[Congressional Record Volume 145, Number 156 (Monday, November 8, 1999)]
[House]
[Pages H11654-H11657]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




RECOGNIZING GENEROUS CONTRIBUTION BY LIVING PERSONS WHO HAVE DONATED A 
                         KIDNEY TO SAVE A LIFE

  Mr. BLILEY. Madam Speaker, I move to suspend the rules and agree to 
the resolution (H. Res. 94) recognizing the generous contribution made 
by each living person who has donated a kidney to save a life.
  The Clerk read as follows:

                               H. Res. 94

       Whereas kidneys are vital organs that clean the blood by 
     removing wastes, and failed kidneys have lost the ability to 
     remove these wastes;
       Whereas in the United States more than 250,000 patients 
     with kidney failure, also known as end stage renal disease 
     (ESRD), have died since 1989;
       Whereas during 1996, 283,932 patients were in treatment for 
     ESRD, and an additional 73,091 patients began treatment for 
     ESRD;
       Whereas the most common cause of ESRD has consistently been 
     diabetes, because the high levels of blood sugar in persons 
     with diabetes cause the kidneys to filter too much blood and 
     leave the kidneys, over time, unable to filter waste 
     products;
       Whereas of the patients who began treatment for ESRD in 
     1996, 43 percent were persons with diabetes;
       Whereas ESRD can be treated with dialysis, which 
     artificially cleans the blood but which imposes significant 
     burdens on quality of life, or with a successful kidney 
     transplant operation, which frees the patient from dialysis 
     and brings about a dramatic improvement in quality of life;
       Whereas in 1996 the number of kidneys transplanted in the 
     United States was 12,238, with 25 percent of the kidneys 
     donated from biologically related living relatives, 5 percent 
     from spousal or other biologically unrelated living persons, 
     and the remainder from cadavers;
       Whereas from 1988 to 1997, the number of patients on the 
     waiting list for a cadaveric

[[Page H11655]]

     kidney transplant increased more than 150 percent, from 
     13,943 to more than 35,000;
       Whereas the annual number of cadaveric kidneys available 
     for transplant has increased only slightly, from 8,327 in 
     1994 to 8,526 in 1996, an increase of less than 100 such 
     kidneys per year;
       Whereas from 1988 to 1997, the annual number of kidneys 
     donated by living persons rose 104 percent, from 1,812 to 
     3,705; and
       Whereas in 1995, the 3-year survival rate for kidney 
     recipients was 82 percent if the donor was a living parent, 
     85 percent if the donor was a living spouse, 81 percent if 
     the donor was a biologically unrelated living person other 
     than a spouse, and 70 percent if the kidney was cadaveric: 
     Now, therefore, be it
       Resolved, That the House of Representatives--
       (1) recognizes the generous contribution made by each 
     living person who has donated a kidney to save a life; and
       (2) acknowledges the advances in medical technology that 
     have enabled living kidney transplantation to become a viable 
     treatment option for an increasing number of patients with 
     end stage renal disease.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Virginia (Mr. Bliley) and the gentlewoman from Colorado (Ms. DeGette) 
each will control 20 minutes.
  The Chair recognizes the gentleman from Virginia (Mr. Bliley).


