Organ donor compensation in effect

Surgery restores the smile to one woman's paralyzed face.

Rasha Abu Joama 311 (photo credit: Carmel Medical Center )
Rasha Abu Joama 311
(photo credit: Carmel Medical Center )
The law to provide financial compensation to live donors of organs – passed two years ago – is finally being implemented in the hope that it will encourage people to donate kidneys. Compensation is for recovery time, pain and loss of work retroactive to May 2008. The budget for compensation is NIS 4 million until the end of 2010, and will cover 150 people who donated a kidney or liver lobe since the law was passed.
The arrangement is not expected to significantly increase the number of donors, but it will offer help to altruistic people who until now have avoided donating an organ because they feared economic risks. Israel Transplant chairman Prof. Rafael Beyar, who is also director-general of Rambam Medical Center, guessed that a total of 100 kidneys may be offered by live donors each year compared to about 80 today. Donors are entitled to receive 40 days of salary if they work; those who don’t will get 40 days’ worth of minimum wages, while expenses of up to NIS 30,000, in exchange for receipts will be paid. Life insurance, psychological treatments, transportations costs involving the donation and recovery and additional medical costs not covered by one’s health funded are also covered.
Almost 700 Israelis are currently waiting for a kidney, making the queue five or six years long. About half of the transplants come from live donors and the rest from cadavers.
The risk of chronic kidney disease in people of African ancestry is significantly higher than in Caucasians, according to a researcher at Haifa’s Rambam Medical Center, who discovered a responsible gene. Prof. Karl Skorecki, a kidney specialist who is also very knowledgeable about genetics and is on the faculty of the Technion-Israel Institute of Technology’s Rappaport Medical Faculty, published his finding in a recent issue of Human Genetics. The type of kidney disease connected to the defective gene can lead to renal insufficiency and require dialysis or an organ transplant.
Chronic kidney disease affects millions in North America, with persons of African background at a four-fold higher risk and those of Hispanic heritage having a two-fold higher risk compared to the rest of the population. The new research points to the APOL1 gene as involved in the increased risk in this population.
There had been an intense race in the international scientific community to determine the genetic link responsible for the greatly increased risk many people of African heritage face for end-stage kidney disease and the need for dialysis or transplantation. In addition to accounting for the risk previously attributed to MYH9 in persons of African heritage, these findings set the stage for a new area of research relating the APOL family of genes to kidney disease more generally.
An operation has restored the smile to Rasha Abu Joama of the Galilee village of Dir-el- Assad. Ten years ago, at the age of 13, a virus paralyzed a face muscle and made it difficult to eat or speak, in addition to making her look grumpy all the time. She described her life as “hell.” Prof. Yaron Har- Shai, who heads the plastic and maxillofacial surgery department at Carmel Medical Center in Haifa, is the only Israeli to have studied the transplanting of muscles from one part of the face for use in other parts, and decided to try to help her.
In the operation, muscle taken from her temple that served in the chewing process was turned into a “smiling muscle.” In what is claimed as a world-first, the muscle at her temple was disconnected and attached to the edge of her mouth. During the surgery, the muscle was stimulated with an electric current, enabling the surgeon to see its effect immediately and set it to make a natural smile. At discharge, Abu Joma hugged Har-Shai and smiled a precious smile. “My life has changed completely. I have thrown away all my anti-depression pills. I can eat and speak normally... I am overjoyed and smile at everybody.”
An article on the innovative procedure was published in the journal Plastic and Reconstructive Surgery.