1253: Organ Donation | Skeptical Sunday

1253: Organ Donation | Skeptical Sunday

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Jordan Harbinger: [00:00:00] Welcome to Skeptical Sunday. I'm your host, Jordan Harbinger. Today I'm here with Skeptical Sunday co-host, writer and researcher Jessica Wynn. And we are not in a bad mood because of tech issues today. Jessica, we are not. No,

Jessica Wynn: I love technology.

Jordan Harbinger: Ah, on The Jordan Harbinger Show, we code the stories, secrets, and skills of the world's most fascinating people and whatever, and turn their wisdom into practical advice you can use to impact your own life and those around you.

Our mission is to help you become a better informed, more critical thinker without throwing my computer through the window during the week, we have long form conversations with a variety of amazing folks, from spies to CEOs, athletes, authors, thinkers, and performers. On Sundays, though it's skeptical Sunday, where a rotating guest, co-host and I break down a topic you may have never thought about and debunk common misconceptions about that topic.

Topics like circumcision, e-commerce scams, diet supplements, ear candling, self-help cults and more. And if you're new to the show or you wanna tell your friends about the show, I suggest our episode starter [00:01:00] packs. These are collections of our favorite episodes on persuasion, negotiation, psychology, disinformation, junk science, crime, and cults and more.

That'll help new listeners get a taste of everything we do here on the show. Just visit Jordan harbinger.com/start or search for us in your Spotify app to get started. Today we're talking about organ donation. It's lifesaving, it's complicated, and occasionally it sounds like an episode of Black Mirror.

And I know what you're thinking. Oh, this is gonna be depressing, but hang on. It is gonna be depressing, but it's also gonna be fascinating, weird, and a little gross. So, you know, perfect podcast material. But here's the bigger question. How far does our responsibility to other people really go? Digging into the science, the myths and the ethics of organ donation is writer and researcher Jessica Wynn.

So set the scene for us, Jess. How many people are waiting for an organ right now? Because basically whenever I hear the number, it's always like a lottery jackpot. It's just a huge number.

Jessica Wynn: It's more than we wanna think. Over a hundred thousand people in the United States [00:02:00] alone are on the transplant waiting list.

Every eight minutes, a new name gets added. In 2024, we did about 50,000 transplants total in the United States. So that's roughly like 130 transplants a day.

Jordan Harbinger: That's actually really impressive. Yeah. How many they do in a day, but yeah, a hundred thousand people on the list and there's 50,000 per year. I don't know how people, how long people can last with a bad organ, but that doesn't seem like,

Jessica Wynn: yeah, 50 50 shot is not, yeah.

Not the best.

Jordan Harbinger: And it might not even work like that, right? 'cause every eight minutes a new name gets added, but like, how often does one get taken off? I don't know. Anyway, that just means a lot of people are still waiting and they might die waiting and, and lists, man, they got a bad rep, Schindler's, Epstein's, organ, whatever.

None of them end well. The lists are always kind of, uh, a downer.

Jessica Wynn: Yeah. Unfortunately, they don't end well. And every day about 13 people waiting for an organ die. Wow. So when you [00:03:00] consider a total of about 8,000 Americans die daily for other reasons, that's tens of thousands of usable organs getting wasted every year.

Jordan Harbinger: Getting wasted. Not in the fun way. Not in the

Jessica Wynn: fun way.

Jordan Harbinger: Yeah. That, oh man. 13 people a day is brutal. Especially if we're not short on organs. They're just. Well, maybe we are, but also we're not getting them where they need to go. Right? If we have the medical skill and we have donors, what is causing the disconnect?

Jessica Wynn: Well, part of it is because only 60% of Americans are registered organ donors. Are you registered?

Jordan Harbinger: Yeah, of course. I kind of thought everyone was, unless you were like 80 years old or super religious in some kind of way. I don't know. We'll talk about that later, but I'm also on the bone marrow transplant list.

Shout out to N mdp.org. Everybody go register. It doesn't hurt to donate this stuff and it can save someone's life,

Jessica Wynn: right? And yeah, please make sure you're registered for everything. Anyone over 18 can register. But honestly, the [00:04:00] bigger issue is more than registration numbers. The shortage is caused by inefficiency in the organ donation system.

So organs often don't get matched in time.

Jordan Harbinger: So is it that people don't wanna donate or is it that we don't have a good system in place?

Jessica Wynn: I mean, it's a little bit of both, but it's more about the system. So most people and most organs are eligible and if you're physically and mentally healthy, you can donate organs like a liver or or a kidney as a living donor.

Jordan Harbinger: Really. Okay. Right. So it's not just after you die though, I feel like, can I get your liver bro is not an easy ask over dinner with the homies.

Jessica Wynn: Yeah, that could be, that could be a little awkward, I guess, but okay.

Jordan Harbinger: Put down that beer. Jordan, I kind of, I have a little favor to ask you.

Jessica Wynn: Pass the potatoes and your kidney.

Jordan Harbinger: That's right. Just one though. Come on, don't be so selfish.

Jessica Wynn: But living donation is safe and donors overwhelmingly recover [00:05:00] well.

Jordan Harbinger: Okay.

Jessica Wynn: Transplant programs like Emory's Living Donor Program, they do full medical evaluations to protect both the donor and the recipient. One living donor can save up to eight lives,

Jordan Harbinger: eight lives, and I don't have to die,

Jessica Wynn: right?

I don't

Jordan Harbinger: know. Would, would you do it, Jess?

Jessica Wynn: I mean, I've never been approached. I like to think I would, but

Jordan Harbinger: you may have disqualified yourself. I

Jessica Wynn: may, I don't know if my, and definitely nobody wants my liver, but I, I don't know. I mean, you know, maybe I have some good parts. I hope I do. But you know, let's be honest, it's a big decision and there's all kinds of consequences that, you know, you might not think about.