                             General Leave

  Mr. BLILEY. Madam Speaker, I ask unanimous consent that all Members 
may have 5 legislative days within which to revise and extend their 
remarks on House Resolution 94, and to insert extraneous material.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Virginia?
  There was no objection.
  Mr. BLILEY. Madam Speaker, I yield myself such time as I may consume, 
and I rise in support of H. Res. 94, a resolution recognizing the 
generous contribution made by each living person who has donated a 
kidney to save the life of another person.
  Americans who donate their organs to save another's life are heroes, 
and I am delighted that the House of Representatives has taken the time 
to recognize them as such. From 1998 to 1997, the annual number of 
kidneys donated by living persons rose 104 percent, from 1,812 to 
3,705. Even so, the number of people on dialysis while they wait for a 
kidney transplant has grown to some 35,000. We have to do more.
  The Committee on Commerce has spent a great deal of time and effort 
in the last year working to develop good solutions to the difficult 
problem of increasing the supplies of donated organs while safeguarding 
the system from unintended bureaucratic interference that would 
dramatically harm efforts to increase donations. Many of those ideas 
are embodied in H.R. 2418, the Organ Procurement and Transplant Patient 
Network Amendments of 1999, which was reported out of my committee just 
3 weeks ago.
  Among the initiatives in H.R. 2418 is a program to provide living and 
travel expenses for those individuals who donate an organ to a person 
requiring a transplant in another State. The committee found that there 
may be many willing donors who would like to save the life of another 
American but find themselves in financial circumstances that would make 
it impossible for them to take a leave of absence from their job. H.R. 
2418 would ease that burden.
  I am also proud to say that due to the Committee on Commerce efforts, 
H.R. 3075, the Medicare, Medicaid and S-CHIP Balance Budget Refinement 
Act of 1999, added $200 million to pay for additional immunosuppressive 
drug therapy. Medicare presently only covers these drugs for 36 months. 
This bill takes a first step at addressing that issue and allows us to 
provide more coverage for needy organ transplant patients. Access to 
these drugs can literally make the difference between life and death.
  While we in Congress continue to do what we can to safeguard the 
organ allocation system from bureaucratic interference, and work to 
address financial problems donors face as well as those recipients who 
needs affordable immunosuppressive drug therapy, let us remember the 
role that the thousands of ordinary Americans have played in the lives 
of their neighbors and families who have donated kidneys. We salute you 
for your sacrifice and your charity.
  Madam Speaker, I reserve the balance of my time.
  Ms. DeGETTE. Madam Speaker, I yield myself such time as I may 
consume.
  First of all, I again want to thank my chairman, the esteemed 
gentleman from Virginia, for bringing this bill up, and I also want to 
thank my colleague, the gentleman from Washington (Mr. Nethercutt), for 
the opportunity to recognize those individuals who are willing to make 
a living donation of one of their kidneys. The gentleman from 
Washington and I are cochairs of the Congressional Diabetes Caucus, and 
both of us recognize that for those who care about that particular 
issue, kidney disease and kidney donation is a critical and important 
issue for us to be discussing today.
  Those who donate kidneys are courageous individuals who give 
selflessly of themselves, literally, to save another person's life. 
Last year, more than 4,000 living donors gave kidneys. That was 31 
percent of the transplants. Over a 10-year period, the number of kidney 
donations has increased by 54 percent, from 5,688 in 1988 to 8,774 in 
1997. The increase in the number of living kidney donors has been even 
more dramatic, from 1,812 to 3,695, a doubling of living donors to 
relatives that received this critical gift of life.
  Every year thousands of lives are saved when a family member, a 
friend, a coworker, or even a member of the community they do not know 
makes the choice to donate one of their two kidneys to someone in need. 
With the need for organ transplants far outpacing the supply, we are 
also starting to see a new type of donation, a nondirected donation, 
where an individual makes a choice to donate a kidney to any patient 
who needs it.
  An outstanding example of a nondirected live kidney donation is Joyce 
Roush. In September of this year, she used the donation of her kidney 
to a stranger as an opportunity to bring the public's attention to the 
possibility of making nondirected donations.
  Most of us are also aware of the case where Sean Elliott, of the 
world champion San Antonio Spurs, needed a kidney transplant and 
received one from his older brother Noel Elliott.

                              {time}  1430

  According to Elliott, he would like to return to playing in the NBA 
this year if possible. Elliott said, ``It's another obstacle I have a 
chance to topple.''
  He has also overcome two knee surgeries. ``It would be a pretty 
awesome accomplishment,'' he said, ``and a great statement for anyone 
who faces adversity. It would be inspirational to a lot of people.''
  While that certainly would be a tremendous inspiration to many people 
across the country, the example of his older brother Noel and 
individuals like Joyce Roush should also be an inspiration and an 
example for people across the country.
  Unfortunately, while there has been a substantial increase in organ 
donations over the past decade, almost 350,000 Americans still have 
lost their lives to kidney failure. Moreover, the number of patients on 
the waiting list for a kidney transplant has increased by 174 percent, 
from 13,943 in 1988 to 38,270 in 1997.
  The number of cadaveric kidney transplants is stagnant, so the fact 
that we are seeing this increase in living donors in recent years is 
good news to the many who suffer from kidney failure. We can perform 
more living donor transplants without either putting the donor or 
recipient in undue danger because of medical advances.
  In 1995, a new type of procedure was developed that made a kidney 
transplant a great deal less intrusive and thus reduced the risk to the 
donor and cut down on the amount of recovery time.
  Madam Speaker, as co-chair of the Congressional Diabetes Caucus, the 
gentleman from Washington (Mr. Nethercutt) and I have over 240 Members 
of the House who have signed on as members of this caucus.
  We know that the most common cause of end stage renal disease has 
consistently been diabetes. In fact, 35 percent of the new cases of 
kidney failure every year and 25 percent of all cases of kidney failure 
come from diabetic causes. This is true because of the high levels of 
blood sugar people with diabetes have that cause the kidneys to filter 
too much blood and leave the kidneys over time unable to filter waste 
products.

