Acouple of B.C. women desperate to find kidney donors for their husbands are among a growing number of people looking online for organs.
Jewel Calibaba of Kamloops, B.C., started a group several months ago on the social networking site Facebook in an effort to find a kidney for her husband, Dale.
And Lois Wilson of Abbotsford, B.C., put an ad on the classifieds site Craigslist, looking for another couple to essentially trade an organ: She would donate a kidney to one of the other couple, if one of them donated a kidney that is a match to her ailing husband, Dave.
The swap method is known as the paired kidney exchange program and has been used in British Columbia for two years. It's also used in Ontario.
"One [appeal]is asking for a kidney to be donated altruistically," or for no other reason than concern for the person, said Ken Donohue of the B.C. Transplant Society.
"The other [appeal]is by being willing to give back by donating to somebody else."
But both Mr. Donohue and a prominent medical ethicist said finding a donor is not as simple as posting an appeal online.
An anonymous donation occurs when a person offers to donate to a stranger.
"But that kidney goes to a person next on the waiting list, as opposed to being directed to somebody," he said.
Neither Mr. Donohue nor medical ethicist Margaret Somerville of Montreal's McGill University have a problem with the swap being proposed by the Wilsons. The method being taken by the Calibabas, however, poses more of a problem.
In Canada, a living donor and the recipient must have a relationship, but there is no way for medical officials to know when a relationship formed or how.
"From an ethical point of view, I think a lot of clinicians would have some issues with somebody making an appeal for a kidney in the sense that, why is the person donating? Are they really altruistic? Is there something untoward? Is there money changing hands?" Mr. Donohue said.
He said that unless the Calibabas' main priority is to increase awareness for the need for organ donors, they are not using the best route.
"If you come forward with a living donor - a friend, co-worker or family member ... doctors can start the assessment process right away," he said. "You need a pre-existing relationship. If it's a stranger, then the red flags go up."
But despite the rule for living donors, should the Facebook effort uncover a person who then becomes a friend, there is no way for officials to know the depth of the friendship.
Prof. Somerville, founding director of the McGill Centre for Medicine, Ethics and Law, said initiatives such as those on Craigslist or Facebook are on the increase.
One big issue is whether it's possible to have a stranger make an altruistic organ donation, she said.
The paired exchange method like the one proposed by the Wilsons is acceptable, Prof. Somerville said, "but it's got to be carefully safeguarded - no sale, no coercion."
Mr. Donohue expects that the paired exchange program will be used in every province and territory before too long.
In Kamloops, Mr. Calibaba said he is still hopeful that the Facebook method will bring a good result.
The waiting list for a cadaver donor is eight to nine years and the page gives him hope.
"I don't have any relatives [to donate]that qualify, so my wife started the group to give me a little bit of hope. I keep reading these words of encouragement on there just to uplift me," Mr. Calibaba said.