There's a famous case from 2012. Where a woman donated a kidney to save her boss's life. Aw. They went through it?

Jordan Harbinger: Yeah.

Jessica Wynn: The boss recovered no problems. The boss went back to work. She had all these complications. She tried to return to work. She used up all her sick days. [00:06:00] Long story short, she was fired by that boss for performative issues during her struggle to recover.

Jordan Harbinger: Wow. Wait, that's one of those like, please tell me there's more to the story. And so they were like, we appreciate your organ, but we still have to let you go. Tell me she won the subsequent lawsuit.

Jessica Wynn: Oh. Oh she sued. But the case was settled out of court confidentially. So I'm not sure how it all shook out a million dollars and

Jordan Harbinger: giving my kidney back, bitch, give it

Jessica Wynn: back.

Jordan Harbinger: I don't think so. Wow. Do corporations have policies for this in place? 'cause it seems like it should be kind of illegal to fire somebody who donates an organ and is like, I'm trying to save the life of a child. They're like, you know what though? We kind of needed you here on Monday, so bye-bye. That's not cool.

Yeah, so

Jessica Wynn: you Luckily I didn't find any other outrageous cases like that, but Okay. I did look into policies and it depends on the state you're in and your employer. So some states guarantee [00:07:00] 30 days of paid leave, which seems short, right? Yeah. If you're on either side of an organ donation, others just follow, there's a federal FMLA rule.

The best companies will offer job protection and continued benefits and insurance for donors.

Jordan Harbinger: So recovery times are set by hr. Mm-hmm. That might be a great question to ask at a job interview to gauge a company's ethics. What's your organ donor policy? And they're just, you can just see on the other end of the zoom call, they're just furiously flipping through a manual.

Like, do we have an organ donor policy? What? Yeah. Um, that's a case by case thing. Um, yeah, that's what they're gonna say.

Jessica Wynn: Exactly. I mean, if you get fired for altruism, that's not really an option for most people.

Jordan Harbinger: No, no. And I'm thinking like, okay, I run this show. Can I do it while I'm sort of recovering from a liver donation?

I don't know. I

Jessica Wynn: mean, you wouldn't know till you did it, right?

Jordan Harbinger: Yeah. I don't know if I want to test those waters. Okay, so what can we actually donate when we're [00:08:00] gone and while we're here? I obviously can't donate my heart and valves and stuff while I'm still alive,

Jessica Wynn: right? We can donate a lot more than you might think.

So your heart, your kidneys, lungs, pancreas, liver, intestines. When

Jordan Harbinger: I'm dead, obviously. Yeah. When you're

Jessica Wynn: dead. Not all of them. I mean the heart for sure, but it's more than organs too. So after you die, you can donate your corneas while you're alive. You can donate skin, tendons, bone nerves, heart valves. The list is really long.

Donated tissue alone can improve the lives of up to 75 people. And it's just wild. What we can donate while we're alive. Like living donations include a portion of your liver. You can donate a portion of your intestines, pancreas. One of your kidneys, even one of your lungs.

Jordan Harbinger: I can donate skin while I'm alive.

Jessica Wynn: Yeah. I think that came from, you know, grafting originally. It sort of

Jordan Harbinger: sure grew

Jessica Wynn: from that.

Jordan Harbinger: I guess if you really need skin. 'cause I'm [00:09:00] thinking like what poor soul is like, oh thanks for your hairy back skin. But I guess if you were like, don't,

Jessica Wynn: if you're a burn victim, you'll take it. Don't don't have a face.

Yeah. You'll

Jordan Harbinger: take it. Or it's like going on your back and you're, why do you have all these weird different patches of hair? Three skin donors. Sorry, it was a bad burn. I'm so curious how that works. That's cra I almost feel like I sh I wonder if you can get them tattooed. Oh yeah, you might. Again, you might have disqualified yourself like, Hey, do you want the one with the Pentagon?

Or do you want like the heart that says Mom on your neck? Oh my gosh. On your face. Also a lung, you can donate a lung while alive. That makes my chest hurt. I'd give my lung to a stranger because if I knew the recipient and had to see them, I think it would take my breath away

and, uh, take my breath away. So, uh, that might be the dumbest joke I'll make this year. So cheesy. Yeah. So who runs, who actually runs this system? Who decides where donated organs go?

Jessica Wynn: So in the United States, it's a network of groups working together. [00:10:00] Back in 1984, Congress passed the National Organ Transplant Act, which created this national system for transplants, and the main player is called the Health Resources and Services Administration.

They oversee the Organ Procurement and transplantation network, basically the hub that connects all the transplant hospitals

Jordan Harbinger: and is it up to each transplant hospital to monitor who needs organs.

Jessica Wynn: So no. So. The United Network for Organ Sharing works under contract with the Health Resources and Services Administration to manage the national waiting list and the distribution of donated organs through the Organ Procurement and Transplantation network.

And then the CMS and the CDC provide additional oversight.

Jordan Harbinger: So basically we have a government nesting doll of bureaucracy.

Jessica Wynn: Yeah. And, and it's complicated and that's what creates a lot of [00:11:00] systemic inefficiencies.

Jordan Harbinger: Too many surgeons in the operating room, I think. Pretty much.

Jessica Wynn: Yeah.

Jordan Harbinger: How do they all come together to get donations to people in need?

You know, how do they, well actually, how do they match people in the first place?

Jessica Wynn: So your blood type and immune system are key to organ matching. The organ size, urgency, and location are the other main factors. So, okay. It's not like a first come, first served fixed list that you're on. There's a lot of variables.

So. The idea of people moving up the list, that's a pretty common myth,

Jordan Harbinger: huh? I guess I never really thought too much about this. I did assume it was first come, first serve. You know, you move ahead when somebody else gets their thing. So could you and I theoretically be a match unlikely with all your rare redhead jeans and stuff?

