This is a very very complicated issue. It's pretty clear to me that there are no steadfast rules determining who will and will not get a transplant, if a matching organ becomes available.

It is quite capricious actually.

I have a friend who smoked her entire life, was in her late 60's, had profound COPD, was diagnosed bipolar in the late 80s, and got a double lung transplant because she had polio as a child.

I have another friend who used cocaine once, had a hypertensive crisis which destroyed his kidneys. Oh yeah, it can and does happen. He's in his 20s, on hemodialysis, and not even considered for a transplant in this state because of drug "abuse". Oh yeah, he's african american and has no insurance.

A sickle cell disease patient deemed "too sick" for a non-ablative bone marrow transplant from a matched unaffected sibling. Also, no insurance.

A heavy drinking minister gets a liver transplant.

Really, its up to the review board and sometimes their decisions can be biased, and sometimes absolutely incomprehensible to most.

A lot of lobbying, back room politics, and monetary considerations get thrown in. I've seen it first hand.

Bottom line? More people need to become organ donors and communicate this wish very clearly and in writing to their families.

A "check" on the driver's license is not a legally binding agreement and ultimately it is still up to the patient's family to allow the organs to be harvested.