move
toward or away from the stimulus um And there's this
(19:28):
battery of tests to establish brain death. And then here's
the clincher. They do an apneus test where they take
you off the ventilator for two minutes and see what happens,
and see what happens. Inevitably, the um, the heartbeat is
going to slow down. And then after two minutes they
put the ventilator back on. But that two minutes where
(19:49):
your brain was starved of oxygen was enough to to
create real brain death if you weren't before. Wow, think
about that. This is why they call you supplementary research man. Right,
that's why that's your superhero. Can you hear like people
fast forwarding through to get through this, partners, It's like Josh, Josh, Josh, Josh. Okay,
(20:09):
So we have this, we have this new definition of
brain death. And when the second apnea test happens and
you're declared brain dead, what they anesthetize you, they inject
you with anti paralytics. Will you into that hospital room
and they harvest your organs, so you actually die from
a lack of organs present in your body. So that's
(20:34):
that it's a ghoulish matter. And this these people who
are in charge of making sure that people donate and
keeping the image of organ donation is a gift of
life alive, have to battle with this, the fact that
it's a very ghoulish process. So who's who's in charge
of this stuff, by the way, for what for that
(20:56):
whole soap op spiel anytime, buddy, Yes, Josh. That would
be called an O p O, which is an organ
procurement organization and they are federally designated nonprofits and they
are local all over the country. There's usually UM one
in the central location of a state and then different
satellite office is obviously because you need to be close by.
(21:19):
You know, you can't be hopping all over the country
to get these organs, although that happens as well. And
they basically responsible for awareness, recruitment, evaluation, UM organ removal,
and transportation. So they're the people that's standing there with
a cooler waiting to drop your organ in there and
rush it to the recipient. They're also the people that
talk to the family generally. Well. Sure, so anytime somebody dies,
(21:42):
you the hospital is legally obligated to notify the organ
procurement organization, right and you know this this is a
good point to bring this up. If you want to
be an organ downer or if you are, you really
need to tell your family the stuff, and you should
have it all in your living will because things can
get a little ugly. UM for instance, let's say you
are from a very strict religious background. Maybe your family
(22:07):
doesn't want you cut up. They think that would be
a bad thing, but you want it. You gotta have that,
you know, in paper on paper, in writing, right, you
need and if you have a documented um in a
lot of cases, even if you if your family is like, no,
we don't want to donate the organs, the organ per
human organization will say, you know what, ts sorry, he
want he or she wanted to be an organ owner.
(22:28):
And the last thing you want after you die is
for your spouse, let's say, to have to mountain this
campaign against your family like a tug of war like that.
You gotta have it all spelled out nice. Um. So
where are we? The United Network of organ Sharing that's
another group. This is where that's where you got the
kidney statistics. We're gonna go back on and look at right. Yeah,
they're in Richmond, Virginia, and they are responsible for placing
(22:50):
donated organs um and maintaining the waiting list like you
just said. And they never close No. Seven three sixty five,
which is how it should be. Obviously, we should calling
them right now to see if they're open now. Let's
not do that. I'm sure they're open. And then Chuck,
there's the Scientific Registry of Transplant Recipients, right, Yes, the
s R t R. And they basically maintain like every
(23:12):
amount of data you could possibly want on transplants, right
for like policy makers and doctors and drug makers and
that kind of stuff. Yes, And there was one more
called the ORGANS sorry, the Organ Procurement and Transplantation Network,
and they're they're just another network that matches people with
recipients and has waiting list that kind of thing, right,
(23:33):
So this is actually a pretty um lean, mean streamlined machine. Yeah,
the Procurement and Donation Network. It has to be right, So, Chuck,
you were saying like they can't be hopping all over
the country, but they have to sometimes. So what happens
with like, let's say somebody dies in Sacramento and they
have the perfect heart that somebody in Tampa needs. What
(23:56):
happens while they will put it into a cooler and
fly to uh what was the destination? Tampa? Tampa? They
fly to Tampa. Apparently like the hospital in Tampa. Those
people will go fly to Sacramento, take possession of it,
and then fly it back unless there's somebody in the like, like,
let's say somebody in Sacramento needed it and somebody at
(24:17):
the Sacramento General Hospital died. That's when that cooler comes in.
Which have you seen the one that's at the office.
We have an organ transplant cooler. Yeah, it's pretty cool,
roxane keeper tab in its. Uh. You know what I
thought was really cool is if you were on the
organ donation list as a living donor, you are actually
(24:39):
given consideration if you need an organ transplant yourself. And
they said that they won't like bump you to the
top of the list, but they will give that a
little bit of extra weight, which I think is that's
only right. Did you also see that? Um, if you
are a living donor and you usually your insurance company
won't raise your rates after that, but move to another
(25:01):
insurer change like plans, they'll hit you with a pre
existing condition. That's how evil. Seriously you sign up for listening,
I will give someone my kidney as a living human
and the insurance companies are like, oh, well, you might
have to charge a little extra for that. Don't you
think we should start publicly executing CEOs of insurance companies?