[[Page H11656]]

  Of those beginning ESRD treatment in 1997, just under half are people 
with diabetes. This is why it is so important every day that relatives, 
friends, and co-workers and members of the community donate kidneys 
both to those that they know and those they do not know.
  I hope we can find ways before we cure diabetes, which is our 
ultimate and, by the way, our short-term goal, still, in the meantime, 
we need to find ways to find these kidneys.
  I want to once again thank the gentleman from Washington (Mr. 
Nethercutt) for the opportunity to recognize these individuals that 
make living donations of a kidney and work with him to make sure that 
we encourage more of this in the future.
  Madam Speaker, I reserve the balance of my time.
  Mr. BLILEY. Madam Speaker, I yield such time as he may consume to the 
gentleman from Washington (Mr. Nethercutt), the principal cosponsor of 
the bill.
  Mr. NETHERCUTT. Madam Speaker, I thank the chairman for his 
generosity in not only yielding me time on this resolution but his 
leadership on the part of the Committee on Commerce in bringing this 
resolution forward today.
  I certainly appreciate the remarks of my colleague the gentlewoman 
from Colorado (Ms. DeGette), who has served very, very strongly as co-
chair of the Diabetes Caucus. We are in this together, the two of us, 
notwithstanding our difference in party affiliation.
  That is the great thing about the Diabetes Caucus, that it looks 
beyond party affiliation and seeks to find a cure for diabetes and, 
thus, help people who have problems with their kidneys.
  So I am very grateful to my colleague from Colorado, who has worked 
so hard and been such a great leader in this issue, along with my 
chairman, certainly, from the Committee on Commerce, and other Members 
of this House.
  I am delighted to rise in support of this resolution, my own, that I 
introduced with other Members that recognizes the generous contribution 
of living kidney donors and acknowledges the advances made in medical 
technology that enable living kidney transplants to be a viable 
treatment option.
  The gentlewoman from Colorado (Ms. DeGette) and the gentleman from 
Virginia (Mr. Bliley) spoke well of the statistical information that is 
out there with regard to the scope of the problem of kidney transplants 
and kidney disease.
  In 1997, 73,000 new patients began treatment for end stage renal 
disease. Of those new patients, nearly half also had diabetes. I have 
had the opportunity to visit my hospitals in the Fifth Congressional 
District of Washington, one of which is Sacred Heart Medical Center. I 
went to the kidney dialysis department and spoke with not only the 
medical people who are serving the public there but those who are 
undergoing kidney dialysis.
  It is not pleasant. It is something that breaks our hearts for the 
people who are stricken with kidney disease. It is so important that we 
encourage people to donate kidneys to people who are living so that 
they can be relieved of their kidney problems. And this is one way to 
do that, that is having living people donate kidneys to those who are 
afflicted.
  In 1996, over 12,000 kidneys were transplanted in the United States. 
About 30 percent of these organs came from living donors. Over the last 
10 years, the number of patients waiting for a kidney transplant has 
almost tripled from 14,000 to over 40,000 people. We know that the 
number of living donors has increased over 100 percent.
  Over the last 10 years, from 1985 to 1994, the 10-year survival rate 
for dialysis patients was just 10 percent. Patients who received a 
cadaveric kidney had a 55 percent survival rate. However, those who 
received a kidney from a living family member had a 75 percent chance 
of living an additional 10 years. If one is that recipient and if one 
is that donor, that is a very significant percentage increase.
  Living kidney donors face the risk and pain associated with major 
surgery and certainly should be commended for their selflessness. 
Without the sacrifice of these brave people who decide to make a 
donation, thousands more would die of kidney failure each year.
  Madam Speaker, when I first introduced this resolution, former 
Senator Jake Garn of Utah called me long distance to express his 