That's right. Just theoretically.

Jessica Wynn: Maybe we could, I mean, we would first look at our blood type, you know, if you're a type O, that means you're a universal donor. And then AB is the universal recipient. And let's be real. If it was you and I, [00:12:00] I'd probably be taking something from you.

Jordan Harbinger: Okay. Yeah. Maybe depends.

I don't know. You're, you're falling apart over here. So say our blood types match, then what?

Jessica Wynn: Then there's the immune system matching and that is really tricky. So this is to decrease the chance of rejection and there's tests like the HLA antibody screening and donor recipient serum cross matching. They get done to measure compatibility of the donors and recipients immune systems to see how they'll react to a donated organ.

Speaker 3: Hmm.

Jessica Wynn: So even that's not perfect. Even after testing and transplantation, you may need to take anti-rejection medications.

Jordan Harbinger: Is there an age cap? 'cause like, I don't want a 90-year-old lung man.

Jessica Wynn: True. But there might be a very healthy 90-year-old lung. You don't know. And, and if you need one, you're not gonna ask how old it is, but that's

Jordan Harbinger: probably true.

Yeah. But it's

Jessica Wynn: the health that matters. Not age. And the size matters too.

Jordan Harbinger: I knew [00:13:00] it.

Jessica Wynn: Size of the organ.

Jordan Harbinger: Yeah, that's what I meant. Oh, no,

Jessica Wynn: no, no. I mean, okay, so I can't get around it. The organ has to fit the recipient's body

Jordan Harbinger: uhhuh.

Jessica Wynn: So donors and recipients must have a compatible height and weight.

Jordan Harbinger: Got it.

Jessica Wynn: As an organ that is like too large or too small, that would cause a lot of complications.

So what doesn't matter to get you an available organ is race, sex, religion, citizenship, or celebrity status.

Jordan Harbinger: Yeah, but I al, you know what, if you get a gay heart, will you become a better dancer?

Jessica Wynn: God, that's as far as I know. That's untested.

Jordan Harbinger: All right.

Jessica Wynn: But I will say with the celebrity status, it was just in the news, Selena Gomez has had a living donation.

Someone donated a kidney to her.

Speaker 3: Wow.

Jessica Wynn: But now they're dragging her because she didn't invite the donor to her wedding. It's like, but like what do you owe people? She doesn't

Jordan Harbinger: know who it is probably. Right,

Jessica Wynn: exactly. But I think the donor, you know, is probably looking for some her [00:14:00] own fame and made that known, which is so bizarre.

Jordan Harbinger: That's very odd because you tell me. But aren't there crazy strict confidentiality laws? Like I think you can't know whose organ you have and you can't know. Who's getting your organ, because that opens up shenanigans where it's like you can end up basically somebody could try to buy it from you.

Jessica Wynn: Well, correct.

Yeah. That slides into the black market. But if your family's gonna donate you, some people do know. I mean, I think again, that's, that's case by case. It's, if you're on the list, you don't know.

Jordan Harbinger: I see. But

Jessica Wynn: if it's, oh my gosh, Jordan needs a kidney, I'm giving it to him, then we would go through the test and make it known that I was giving it to you.

So it, it really depends how you do it, if it's from the list or not. And I guess when Selena Gomez needed a kidney, I don't know the exact story, but I would imagine everybody wanted, all her fans wanted to help her, you know? So yeah, it's just strange. But you know, it's also the medical urgency that [00:15:00] matters when you're on the list.

So a patient's severity of illness is a critical factor. Particularly for organs like the heart and lungs. So waiting time also matters. Like the time a patient has spent on the waiting list is a factor, but it's not the only one. Pediatric status is another factor. So children are prioritized, but they have to receive child sized organs.

Jordan Harbinger: But some of this I find hard to believe, like you're telling me Oprah's not cutting the line. Come on.

Jessica Wynn: Not in the US system. It, it really doesn't work that way. And that would be so much harder to line up than you think. The physical distance between the organ and the recipient, that's a big factor. So Oprah would have to be ambulance chasing, but only of people with her blood type and body type and compatible immune system.

You know, that's not easy to throw money at. Then there are a lot of misconceptions just about how it all works. So don't get me wrong, even though the system doesn't [00:16:00] consider race or wealth, people with better insurance who live near bigger hospitals, they do have an advantage. So it's not bias in the code, it's bias in the system, you know?

Jordan Harbinger: I see. So basically, it depends on who dies near me and how alike we are. That still doesn't seem fair because it's just left up to chance. But I, I mean, you can't really fault anyone for that, I guess. I

Jessica Wynn: know, but that's pretty much how it works, you know? And of course, unequal access is baked in. It's not perfect.

The organ donation system can fail low income individuals, but it's because of health insurance inequality. Racial inequalities existed at every stage from being added to a waiting list to finding a match. But studies show some of this is because there's more distrust in the healthcare system in some of those communities.

So. Wealthy insured or well connected patients can receive preferential treatment because they have the [00:17:00] access. So with access to care, sometimes denied based on non-medical factors like your financial status or criminal history. Wow. What do you mean? Well, people who have lower socioeconomic status, they have lower referral rates and are less likely to give consent to participate in the donation process.

And the poorer a person is the more challenging it is to cover the cost of transplant evaluation, post-transplant care, and insurance related copayments and medications.

Jordan Harbinger: Okay. So when an organ becomes available and is matched, what actually happens? Who gets it? Walk me through how the system matches an organ to somebody.

Jessica Wynn: Okay, so the United Network for Organ Sharing runs a national computer system that evaluates match runs. It generates a ranked list based on urgency, meaning who's the sickest or closest to death. Then they consider the size, the blood type, and the [00:18:00] geography. So transplant centers have about an hour to accept or decline the organ.

