[Congressional Record (Bound Edition), Volume 153 (2007), Part 13]
[Senate]
[Pages 18208-18209]
[From the U.S. Government Publishing Office, www.gpo.gov]




              CHARLES W. NORWOOD LIVING ORGAN DONATION ACT

  Mr. REID. Mr. President, I ask unanimous consent that the Senate 
proceed to the consideration of Calendar No. 77, H.R. 710.
  The ACTING PRESIDENT pro tempore. The clerk will report the bill by 
title.
  The assistant legislative clerk read as follows:

       A bill (H.R. 710) to amend the National Organ Transplant 
     Act to provide that criminal penalties do not apply to paired 
     donations of human kidneys, and for other purposes.

  There being no objection, the Senate proceeded to consider the bill.
  Mr. LEVIN. Mr. President, this bipartisan substitute is nearly 
identical to S.487, which I introduced along with Senators Bond, 
Dorgan, Graham, Durbin, Mikulski, Pryor, Cardin, Isakson, Coleman, 
Brown, and Chambliss, and which passed the Senate on February 15, 2007. 
Companion legislation was introduced in the House where it was renamed 
in honor of our House colleague, the late Representative Charles 
Norwood, a longtime advocate of organ donation, who sponsored the 
legislation earlier this year along with Representative Jay Inslee.

[[Page 18209]]

  Our legislation, the Living Kidney Organ Donation Clarification Act, 
will save lives by increasing the number of kidneys available for 
transplantation through a process called paired organ donation. It 
addresses this relatively new procedure, which is supported by numerous 
medical organizations, including the United Network for Organ Sharing, 
the American Society of Transplant Surgeons, the American Society of 
Transplantation, the National Kidney Foundation and the American 
Society of Pediatric Nephrology. Paired organ donation, which did not 
exist when the National Organ Transplant Act, NOTA, was enacted more 
than two decades ago, will make it possible for thousands of people who 
wish to donate a kidney to a spouse, family member or friend, but find 
that they are medically incompatible, to still become living kidney 
donors.
  The legislation is necessary because the National Organ Transplant 
Act, NOTA, which contains a prohibition intended by Congress to 
preclude purchasing organs, is unintentionally impeding the 
facilitation of matching incompatible pairs. Our legislation would 
simply add kidney paired donation to the list of other living-related 
donation exemptions that Congress originally placed in NOTA. It removes 
an unintended impediment to kidney paired donations by clarifying 
ambiguous language in section 301 of the National Organ Transplant Act, 
NOTA. That section has been interpreted by a number of transplant 
centers to prohibit such donations. In section 301 of NOTA, Congress 
prohibited the buying and selling of organs. Subsection (a), titled 
``Prohibition of organ purchases,'' says: ``It shall be unlawful for 
any person to knowingly acquire, receive, or otherwise transfer any 
human organ for valuable consideration. . . .'' This legislation does 
not remove or alter any current provision of NOTA, but simply adds a 
line to section 301 which states that paired donations do not violate 
it.
  Congress surely never intended that the living donation arrangements 
that permit kidney paired donation be impeded by NOTA. Our bill simply 
makes that clear. Some transplant professionals involved in these and 
other innovative living kidney donation arrangements have proceeded in 
the reasonable belief that these arrangements do not violate section of 
301 of NOTA, but they contend that they are doing so under a cloud.
  In the process of kidney paired donor transplants, a pair consisting 
of a kidney transplant candidate and a biologically incompatible living 
donor is matched with another such pair to enable two transplants that 
otherwise would not occur. In other words, the intended recipient of 
each donor is incompatible with the intended donor but compatible with 
the other donor in the arrangement.
  No Federal dollars are needed to implement this change. And, for each 
patient who receives a kidney, Medicare will save roughly $220,000 in 
dialysis costs. It is essential that we make the intent of Congress 
explicit so that transplant centers which have hesitated to implement 
incompatible living kidney donation programs can feel free to do so.
  Mr. REID. Mr. President, I ask unanimous consent that the Levin 
amendment at the desk be considered and agreed to, the bill, as 
amended, be read three times, passed, the motion to reconsider be laid 
upon the table, and that any statements relating to the bill be printed 
in the Record, the above occurring with no intervening action or 
debate.
  The ACTING PRESIDENT pro tempore. Without objection, it is so 
ordered.
  The amendment (No. 2025) was agreed to, as follows:

              (Purpose: To provide a complete substitute)

       Strike all after the enacting clause and insert the 
     following:

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Charlie W. Norwood Living 
     Organ Donation Act''.

     SEC. 2. AMENDMENTS TO THE NATIONAL ORGAN TRANSPLANT ACT.

       Section 301 of the National Organ Transplant Act (42 U.S.C. 
     274e) is amended--
       (1) in subsection (a), by adding at the end the following: 
     ``For purposes of this section, human organ paired donation 
     and similar practices, as defined by the Secretary, shall not 
     be considered to involve the transfer of a human organ for 
     valuable consideration.''; and
       (2) in subsection (c), by adding at the end the following:
       ``(4) The term `human organ paired donation' means the 
     donation and receipt of human organs in a circumstance in 
     which each of the following applies:
       ``(A) An individual (referred to in this paragraph as the 
     `first donor') desires to make a living donation of a human 
     organ specifically to a particular patient (referred to in 
     this paragraph as the `first patient'), but such donor is 
     biologically incompatible as a donor for such patient.
       ``(B) A second individual (referred to in this paragraph as 
     the `second donor') desires to make a living donation of a 
     human organ specifically to a second particular patient 
     (referred to in this paragraph as the `second patient'), but 
     such donor is biologically incompatible as a donor for such 
     patient.
       ``(C) Subject to subparagraph (D), the first donor is 
     biologically compatible as a donor of a human donor for the 
     second patient, and the second donor is biologically 
     compatible as a donor of a human organ for the first patient.
       ``(D) If there is any additional donor-patient pair as 
     described in subparagraph (A) or (B), each donor in the group 
     of donor-patient pairs is biologically compatible as a donor 
     of a human organ for a patient in such group.
       ``(E) All donors and patients in the group of donor-patient 
     pairs (whether 2 pairs or more than 2 pairs) enter into a 
     single agreement to donate and receive such human organs, 
     respectively, according to such biological compatibility in 
     the group.
       ``(F) Other than as described in subparagraph (E), no 
     valuable consideration is knowingly acquired, received, or 
     otherwise transferred with respect to the human organs 
     referred to in such subparagraph.''.

     SEC. 3. REPORT.

       Not later than 1 year after the date of enactment of this 
     Act, and annually thereafter, the Secretary of Health and 
     Human Services shall submit to the appropriate committees of 
     Congress a report that details the progress made towards 
     understanding the long-term health effects of living organ 
     donation.

     SEC. 4. NO IMPACT ON SOCIAL SECURITY TRUST FUND.

       Nothing in this Act (or an amendment made by this Act) 
     shall be construed to alter or amend the Social Security Act 
     (42 U.S.C. 301 et seq.) (or any regulation promulgated under 
     that Act).

  The amendment was ordered to be engrossed and the bill to be read a 
third time.
  The bill (H.R. 710), as amended, was read the third time and passed.

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