A ‘Preventable Tragedy’: Dying for Lack of an Organ Donor

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  • A Public Misinformed About the Federal Budget
  • Making Bread by Hand
  • Foie Gras ‘Status’
  • Against Gambling

Credit…Musubu Hagi

To the Editor:

Re “She Feared the Organ Donation System Would Kill Her. It Did,” by Kendall Ciesemier (Opinion guest essay, Feb. 1):

I read this essay with great sadness. When we testified together before Congress, I was inspired by Tonya Ingram’s story and resonant voice to our legislators: “Please don’t make us wait.”

Tragically, she was one of 12,000 people last year on waiting lists who died or became too sick to receive a transplant.

As a transplant surgeon who studies organ donation, I believe that the organ shortage is due to ineffective regulation and failing contractors. High-quality research over 20 years demonstrates that for every donor used, even more potential donors are wasted — enough to end most deaths and dramatically reduce dialysis time.

Members of Congress agree on the solutions: Replace failing local organ contractors and break up the national organ monopoly.

Time matters in transplantation. For the thousands who face the prospect of death this year while waiting for an organ, I implore the Biden administration to move forward with common-sense reforms, and recall the words of Ms. Ingram: Please don’t make patients wait.

Seth Karp
The writer is the surgeon in chief at Vanderbilt University Medical Center and director of its transplant center.

To the Editor:

The Association of Organ Procurement Organizations is saddened by the news of Tonya Ingram’s death. Sadly, 17 people die each day waiting for a lifesaving transplant. There is no question that Americans, especially those suffering from acute kidney disease, deserve greater access to organs for transplant. However, Kendall Ciesemier placed the responsibility on organ procurement organizations (O.P.O.s) while ignoring critical facts about why more organs are not transplanted.

O.P.O.s, the nonprofit entities federally designated to facilitate the recovery of organs from deceased donors, have been working for decades to bridge the gap between the availability of organs and the growing need for organ transplants in the U.S. Recent data released by the Organ Procurement and Transplantation Network shows that since 2010, there has been an 87 percent increase overall in deceased organ donors.

However, the number of organs recovered by O.P.O.s that go to waste because they are refused by transplant centers is rising dramatically. In fact, 7,543 kidneys, 26 percent of all kidneys offered by O.P.O.s for transplantation in the U.S., were turned down by transplant centers last year.

This rise in rejection rates was called out by the National Academies of Sciences, Engineering and Medicine as a major concern. It is disheartening to the O.P.O.s that work each day to increase the number of organs they are recovering. But it is devastating to patients living — and often dying — on dialysis, waiting for an organ.

O.P.O.s have no control over whether organs are actually transplanted into patients. For the entire system to save more lives, we need to ensure that transplant centers have clear organ acceptance criteria, have the appropriate resources to process the influx of available organs and use organs from more medically complex donors.

Every American can help ensure that more organs are available for transplantation by registering as an organ, eye and tissue donor on the National Donate Life Registry:

Barry Massa
McLean, Va.
The writer is president of the Association of Organ Procurement Organizations.

To the Editor:

Seven years ago, I donated my right kidney to a stranger. This year, I’m being evaluated by a transplant center to donate a lobe of my liver to another stranger.

I’m grateful that I have the good health, financial stability and social support to be a living organ donor. But as Kendall Ciesemier makes clear, the U.S. organ donation crisis is a systemic problem that will never be fixed equitably or effectively by individual solutions.

How many more people will die before the Biden administration steps up to its responsibility for making meaningful systemic reforms?

Jennifer Roberts
San Francisco

To the Editor:

There is an urgent need to reform the U.S. organ donation system. Americans are dying every day because too often organ contractors fail to do their jobs, and the federal government fails to hold them accountable.

That some 28,000 organs are going unrecovered each year is a wholly preventable tragedy. That this tragedy disproportionately harms patients of color who too often receive inequitable and inferior treatment from a taxpayer-funded system makes it even worse.

We support bipartisan calls from Congress to break up the national organ monopoly held by the United Network for Organ Sharing, to ensure that failing local organ procurement organizations are replaced by high performers, and to open data for evidence of effective and equitable performance.

Most health care policy issues are complex. This one is not.

Jennifer Erickson
Abe Sutton
Ms. Erickson served in the White House Office of Science and Technology Policy under President Barack Obama. Mr. Sutton served on the National Economic Council under President Donald Trump.

To the Editor:

Kendall Ciesemier’s heartbreaking essay reveals the need for organ donation reform so that donated organs and tissue can be processed safely and efficiently. According to Donor Network West, 95 percent of Americans are in favor of organ donation, but only 58 percent are registered to be donors.

What is also needed are laws at the state level, and perhaps the national level, that would make organ donation the default choice in the absence of documented rejection to be an organ donor.

Robert A. Edelman
Oakland, Calif.
The writer is an ophthalmologist.

A Public Misinformed About the Federal Budget

President Biden and Speaker Kevin McCarthy have blamed each other for the impasse in raising the debt ceiling.Credit…Doug Mills/The New York Times

To the Editor:

Re “Biden Demands Details on Budget Cuts From McCarthy” (, Jan. 31):

You write that in the debt limit fight, “Mr. Biden is seeking to force Mr. McCarthy to specify which programs he would cut — a list that most likely includes some spending that is popular with the public.”

That’s true — but, as Speaker Kevin McCarthy knows, unless media outlets start giving the public more actual information about what’s in the budget, the public won’t believe it.

Polls have shown that the average American thinks that over 50 percent of the federal budget is “wasted.” People have no idea that most of the budget goes to Social Security, Medicare, Medicaid and the military. That gives Republicans an enormous advantage in budget fights: People assume we can just “cut the waste.”

The news media is a huge part of the problem: You hardly ever see articles that recite simple facts about the budget. Until such articles become commonplace, Republicans will retain an enormous unfair advantage in budget fights.

Steve Novick
Portland, Ore.

Making Bread by Hand

The bread maker has helped Donna Thomas, who has arthritis, make brioche.Credit…Octavio Jones for The New York Times

To the Editor:

Re “Bread Bakers, and the Machine They Love” (Food, Feb. 1):

The joys of homemade bread go far beyond just the texture and taste. The tactile experience of creating a satiny supple dough with one’s own hands from a gloppy mess of flour and water defines satisfaction.

Also, experienced bread bakers assess the appropriate amounts of flour and hydration in a dough by feel, outside of the recipe’s parameters. Finally, shaping loaves is creative and fun.

Using a bread machine deprives the baker of all of these pleasures.

For those who really don’t have time or the physical ability to make bread by hand, a bread machine will deliver “homemade” bread, but it is a poor substitute for the handmade bread experience.

Barbara Giesser
Pacific Palisades, Calif.

Foie Gras ‘Status’

In 2019, animal rights activists won the first battle over foie gras in New York City, when the City Council passed a law banning it.Credit…Desiree Rios for The New York Times

To the Editor:

Re “The War Over Foie Gras in New York City Rages On” (news article, Jan. 28):

Given the current understanding that animals feel pain and suffering much like humans, it’s sad that the New York elite have to gain “status” through the torture of ducks and geese in the making of foie gras. Surely they can buy more expensive Champagne, watches, clothing and cars to show off.

Michael Fasman
San Francisco

Against Gambling

Credit…Al Behrman/Associated Press

To the Editor:

Re “Developers Chasing a New York Casino” (news article, Jan. 19):

Regarding gambling, there is one sure bet: Gambling has never done humanity any good, and never will.

Brant Thomas
Cold Spring, N.Y.

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