It's really high stakes.

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Jordan Harbinger: Don't forget about our newsletter Wee bit wiser. It delivers pretty much every Wednesday and it is a great companion to the show. Something practical, something you can apply right out of the box. You love reading this, I know because many of you hit reply and that reaches me directly.

Go ahead and go to Jordan harbinger.com/news. That's where you can find it. I would love to hear from you and I would love to know what you think of the newsletter. Alright, now back to Skeptical Sunday. So I'm imagining somebody at every hospital is sitting there and their full-time [00:21:00] 24 7 job like this.

This desk is just staffed with somebody who. This thing comes in and a little alarm goes off and they're like, Bing. And they look at the patient record and they maybe confirm with the doctors or the ICU nurses and they're like, is this guy ready? And they're like, hit the, this is, I would, I would be so curious to see how this works.

'cause if you've got an hour that you have a lot to arrange in an hour to prep a patient for surgery, flying organ in on like a helicopter or something, it

Jessica Wynn: sounds so stressful.

Jordan Harbinger: And also like, is the doctor that does this currently in the hospital scrubbed up and cleaned? Because like, if not, call that guy right now.

Right. And like police escort to the hospital.

Jessica Wynn: Exactly. And, and if you're the patient, sometimes your. You would've been in a condition yesterday to receive a donation, but maybe not today. I mean, it's, there's just so much to think about in that hour.

Jordan Harbinger: Geez, this is like the, the most stressful tinder kinda, why would a hospital swipe left on an organ, for example?

Does that ever happen?

Jessica Wynn: Yeah, it does for sure. I mean, and it's for all the [00:22:00] matching reasons we spoke about. So the transplant center can say, this organ isn't healthy enough for this patient. It's too risky, or the organ's not the right size, or it has unacceptable antigens for this particular patient. So it's based on their patient's current medical status, the organs condition, and then logistics.

So if the transplant center's medical team declines the organ for any of those reasons, it's then offered to the next candidate on the ranked list. And this process continues until a transplant center accepts the organ or the list. It's exhausted. Sometimes they just can't find a recipient and the organ is given for research if authorized by the family, or it's simply just not recovered at all.

So the system is designed to be ethical and impartial. A lot of times the problem isn't the matching the problem is getting the organ to the patient in time.

Jordan Harbinger: How long can an organ last once it's outta the [00:23:00] body?

Jessica Wynn: I mean, that depends. So kidneys can survive up to 36 hours on ice.

Jordan Harbinger: Wow.

Jessica Wynn: Yeah. Hearts and lungs only last about four to six hours.

They do make these pump machines that can stretch that. So a liver on ice might last six to 10 hours, but on a pump it'll last 24 hours. And transport really matters. According to estimates, 3% of wasted organs were the result of transportation issues. So the distance between the donor and the recipient hospital is a crucial consideration.

You can't throw an organ on a Greyhound bus and just like hope for the best, you know?

Jordan Harbinger: Yeah, that would suck. I mean, I get frustrated waiting for Amazon, but they're, at least they're not shipping my liver right. It's actually quite amazing that organs can last really any significant amount of time outside the body.

Jessica Wynn: I know it's wild and transport works differently in every country, but the necessity led specifically in Italy. It led the Italian [00:24:00] police to transport organs like an action movie. So to save crucial time during a transplant, Italian police use this specially equipped Lamborghini to deliver donated organs.

Jordan Harbinger: Wow. The

Jessica Wynn: car can speed the organ to its destination much faster than traditional transport, which is. Especially important for organs with a short preservation time. Like, like hearts.

Jordan Harbinger: There's so many. I wanna see this in action, right? And I'm imagining some Italian guy with like a special painted police, whatever, Lamborghini with a refrigerated trunk with a kidney in it, going 180 miles an hour down curvy mountain roads, stopping for an espresso, and then going and a cigarette, and then continuing.

Back on the road to deliver this somewhere in Italy.

Jessica Wynn: How do you get that job? Is it like retired race car drivers? I don't know. I don't know.

Jordan Harbinger: It probably is like cops and or medical personnel who like, it's gotta be one of the most coveted positions. [00:25:00] Right. You get to drive with reckless, abandoned actually like all Italians on, but, but you won't get in trouble for it.

In fact, you get paid to do it. They

Jessica Wynn: did not get pulled over. Yeah, that's right.

Jordan Harbinger: Yeah. You literally, if the police try to pull you over, you're just like, Hey, there's police behind me. Call 'em off.

Jessica Wynn: Yeah. I think they would more likely just give you an escort because the, if they can

Jordan Harbinger: keep up

Jessica Wynn: Yeah. If you look up the car, it's very obvious.

It's a, a special Lamborghini.

Jordan Harbinger: Yeah. I kind of wanna see that. So this stuff's not taught in med school. I'm guessing it's this is like fast and furious ICU drift.

Jessica Wynn: Right, right. It helps that solid organs. Don't need nerve reconnection. That's why ah, those organs can last so long,

Jordan Harbinger: so, okay. I don't know much about, uh, clearly I dunno much about the body, but I assume that just means the nerves grow back on their own somehow.

That's actually incredible.

Jessica Wynn: It really is. And that, yeah, that's how it works. They don't have to attach each little nerve, so rejection still happens if the immune system attacks the organ and then the organ is damaged beyond use. [00:26:00]

Jordan Harbinger: Right. So the body kind of ghosts the donate, it sees it as an outside thing that doesn't belong there and then.

Jessica Wynn: Right. And that's what all the testing is for, for the compatibility to, to just make sure as best they can. That that won't happen. But it, it still does though. I see. And organs are different from other transplants involving limbs, that's where nerve connection is vital for function. So those Sure.

Transplants are more complicated.

