The Silent Auction for Life: How Wealth Skews the Organ Transplant System
More then 5,000 Americans died waiting for a kidney transplant in 2025 – roughly a dozen each day. Among them was Harrison roberts, my first cousin, a man whose life was a testament to resilience, ultimately lost to a system increasingly tilted toward those who can afford to bypass the wait.
Harrison,remembered as a rambunctious boy who delighted in bouncing on my back at Thanksgiving gatherings,faced a series of health battles. His father succumbed to cancer when Harrison was 15, and two decades later, Harrison himself received a Stage 4 colon cancer diagnosis. Doctors initially offered a grim prognosis,but Harrison,a father of two young daughters,refused to surrender,enduring grueling rounds of chemotherapy.
Years passed,punctuated by periods of silence,yet a visit during his chemo treatments around 2005 at Massachusetts General Hospital forged a deeper connection.It was a difficult time, and I realized that facing cancer often leads to isolation, with friends hesitant to offer support, fearing contagion.
Harrison ultimately beat the cancer, but the treatment severely damaged his kidneys, leading to four years of dialysis. This meant three hours, five days a week, tethered to a machine. During those hours,we spoke almost daily – about books,politics,family,and life itself. Sometimes, words weren’t necessary; we’d simply share the silence, punctuated by the ambient sounds of the hospital or, as Harrison described it, “a cross between a medical clinic and a bus station.”
He desperately needed a kidney transplant. Six friends and relatives volunteered, but all were rejected. harrison suspected Mass General prioritized maintaining its transplant success rate. His reasoning was stark: a patient with a history of cancer and a quadruple bypass, whose heart was weakened by dialysis, presented a higher risk. A failed transplant would negatively impact the hospital’s statistics. A nurse, he recalled, even suggested he was wasting his time there.
I urged him to explore other options – Barnes Hospital in St.Louis, the University of Chicago Medical Center, or the University of Illinois Hospital, all with reputable transplant programs. The University of Illinois Hospital was eager about evaluating him, but by then, further heart complications and vein problems, culminating in the loss of part of his foot, made travel unachievable. We watched his daughter’s college graduation via Zoom, and I spent two weeks with him, driving him to dialysis and learning to play Go.
This personal tragedy gained a chilling national context on december 16, when the New York Times published a front-page exposé, “Hospitals Cater to ‘Transplant Tourists’ as U.S. Patients Wait for Organs.” Initially, we’d joked about the possibility of seeking an organ on the black market in Southeast Asia. But the reality was far more unsettling: American hospitals were actively catering to wealthy foreign patients willing to pay up to $2 million to jump the transplant queue.
The article detailed how the wife of a Japanese hotel magnate received a heart at the University of Chicago Medical Center, followed by a substantial donation from her husband to a charity linked to the surgeon. Approximately 1,000 foreign patients annually receive transplants in the United States through this practice. When questioned, the University of Chicago claimed it “considerably improved access to organ transplantation in recent years.”
Harrison roberts was,in my eyes,a hero – a man who faced unimaginable adversity with bravery and humility. As he himself put it,”Nobody’s a hero for running out of a burning building.” He fought a rigged game until the very end, succumbing to kidney disease on August 31 at the age of 58, while others bypassed the system with a financial “fast pass.”
It’s a familiar story, another example of a system skewed to favor the wealthy.But this time, the stakes are life and death.
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