support for the resolution. For, you see, Senator Garn donated a kidney 
to his adult daughter; and she has lived very well over the last few 
years despite having some complications from diabetes and other 
diseases.
  This resolution means something to people out there in the real 
world, people who have donated and who are waiting for a donation. So 
my hat is off to Senator Garn and so many others for the recognition 
they deserve for their commitment to their families and their self 
sacrifice so that other people can live.
  I am one, along with the gentlewoman from Colorado (Ms. DeGette) and 
the gentleman from Virginia (Mr. Bliley), who has been a strong 
supporter of medical research. The advances made in medical technology 
are what makes this life-saving procedure possible.
  As the gentlewoman from Colorado (Ms. DeGette) mentioned, 
laparoscopic nephrectomy is a new technique for obtaining a kidney from 
a living donor that is less invasive and leads to shortened hospital 
stays and recuperation time. Advances in immuno-suppressive drugs have 
increased survival rates for transplant recipients. This is fantastic 
research that is ongoing that is continuing in the NIH through the good 
work of the chairman of the Committee on Commerce and others.
  As we in the Congress and the President work through this final 
detail on the Labor, Health and Human Services bill, an appropriations 
bill, I happen to be a member of that committee, it is encouraging to 
they that we have a mutual commitment to increase funding for 
biomedical research at the National Institutes of Health.
  It is in the national best interests of the country and certainly the 
interests of every Member of this House and the other body and the 
President that we increase medical research but we also focus on the 
absolute sacrifice that is being undertaken every day by selfless 
people who just want to help save a life. So I urge my colleagues to 
support this resolution.
  I thank, again, the chairman of the Committee on Commerce and the 
gentlewoman from Colorado (Ms. DeGette) for their great work in 
pursuing this.
  Ms. DeGETTE. Madam Speaker, I yield myself such time as I may 
consume.
  Madam Speaker, again, I would like to thank them for their leadership 
on this bill.
  Mr. STARK. Madam Speaker, I rise in support of House Resolution 94, 
in recognition of the generous gift made by each living person who has 
donated a kidney to save a life. Of those approximately 63,000 
Americans currently awaiting an organ transplant, almost two-thirds are 
in need of a kidney. Since 1989, more than 250,000 patients with kidney 
failure have died. However, with today's medical advances, living 
kidney transplantation has become a feasible treatment option for 
patients with end stage renal disease. Unfortunately, the number of 
people on the waiting list continues to grow more quickly than the 
number of organ donors.
  Research points to a clear need for incentive programs and public 
education to increase organ donation. To help encourage donations and 
to increase the number of organs available for potential donation, I 
introduced legislation this Congress, H.R. 941, the ``Gift of Life 
Congressional Medal Act of 1999.'' This bill would create a 
commemorative medal that honors organ donors and their families. We 
need to use every possible opportunity to increase the number of 
donated organs. This Act is intended to draw attention to this life-
saving issue, and to send a clear message that donating one's organs is 
a selfless act that should receive the profound respect of our Nation. 
I hope Members would also consider this effort to increase donations.
  In addition to increasing the number of organ donors, it is important 
that we ensure our nation's organ allocation system is fair. 
Unfortunately, the current system relies more on geography than medical 
urgency. As a result, organs are offered first to people in a local, 
regional area and only when there are no local patients available is 
the organ offered to sicker patients on a broader level. This means 
that some of the most deserving of patients will not receive an organ 
solely because of where they live or where they undergo treatment--
which often times is a health plan's decision.