Jordan Harbinger: Yeah. I would imagine it's kind of pointless to have an arm or a hand if you, if it's just limp and sitting there. Right. Exactly. Yeah. Wow. I have so many questions. First, if I'm an organ donor. This is probably really dumb, but some people think this, I guarantee you our doctor's gonna not try as hard to save me.

It's like, oh, he is dying. Ah, he is an organ donor.

Jessica Wynn: So many people think that there's a whole George Carlin bit about it. Yeah.

Jordan Harbinger: And then play some of the bit if you decide to,

Jessica Wynn: okay. I mean, it's just completely false. Doctors fight just as hard for every [00:27:00] patient.

Speaker 3: Sure.

Jessica Wynn: An organ donation is only considered after every lifesaving option has failed.

I mean, a fun fact is the hospital is typically not even aware of the patient's registry status. The info's typically pulled by an organ procurement organization and provided to the hospital after death. So the organ procurement organizations have access to the state and national registry. The doctors do not.

Jordan Harbinger: Right. I wanna believe that's how doctors think. I don't think, it just, it seems a little too farfetched to me that a doctor would, to let someone die to get their organs. That's too, I

Jessica Wynn: know. And I pessimistic. I mean, you have to have some faith in humanity and the Hippocratic Oath here, but doctors aren't villains.

Doctors don't get bonuses for organs. No one is letting you die to grab your kidney. It just doesn't make any sense.

Jordan Harbinger: Right. Okay. So for donors, people who are selfless enough to offer themselves after they die, how does it affect their families? I'm [00:28:00] hoping there's no cost to the people I leave behind.

'cause I've heard, again, from the same like anti organ donation dummies online. Oh my. Your family has to pay for the organ donation, which makes no sense to me whatsoever.

Jessica Wynn: Yeah, that's not true. That's another weird myth. I'm not sure where it stems from, but No, it's free. No bills, no charges. If you register to be an organ donor.

There are absolutely no charges to your family or your estate.

Jordan Harbinger: You know, it's funny. I know a guy who, this guy used to run this app called Burner. I don't know if he still does, but. He was like a really smart guy and I think he used to work at Yahoo and he was so anti organ donation. He's like, yo, it's all a racket and the hospitals make money.

And the doctors, it was like the dumbest, A lot of smart people think really dumb things, especially about topics like this. I don't really get it.

Jessica Wynn: And then they hear it from somebody they trust who's really, they think is really smart. And yeah, it just,

Jordan Harbinger: exactly.

Jessica Wynn: I know a lot of people think that it's unfortunate.

Jordan Harbinger: Okay, so there's no charges to your family or your estate if you die and donate a [00:29:00] bunch of your organs, finally something in healthcare that's free. Yeah. All right. So my appendix costs $20,000 to take out, but my kidney is just free to give away. Yeah. That, yeah, that makes sense. That's how it works. What about age?

I joked earlier about the 90-year-old lung, but are are elderly people donating? I mean, it seems like that's a lot of the people who die are, you know, old.

Jessica Wynn: Yeah. Right. I mean, people of all ages can donate and it's the health of the organ that matters, not your age. So anyone at any age can donate. You have to be 18 to register.

But donations get worked out at all ages. So people, unfortunately of all ages are waiting for transplants. And people from senior citizens and to newborns have been organ donors. Many states allow people under 18 to register as organ donors on. It's sort of a gonna need on what's needed, but their families will make the [00:30:00] final decision if they pass away before turning 18.

But most donors are over 60.

Jordan Harbinger: Grandma could save your butt. Literally. Is it painful for the donor? I mean, that's probably a dumb question 'cause I guess a lot of the time you're dead. But I'm obviously talking about living donors.

Jessica Wynn: I mean, of course, you know, it's not risk free. It is surgery, but for living donors, the process is carefully managed.

You know, risks are minimal in addition to organs. You can donate blood. I mean, I think most of us have done that. That's not painful. Unless you're scared of needles, you can donate platelets. You're a bone marrow donor, you can donate veins I mentioned before, corneas and skin and tissue. And thanks to advances in medicine and technology, the list of what we can donate continues to grow.

So most recently, faces and hands have been approved for transplants.

Jordan Harbinger: Wait, faces? I've heard about Hands but Faces. This is a [00:31:00] John Travolta Nick Cage movie. Except Worse, which is a really, that's, you know, maybe not worse. No, nothing's really gonna be worse than a John Travolta Nick Cage movie, but, okay.

Face donation, right? Tell me, right.

Jessica Wynn: Isn't plastic surgery it, it's, it's getting it from someone else. So, damn. In 2012, a man in Virginia received what was then the most extensive full face transplant ever. So he survived losing his lips and nose from a gunshot. In 1997, he got a new jawbone teeth tongue.

Facial tissue and he got it all done in 1 36 hour surgery. Completely new face.

Jordan Harbinger: That is crazy. What is freakier? Waking up with somebody else's face or knowing that your face is walking around on a stranger. It's crazy. Dang. Okay, so that was successful.

Jessica Wynn: It was. And within a week of his transplant, this 37-year-old guy who'd been wearing a mask since his [00:32:00] accident, he could perform activities such as shaving and brushing his teeth.

He recovered quicker than they expected. And you know, basically they just restored the entire facial function and form.

Jordan Harbinger: There's a joke in here somewhere because shaving is such a pain in the ass. Right? Right. He's like, oh. It's like, I have

Jessica Wynn: to do that again. Congrats.

Jordan Harbinger: Do you have a face? And it's like, uh, but you kind of need to shave.

And you're like, oh, you couldn't figure that out, eh, whose hair is this? Gave me this.

Jessica Wynn: Yeah. I don't, yeah. Like,

Jordan Harbinger: ugh. When I check the donor box, I'm saying it's cool to give my face away. Wow. That is just, that's crazy. Can I pick and choose what I'm willing to donate? I'll give it all away when I'm dead. But I think some people get freaked out.