It should be part of the healthcare reform package. Right,
(25:23):
of course we don't mean that, right, Thanks for the
Ceoh so chuck. When when you're talking about people running
around with coolers and all that, it kind of creates
this harried pace right in your mind. Um, and that's
very much true. You have a very short amount of
time for an organ to survive. Remember I said, like
even five minutes can kill a heart once it's deprived
(25:44):
of oxygen, which it stops beating, right. Um. What happens
when you die too, The body undergoes all these huge changes. Um.
That happened almost immediately, Like, um, there's this uh, parasympathetic
flow of chemicals right um, which is like kind of
fight or flight on steroids. So I guess it's a
(26:07):
sympathetic flood. Like dopamine levels increase eight hundred percent, epinephrin
levels increase, nor EEF levels increase. So all these chemicals
that are meant to like either speed you up or
slow you down or just flooding fro the body. That's
why you have to take the drugs right most times, Well, no,
this is when you die. So when they're trying to
(26:29):
harvest these organs, they're like trying to get them out
of the body before this flood just damages these things
I thought you meant as a recipient that would happen. No,
that'd be pretty awesome though, to have your dopamine levels
raised eight percent, right, But it's not as easy as
just throwing the new heart in there either and sewing
you up and say good luck with your life. No, no,
it's not you. And uh, there's also some expectation that
(26:52):
you lead a very healthy life after that. You're not
supposed to be drinking or smoking or swearing, and um,
you have to stay away from call girls and things
like that. Yeah, you shouldn't get a new liver and
then like dive into the vodka bottle. You're you're pretty
much signing a contract to become ned Flanders after you
get your organ donation. Yeah. Actually, just over Christmas heard
(27:13):
of a friend of a friend of a family member
that was a candidate for I think a liver transplant
and they would not do it because he wouldn't enter
um rehab. Really yeah, wow, so that's hardcore. Yeah, that
guy's dedicated to the booze, isn't it. Yeah, pretty much. Um,
(27:35):
And also you're if you are a recipient, there's some
expectation that you pay, like for the lodging and travel
expenses of the person who donated. Yeah, it's kind of
an unwritten rule from what I understand well and have
to be real, you know, it's kind of against the
law really well, but it makes sense though, because if
you're let's say, you want to donate a kidney to
someone that lives across the country and you're spending money
(27:57):
off from work and flying out there and putting yourself
all right, it's gonna cost you some dough and a kidney. Yes,
you'd have to be a really nice person to be
an an anonymous Yeah, that'd be cool. All right. So, Chuck,
(28:35):
you want to talk about the black market? Yes, the
black market does exist. Isn't that crazy? Um? Yeah, but
not surprising. No, but it's pretty interesting. Um. It obviously exists, Um,
typically outside of the United States, although there have been
some cases inside the United States. Usually it's like, and
(28:56):
this is what's so said. Usually it's impoverished nations, And
what happened is that will be a couple of countries involved.
You'll take someone out of a really poor country offered
them like five thousand dollars for their kidney, and then
the middleman will get, you know, a hundred thousand dollars
for that kidney. And you know, it's not like these
are done in professional surgical rooms. It's a lot of time.
(29:16):
It's it's the back room, if you know what I mean.
And that's actually exactly what happened in two thousand three
in South Africa. Yeah, they were importing people from uh I,
guess the City of God in Brazil. Yeah, slums of Brazil. Yeah,
and um giving them five grand for their kidney and
then turn around selling it for a hundred k yep.
(29:37):
That's nuts, yep. And uh where else did it happen?
Villagers in India so that they were getting they weren't
getting nearly. They were getting about eight hundred dollars for
their organs, which is just unbelievable. And at one time
the Israeli organ brokers were obtaining these from Soviet Bloc
nations and doing the operations in Turkey. And this one
(30:00):
guy made a middleman, made about four million dollars before
he was caught, which is not bad harvesting organs, although
I imagine being an illegal organ broker is a fairly
stressful job. Yeah, and it happens in the US too,
although customarily it's um an organ broker and a nefarious
funeral director who harvest organs before cremation. Did you know
(30:22):
this happened? No? I didn't either, and I saw all
the six ft under of course you did. Uh. Did
you see the movie Thererista's No, that wasn't very good.
That was the the deal there though kids are like
captured in the jungle. No, but it was like an
Eli Roth movie. It was like hostile, except they were
(30:43):
harvesting organs basically instead of just blind torture. Uh. And
speaking of that Thereristas. That actually does happen in the world.
It's not just old wives tales. Poor Mohammed legend kidney
theft does happened. It really does, Mohammed. What do you say?
(31:04):
His name was Selim Khan. Yes, he lived in Delhi, India,
and he was looking for a day's work and agreed
to go to a house under the premise that he
would get about four dollars a day for performing uh work.