[[Page H11657]]

  In fact, patient outcome data recently released by the Department of 
Health and Human Services (HHS) suggest a patient's chances of 
getting a new heart or liver and surviving at least a year greatly 
varies depending on where the patient goes for a transplant. For 
example, at the University of Kansas Medical Center, 89% of people 
waiting for liver transplants received them within a year in the mid-
1990s, while at the University of Maryland in Baltimore, only 21% of 
patients received livers within a year. Depending on the transplant 
center, a patient's likelihood of dying within a year of listing for a 
liver transplant can range from 7% to 22%. A system that offers a level 
playing field to all patients no matter where they live is in 
everyone's best interest--medical urgency rather than geography should 
be the determining standard.

  Today, as we recognize the generous contribution made by each living 
kidney donor, we here in Congress need to be consistent in our message. 
While we're encouraging people to serve as organ donors, we also have 
Members introducing legislation that would harm organ donations and 
would permit geography to continue to serve as a barrier to organ 
allocation and transplantation.
  For example, the ``Organ Procurement and Transplantation Network 
Amendments of 1999'' (H.R. 2418) would remove HHS' legitimate authority 
to oversee the organ allocation program and would require HHS to 
rewrite its recently revised organ allocation regulations, while it 
simultaneously makes data less available to the public. If enacted, the 
transplant center performance data recently released by HHS would be 
unavailable to the public. This harmful legislation would set different 
allocation policies than recommended by the Institute of Medicine (IoM) 
and is probably unconstitutional in its delegation of power to a 
private contractor.
  Perhaps most disturbing, H.R. 2418 would provide unreasonable 
protections for The United Network for Organ Sharing (UNOS), the 
current private contractor in charge of disturbing organs procured for 
transplant. A recent Forbes magazine article characterized UNOS as 
``the organ king: an outfit with life-and-death power over patients 
waiting for transplants'' which has ``evolved into a heavy-handed 
private fiefdom.'' This bill essentially gives UNOS a monopoly on the 
contract and the Forbes article provides even further evidence of the 
need to oppose legislation which protects this contractor.
  We are also currently facing a 90-day moratorium effort in the Labor-
HHS Appropriations bill and just last Friday, legislation was 
introduced to delay the effective date of the HHS rule. This delay of 
the Secretary's organ allocation rule would keep the Administration 
from implementing the important, new HHS regulations, strongly 
supported by evidence from the IoM, and would lead to hundreds more 
needless deaths. The HHS organ allocation regulation attempts to move 
to a system based on medical necessity instead of geography with 
medical professionals making medical decisions about the best way to 
allocate the limited number of donated organs. The rule incorporates 
comments from the IoM, transplant community, patients, and the general 
public to ensure the neediest patients receive organs first--regardless 
of where they live. Further efforts to delay this rule are only causing 
needless deaths.
  In vetoing the DC-Labor-HHS appropriations bill last week, the 
President called the appropriations rider that would delay the 
implementation of HHS' final Organ Procurement and Transplantation rule 
for 90 days ``a highly objectionable provision.'' As the President 
stated: the HHS rule ``provides a more equitable system of treatment . 
. . its implementation would likely prevent the deaths of hundreds of 
Americans.'' I would hope that the President's strong opposition to the 
Appropriations bill's moratorium on the HHS transplant regulation will 
be honored by Congress.
  Let's increase the number of organ donors, make our organ allocation 
system fair, and bring an end to all the needless deaths. And let's be 
consistent in our message--vote for H. Res. 94 to recognize those who 
so generously give the gift of life. Vote against any effort to remove 
or delay the Secretary's legitimate oversight authority and to give a 
private contractor a monopoly over the nation's organ allocation 
program. And support a fairer allocation system that bases transplant 
decisions on common medical criteria and pure professional medical 
opinion and medical need--not geography.
  Mr. CAPUANO. Madam Speaker, I rise to commend those living persons 
who have given the precious gift of life through the selfless act of 
donating a kidney. Today I join the majority of the Members of Congress 
in supporting H. Res. 94, which recognizes the generous contributions 
of those who have made this sacrifice, and acknowledging the advances 
in medical technology that have made living kidney transplants a viable 
treatment option.
  Madam Speaker, on many occasions this session, Congress has debated 
the costs of health care and health related research. These debates 
would be futile were it not for the courage of the living donors who 
make specialized medical services, such as kidney transplants, 
possible. Today, we have come together not in debate but rather in 
overwhelming support of those individuals that live day to day with 
life threatening kidney ailments as well as the families who support 
these individuals in their time of need. More importantly, we are here 
to pay homage to those ordinary heroes, whose contributions to medical 
science will not be measured by prominent appearances in medical 
journals, but whose actions will be forever recorded in the hearts and 
minds of the individuals to whom they have donated a kidney.
  Madam Speaker, in my district, I know of numerous life-saving acts 
that were unselfishly committed by individuals whose courage was not 
realized until the idea of kidney donation was thrust upon them. With 
this in mind I would like to take this opportunity to acknowledge that 
their actions have not gone unnoticed and to thank these remarkable 
citizens for their contributions to their families and neighbors.
  Ms. DeGETTE. Madam Speaker, I yield back the balance of my time.
  Mr. BLILEY. Madam Speaker, I have no further requests for time, and I 
yield back the balance of my time.
  The SPEAKER pro tempore (Mrs. Biggert). The question is on the motion 
offered by the gentleman from Virginia (Mr. Bliley) that the House 
suspend the rules and agree to the resolution, H. Res. 94.
  The question was taken.
  Mr. BLILEY. Madam Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the 
Chair's prior announcement, further proceedings on this motion will be 
postponed.

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