They don't wanna donate.

Jessica Wynn: Oh yeah. I've heard somebody say, um, they don't wanna donate their eyes because they don't want somebody looking at stuff they don't wanna see. Oh God. And it's like, not how it works.

Jordan Harbinger: That's one of the dumbest things I've ever heard in my life, but Okay. But

Jessica Wynn: yes, you can pick and choose.

So each state has a registry and you can go online and pick whatever organs you'll be willing to part [00:33:00] with. So you can specify if you want it to be for transplants or only medical research or education. So,

Jordan Harbinger: okay. Yeah. I wanna leave a note to the person who gets my face that says, you're welcome, you handsome devil.

Jessica Wynn: I wanna be one of those Body Worlds exhibit just, yeah. Standing there. Horrifying people, but scaring children. Right. The middle school field trip or whatever. But what's an interesting debate about organ donation is. Opt in or opt out. So here in the US we opt in, right? You have to actively register to be an organ donor.

But many countries have an opt out system, meaning you're a donor unless you officially say otherwise.

Jordan Harbinger: This is such a weird thing 'cause it seems like with a stroke of a pen, you could basically solve the whole, Hey, we don't have enough organs problem. Right? Because I'm gonna go ahead and guess that the majority of people die never having thought about this for one solitary second.

Mm-hmm Especially the [00:34:00] people who don't die of old age natural causes. You know, if you're just out driving and you get in a car crash, it's like, I was gonna opt in, I don't know, later or something. It's just like, right. Why is it an opt-in system? Makes no sense. It, it's gotta have something to do with our sort of puritanical freedom background.

I don't know, I'm, I'd be curious about that. So in other countries, the government assumes ownership and unless you file the right paperwork saying you don't want your organs to get donated, that is a huge ethical debate. Is that overreach or not? I don't know. And what about family members? Can they override your choice somehow?

Jessica Wynn: Legally? No. If you are over 18 and registered, that's legally binding upon death. But even here, families sometimes complicate things. So some organ procurement organizations will still ask families for consent. That can sometimes override the donor's wishes, but that doesn't really happen that often. If there is opposition, then that's taken on a case by case basis.

So you [00:35:00] should talk about it. You should let your family know if you're registered to avoid any hospital drama.

Jordan Harbinger: I'm still trying to convince my parents 'cause they're just kinda like, nah. But it's like, uh, do you have a reason or you just didn't fill out the paper because you don't quote unquote have time, even though you watch seven hours of TV every day.

Alright, so you, you said there's no cost, but what about compensation? There's probably a lot going on here, but should donors or their families be compensated? Are there funds for this kind of thing? Do they incentivize it at all? I

Jessica Wynn: mean, this is just another ethical minefield. So on the one hand, pun intended.

Jordan Harbinger: Mm-hmm.

Jessica Wynn: Paying for organs could lead to exploitation, but some argue compensation might reduce black markets because if donors were legally compensated for donating organs, it would increase the legitimate supply and reduce the demand that fuels all the illegal organ trafficking. Philosophers debate this all the time.

Are we morally obligated to give until it [00:36:00] hurts, or is donation an act of choice? Not duty

Jordan Harbinger: give until it hurts. Not a great slogan for our organ. That might be why only 60% of Americans have opted in. Why do you think most people hesitate to register? To me, I bet it's just laziness and like, not having thought about it.

Jessica Wynn: It's a freaky thing to think about, you know? But I, I think it's a lot of things. It's, it's natural to think organ donation is weird. It is weird. It's amazing. We can even do it. And it's an uncomfortable thing to think about. There's fear, there's mistrust, there's all these medical myths. But successful transplants have been happening since 1954 when a liver was transplanted in Boston.

It's not a thing that can be normalized though, and I just don't think people realize how many lives they can actually save by checking that box, you know?

Jordan Harbinger: Yeah. It's just such a profound question of do we owe each other anything, or is it just a noble choice? I think in a [00:37:00] lot of traditions, religion, or whatever has made the choice for people.

Right.

Jessica Wynn: Actually, most major religions support organ donation. Oh, wow. Yeah. Of course, there's some communities that hesitate or there's specific cultural and spiritual beliefs that might play a role, but the majority of belief systems, but all the main organized religions, they all support organ donation.

Jordan Harbinger: I remember a teacher in middle school and she claimed to refuse on religious grounds.

And we were like, Hey, I want some clarity on this. I remember this is like seventh grade and 2020 hindsight. She was just a selfish coward. 'cause her main issues were not like, well in my tradition it was like, it's weird, it's icky. I don't want somebody to take out my eyes. Right. And I was like, you're dead.

You're not gonna need 'em, dude. No,

Jessica Wynn: but

Jordan Harbinger: we don't Yeah.

Jessica Wynn: Ever like to think about ourselves as dead, but

Jordan Harbinger: like how precious are you about your dead rotting carcass for God's sake. And malpractice fears don't help people hear, you know, horror stories like organs removed before death from people who didn't [00:38:00] consent or they amputate the wrong leg and you're like, no, they took all my kidneys.

I mean, that's what sticks in people's minds, right?

Jessica Wynn: Yeah, it's true. I mean, and the sad part is there have been these terrible cases and the exploitation's a real issue, you know, in poorer regions. People can be pressured to sell onto the black market, and that leads to serious health and mental health consequences.

Even medical staff and funeral homes can get caught up in the pressure. There's inequities in access and wealth that can affect outcomes, but within the legitimate system here, donation is safe and it's fair and it's vital, so you just have to do it the right way.

Jordan Harbinger: But just to be clear, there are organizations that pay for organs.

Is that right or no?

Jessica Wynn: No, no. Not legally. Okay. US federal law bans payments for organs. So if someone offers money, that's the black market.

