Toronto, Canada - An ailing Toronto woman angry over the cancellation of her scheduled kidney transplant may yet be able to receive the organ from her would-be Australian donor -- thanks to the friendship they developed during their three-month Canadian ordeal.
In the latest twist in an already bizarre case involving accusations of brainwashing by a so-called "kidney cult," Sandi Sabloff and Ash Falkingham plan to seek approval for the transplant under Australian law that prohibits organ donations arranged between strangers but allows them between "friends" who can demonstrate a "close relationship."
New ethical guidelines for organ transplants from living donors were released last week by Australia's National Health and Medical Research Council. While highlighting concerns about potential donors and recipients linking over Internet sites to plan a transplant, the report notes that donations by friends are commonly approved and that most transplants occur "within families or other close relationships, with donor and recipient either genetically or emotionally related."
"I think it's quite likely that we now have the kind of friendship that would be viewed by hospitals here as a legitimate relationship," the 22-year-old Falkingham told CanWest News Service in an interview from Sydney.
Falkingham's planned gift to Sabloff was scuttled by the Toronto General Hospital after the man's parents told transplant doctors that he was under pressure to donate because of his membership in the controversial Jesus Christians -- a tiny religious group whose members believe organ donation is the ultimate act of devotion.
The hospital will not divulge its reasons for cancelling the scheduled April 30 surgery because of privacy restrictions, but Sabloff and Falkingham insist he was cleared for the transplant by psychiatric experts and that the operation was scrapped only because hospital officials feared negative publicity over Falkingham's religious views.
Falkingham and Sabloff initially connected through an Internet site linking potential organ donors and recipients, then maintained a regular e-mail correspondence, before he came to Canada in March ahead of the planned surgery.
During the weeks he spent in Toronto waiting for the operation that never happened, Falkingham and Sabloff visited Niagara Falls together and "he spent three months practically living here," Sabloff said in an interview from her home. "Maybe I could go to Australia and maybe they would take that as a friendship."
Falkingham took as a positive sign that the Australian guidelines have expanded to include "non-directed altruistic" donations - anonymously supplied organs or tissues given to recipients according to medical priority, similar to how blood banks work.
But the kind of "directed" donor-to-recipient transplant sought by Falkingham and Sabloff is only permitted between family members or close friends.
"Overseas, the growing use of living donors has given rise to more controversial methods of organ and tissue solicitation, including private advertising, community-based groups soliciting on behalf of individuals and Internet sites that link patients with potential living donors," the Australian guidelines note. "Such arrangements are illegal in this country but can be accessed by Australians."
That prohibition has led Falkingham and Sabloff to consider approaching Australian hospitals - which, despite the new national guidelines, have a patchwork of policies across the country - for permission to undergo a friend-to-friend transplant.
Sabloff - whose father died of kidney disease and whose brother received a kidney transplant - said the Australian option is worth exploring but added that her time to find a functioning kidney is running out.
Money is also a major issue, she said, noting that a privately financed operation outside of Canada could cost more than $200,000.
"I'm down to about seven per cent (function) left in one kidney," Sabloff said. "I don't know if we're going to be able to find a way to do this."
While Australia's medical research council - like health agencies in Canada and elsewhere - is trumpeting the need to increase organ transfers from living donors, the country's new guidelines stipulate the need to "ensure that the autonomy and welfare of the donor takes precedence over the needs of the potential recipient, that both donors and recipients are fully informed about the potential risks, and that conflicts of interest are avoided."