Organs and statistics

Statistics can be as misleading as they can be enlightening.

A critical eye and pertinent questions are required to pierce the veil of numbers that sometimes blurs our vision.

The year-end report recently released by Israel Transplant claims that over 100,000 Israelis registered for organ donor cards in 2012, an all-time high. This seems like good news: more donor card holders means more donations, more donations mean more lives saved. Perhaps, but perhaps not.

Why? This past year Israel Transplant embarked upon an advertising campaign to educate the public about new legislation enabling citizens with organ donor cards to get priority on transplant waiting lists should they ever need an organ. So it is possible (although not necessarily so) that a large number of Israelis are registering for organ donor cards as an insurance policy, with no intention to actually donate their organs. Since the Israeli medical establishment allows a person’s family to refuse donation regardless of whether the person has an organ donor card or not, having such a card does not guarantee donation.

Consider the infamous case of Avi Cohen. Cohen had gotten a donor card in earnest, but Rabbi Yaakov Ifergan (who pretends to have supernatural powers and is known as “the X-ray rabbi”) told his wife not to allow the donation of his organs, claiming Cohen would be the first person in history to wake up from brain death (he didn’t).

So it’s very possible Israelis are gaming the system and this statistic does not necessarily mean what it seems to. More organ donor cards does not necessarily mean more donations.

The report also optimistically states that the number of people who died while waiting for a transplant was 91 in 2012, down from 105 in 2011. It went on to state that the percentage of deaths of those waiting for a transplant in Israel was eight percent of the list, compared to an average of 22% in European countries, with even higher rates in Germany, the Netherlands, Belgium and Austria. These statistics also sound encouraging.

However, the difference between 91 and 105 is small. The vicissitudes of life include random fluctuations, and it would be foolish to interpret these numbers as demonstrating a trend. Moreover, more and more Israelis are traveling abroad to get their transplants, and so are not in Israel to become part of the statistic. Sometimes Israelis get organs legally by getting on waiting lists in foreign countries, sometimes they buy organs illegally, and sometime they die abroad waiting.

I recently met an Israeli in Jerusalem who showed me his chest scar and said he bought his heart in China. If he had stayed in Israel, he assured me, he would be dead (and part of the statistic). Just a few months ago, the former head of the Mossad, Meir Dagan, needed a liver. Did he wait around in Israel? No. He used his connections (and possibly his money) to jump the queue in Belarus and get himself a liver.

So Israelis might be dying abroad or buying organs abroad and they would not show up in this seemingly encouraging statistic.

The report does cite one very significant number. Since there were less traffic accidents deaths (23% less) and stroke victims last year, there was a smaller pool of potential donors. This fact is extremely important. So much so that it actually constitutes the only legitimate benchmark when comparing donation rates across countries, that would allow us to determine the effectiveness of Israeli organ donor campaigns and transplant coordinators.

I hope next year in Israel we will see in the end-of-year report the percentage of brain-dead patients in Israel that had their organs recovered compared to those in other European countries.

Ultimately, with more than 1,100 Israelis waiting for organs, the most important statistic that we all care about is the number of actual organ donations going up year by year. Unfortunately they are not. You can help by registering in earnest for your organ donor card at www.adi.org.il.

The writer is founder and director of the Halachic Organ Donor Society whose mission is to save lives by increasing organ donation from Jews to all of humanity.

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