Jordan Harbinger: Yeah. Actually we, I covered this a long time [00:39:00] ago with a human rights lawyer, episode 497, on illegal organ traffic that that was mostly focused on China, I think. I mean, it's been a long time, but that was kind of a, there was a whole thing with China doing it.

And there was like a China memo that this guy wrote. Anyway, yeah, there's a lot of that going. I know there was. I don't know if it still happens. I'm gonna guess it does.

Jessica Wynn: Yeah. And they're the stories that stick with people and scare people. So yes, it's dangerous,

Jordan Harbinger: right?

Jessica Wynn: Getting paid for organs is illegal and it's nothing like how the real system works.

Legitimate organ donation is not shady. So give it up you guys.

Jordan Harbinger: Yeah. I don't want a rogue surgeon at a Motel six swapping my liver for a few thousand bucks.

Jessica Wynn: That's understandable. But

Jordan Harbinger: yes.

Jessica Wynn: You know, speaking of the liver, let, let's talk about how absolutely incredible our livers are. You can donate up to two thirds of your liver and both pieces.

The part donated and what's left of yours will regrow to full size in about [00:40:00] six weeks.

Jordan Harbinger: All right, let me, let me counter, why don't I donate one third, which is what I would've been keeping. And then you regrow my liver to full size in about six weeks. Why am I the donator stuck, I guess. 'cause I'm the healthy one, but wow.

It's like salamander parts. That is crazy,

Jessica Wynn: right? I know. It's more like a starfish actually. So the regenerative ability makes the liver the longest lasting transplanted organ. Sometimes it even outlives the recipient. And a deceased donor's liver can be split in two and save two lives.

Jordan Harbinger: I wonder if there's ever been a person who gets a liver transplant lives of it for a while, dies.

They take that out, split it into two, give it to two more people. Like I can

Jessica Wynn: tell you No, no, no. They, you can't, it's not a thing. That's not a thing. I mean, if some, if a organ's. Used and connects with a different human, it's not gonna work a second time, so Oh, really? Yeah. And if it's same if it's rejected.

If, if you get a transplant, your body re Well then it's damaged. Yeah. Then it's damaged,

Jordan Harbinger: [00:41:00] right?

Jessica Wynn: Yeah. Yeah.

Jordan Harbinger: I guess maybe it goes through hell and back being put into a new human and then it actually kicking up and restarting. Yeah, I was

Jessica Wynn: curious about that. But it's, they whether, I mean, I don't think it would work, but they definitely don't do that.

Jordan Harbinger: Man, that's still amazing. But I, I am guessing not every organ does this. Right. That's a unique to the liver kind of deal. Correct.

Jessica Wynn: Yeah. No other organ regenerates. A deceased donor kidney, for example, lasts about 10 years, so a living donation can last about 15 to 20. And here's something really odd. This means a person might receive several kidneys in their lifetime.

And surgeons don't remove the old ones, they just stack the new ones on top.

Jordan Harbinger: Wait, so people are walking around with extra kidneys on each side, so somebody could have like three or four kidneys?

Jessica Wynn: Yeah. The kidneys only removed if it causes problems and doesn't seem to cause problems that often. So yeah, some people have three, even four kidneys.

Jordan Harbinger: That does kind of make sense. Why take one out [00:42:00] if it's operating at 30% capacity? Mm-hmm. You might need that, right? Jeez. Imagine the TSA guy looking at the x-ray, like, sir, uh, you appear to be smuggling kidneys inside your body. That's just gotta look so weird. Try and explain that. Yeah.

Jessica Wynn: I'm so vain. I'm like, how, how much would that add to my body weight?

Jordan Harbinger: Yeah. No, that's funny. That's that's funny. Like, oh, are my pants still gonna fit if I have an extra kidney on each side

Jessica Wynn: pass? There's also a cool thing called domino chains, and that's built on an altruistic donation. Which triggers a whole series of matches. So the concept was pioneered at Johns Hopkins and it takes a group of incompatible donor recipient pairs and links them with other pairs in a similar situation.

So like if you needed a kidney and no one you knew was a match, you're basically put on the waiting list for a match to pop up. But this domino chain connects all the willing donors to people in need. [00:43:00] So I might not be a match for you, but I might match with someone on the east coast and their incompatible loved one matches with you.

So it's this little swap going on. I mean, it's astounding how many lives can be touched by this selflessness. And the longest donation chain was in 2012 when 60 people were matched, and it resulted in 30 new kidneys.

Jordan Harbinger: Wow. That is the most complicated chain letter, but it's weird. It's, that's the

Jessica Wynn: kind

Jordan Harbinger: of chain reaction we like around here.

Yeah.

Jessica Wynn: It's happened several times. There was a six person kidney swap in April, 2008, then a 16 person chain the next year. It's a way to not get on the list if you can make it happen, you know?

Jordan Harbinger: Wow, that's incredible. Do people ever need multiple different organs at the same time?

Jessica Wynn: Yes. It's not uncommon for a patient to receive a liver kidney transplant or a heart kidney combo.

Definitely happens. Sometimes it includes even more. In 2012 doctors gave a 9-year-old girl, six [00:44:00] organs in one surgery. Wow. It was about a 16 hour surgery and she got a new stomach, liver, spleen, small intestine, pancreas, and part of an esophagus.

Jordan Harbinger: Part of an esophagus. Why is esophagus the most surprising one out of all these?

But it is somehow.

Jessica Wynn: I know, I couldn't even read what, why she needed all of this, but it was a har Oh, it was a horrible accident. I was curious. Curious. But I was like,

Jordan Harbinger: I probably don't wanna know. Yeah.

Jessica Wynn: But it was the first ever esophageal transplant. And she survived. Huh? I can't find any updates on her, but I think I tracked her down on social media and if it was the right person.