Their construction work. All is on the up and up
so far then, he has held at gunpoint for several
days along with two other day labors. They were taken
to an operating room drugged and they awoke with a
(31:28):
horrific pain in their side and minus one kidney. And
when they took him to the hospital. When he went
to the hospital, he checked him out and he had
indeed been down one kidney. Not an urban legend. That
really happens, although it makes me wonder if the urban
legend gave rise to the actual practice. Oh yeah, you know,
maybe so. And Josh, the one US case that was
(31:49):
in here was really interesting too. Yes, Michael Master Master Marino.
There's an oral surgeon in New York and he opened
a company called Biomedical Tissue Services with an embalmer, which
should have been a real red flag that he partners
up with an embalmer. And this is in the year
two thousand, not even that long ago. Actually it was
ten years ago. I'm old. Uh. For many years though,
(32:11):
they harvested human tissue provided by funeral homes and sold
it to research facilities. And one of those bodies belonged
to who Alistair Cook Alistair Cook, famous host of Masterpiece Theater.
So he was chopped up and given to unwitting well,
I don't know about recipients. They did harvest some of
his tissue. Yeah, yeah, how about that? It's pretty awesome.
(32:34):
So where are we now? We are I think we're
at the point where we check those stats. I have
them written down here as of two oh three pm.
What time is it now? Chuck's got to get out
of his h Okay to thirty one. I gotta telling
any disappointed if this number hasn't gone down, I think
all of our listeners will be too. So we started
(32:57):
out Chuck with a total of one five thousand two
on the waiting list. What are we at one oh five? Okay,
nothing has changed in twenty minutes with the kidney. We
are at three thousand twelve. Well, it would be the
same because that was the master stat. So the kidney
didn't change either. Let's just hope Jerry didn't put a
(33:18):
drum roll in anywhere, right. But I will say, though,
don't be disappointed, because, like I said earlier this morning,
um three people received kidneys that were in searches. Yeah,
let's let's like to think the other scenario hand out.
Are you a donor? I don't remember I was. At
one point in time I was seven bucks off, But um,
(33:41):
I think I'm going to go ahead and do it. Yeah,
this article inspired me because I'm of the belief that
the human body after you die is like worm dirt,
So I have no problem with donating my entire body
or all my organs, none of that. Yeah. Well, if
you want to learn more about oregan donation, you can
(34:02):
read Tom Sheeve's article on how stuff Works dot com. UH.
You can also check out the UM what is It
Chuck the Organ Procurement Network UM for their side of
the story. But I think you should also check out
the Life Guardian Foundation. They have a very much opposing
view of organ donation. So such a controversial topic should
(34:23):
probably um get all of the facts before you make
the very um important decision of whether or not you're
going to be a dead donor. And if you decide
that you want to be, like Chuck said, let everybody know,
tell everybody, tell strangers on the streets. Just anytime you
meet a doctor, go I'm going to be an organ door.
And you may want to make the decision with your
loved ones as well, sure, even though ultimately it is
(34:46):
it is your call. So good luck with being a
rag doll in the afterlife, which leads us, of course
to listener mill. Yes, Josh, I am going to call
this U interesting cleptomania story from Sarah Okay um Hi, Josh,
Chuck and Jerry. And she even spelled it correctly. Wow.
(35:08):
I think that deserves a T shirt, don't you. Oh?
Actually she didn't. Sorry to ours Okay close though. Uh.
Here's a story that I always think of when you
hear anything about kleptomania. A while ago, I was working
in a large independent bookstore that had been a city
institution for years. Like any retail establishment, they had experience
about ten theft loss a year, nothing too unusual. However,
(35:30):
one day in the late eighties, they received a thick,
densely written journal which detailed to the day, our moment,
weather condition, et cetera, every single book this person ever
stole from the bookstory but this guy turned it in. Uh.
They showed it to us in sales training. It was
written in a cramped hand, all pages front and back,
which is really creepy. When you're writing on the front
and back, you're either really green or you're like a
(35:53):
serial killer. That's what I think. Uh. Sometimes a clipping
or a picture from one of the stolen books is
taped to it. So of course the bookstore said, huh,
maybe we should prosecute since they confessed basically to stealing
over a period of twenty years, adding up to thousands
of dollars. Whose recognis They contacted the people that returned address,
and it turned out the person who wrote in was
(36:13):
a son or daughter the very prominent local family, active
in politics and big charities and the like, the kind
of family they named Wings of Hospitals after hot sarahs
So of course they didn't want their good name drafted
the mud and apparently settled out of court for an
undisclosed Some money can do that. I guess that journal
was something to behold though, So um, that's what Sarah says.
(36:35):
That is definitely a c. That's awesome. Yeah. Cool. Well,
if anybody's ever sent you a cryptic or disturbing journal
and you want to tell us about it, or if
you just want to say hi, you can send us
an email at stuff Podcast at how stuff works dot com.
(36:57):
For more on this and thousands of other topics at
how stuff works dot com. Want more how stuff works,
check out our blogs on the how stuff works dot
com home page. H
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