She's in grad school for architecture and doing just fine.

Jordan Harbinger: Incredible. Yet terrifying somehow. Yeah.

Jessica Wynn: And more terrifying. Not all donations come from humans. So it's called xenotransplantation and it's heavily researched now, and it experimented with all the time.

Jordan Harbinger: This is animal organs transplanted into humans.

I think [00:45:00] we've all read the headlines about this here and there. Yeah, yeah,

Jessica Wynn: exactly. And it's mostly done with pigs. So our organs are similar and genetic editing makes them less likely to be rejected. And if you're wondering like me, why don't we just use chimps?

Jordan Harbinger: Yes. I was wondering that actually.

Jessica Wynn: Yeah.

It's, it's proved to always have severe immune rejection. Like our organs might be the same, but our immune systems are not compatible. It's really weird.

Jordan Harbinger: Interesting.

Jessica Wynn: Yeah.

Jordan Harbinger: Fecal transplants are real. It's science. It's disgusting, but it works. You can't buy health like that though. You can buy this, which is way less disgusting.

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[00:48:00] From the website or on the website at Jordan harbinger.com/deals. Now for the rest of skeptical Sunday. That is interesting. So pigs already, man, they gave us bacon and footballs, now they're lending us organs. Those are altruistic overachievers, those pigs.

Jessica Wynn: Yeah. And, and pigs have been part of medicine for decades.

My own father had a pig valve put in his heart in like the early two thousands.

Jordan Harbinger: Wow. Farm

Jessica Wynn: to table cardio. Nice, right? Yeah. More or less. But pig heart valves go back to the 1960s and the first full pig to human heart transplant was done just in 2022. In 2024, doctors in Massachusetts performed the first transplant of a pig kidney into a living human.

Jordan Harbinger: That is so recent. Yeah. There has to be so much here as far as the role of genetic editing and all that stuff. Yeah, it's,

Jessica Wynn: it's intense. And the pig organs are genetically edited to remove genes that would [00:49:00] cause a patient's immune system to reject the organ immediately. And human genes are also added to the pig organs to further increase the chances of the human body accepting the transplant.

It's still experimental and it's very rarely used. It's specifically for patients just with no other options, but pig to human hearts, kidneys, even lungs are happening. And the primary reason for xenotransplantation is just the critical shortage of human organs available.

Jordan Harbinger: What about limbs? No one's walking around on pig hooves like some production of animal farms, so obviously it's limited in what we can take from these.

Of

Jessica Wynn: course. In New Zealand, this guy Clint Hol, he lost his hand in a saw accident of while he was incarcerated, and he later became the first recipient of a transplant hand in 1999. So although he requested to have that hand removed a few years later when it became, as he said, [00:50:00] mentally detached from it.

Jordan Harbinger: Okay, what does that even mean? I'm not

Jessica Wynn: sure it was,

Jordan Harbinger: this guy's not all there. Yeah, yeah,

Jessica Wynn: it was, but it really messed with him. But since then, surgeons have done double arm and double leg transplants and since that's a lot for the cardiovascular system to support, there have been failed triple and quadruple limb transplants.

But right now, double transplants seem to be the limit.

Jordan Harbinger: This is all quite impressive. But when you say failed, I, I mean, I think about all the wasted organs and the lost shipments and the other horror stories of all this. I

Jessica Wynn: know, I mean, I'm trying to focus on the positive, but. The rare and shocking cases exist.

There are misses, and that's where the ethical framing really matters. So bioethics is full of stories of people declared dead when they weren't.

Jordan Harbinger: I see. Okay. Nothing inspires confidence in a system like the phrase, oops. He wasn't dead yet, but wow. Patients are declared dead too soon. How does that happen?

That's horrible.

Jessica Wynn: Yeah. A lot of this involves brain dead [00:51:00] patients, and it just leads to a discussion in bioethics that shows how complicated defining death can be. But as far as organ donation, there are cases like in Kentucky in 2021, where a man was wheeled into the operating room for organ recovery.

But then the staff realized he was moving and crying. Oh my God. The surgery was stopped, but it was chaos.

Jordan Harbinger: That is everybody's nightmare awake on the table, and they got the saw out. Oh God. And they're about to start harvesting, like, oh my God, they're

Jessica Wynn: not gonna give you anesthesia if they think you're dead.

No,

Jordan Harbinger: that's a good point. I didn't even think about that. Oh gosh, gross.

Jessica Wynn: Yeah. I mean, it's just all so sci-fi and no one was acting nefariously there, or trying to sell the organs or anything. It's just that sometimes people are accidentally declared dead. It really does happen. And it's cases like this that undermine public trust.

Yes. Because that's what makes the headlines not all the success [00:52:00] stories. So combine that with wasted organs, tens of thousands of organs that are lost to mismanagement and outdated tech, and there's a lot of systemic failures.

Jordan Harbinger: Yeah. So this is just bad oversight.

Jessica Wynn: Yeah, pretty much. I mean, organ procurement organizations aren't always held accountable for underperformance.

That's led to thousands of preventable deaths. So there's outdated databases. Somehow organs get lost. It's a mess, and it causes fewer people to register. So some reforms are happening, but there's a layer of difficulty given an increase of mistrust, just overall with our health agencies.

Jordan Harbinger: If people weren't convinced before, I guess it's not getting easier, I

Jessica Wynn: know, but the current health and human services have started cracking down on organ procurement organizations and have even completely shut one down in Florida for failing across the board.

So for all other organizations, they added a new oversight agency called the [00:53:00] Patient Safety Officers. This just seems to be an organization that only tracks the mistakes and the negatives.

Jordan Harbinger: I'm not sure if these officers build trust in anything. You know, sign up to donate your organ might get lost in shipping.

Maybe it'll be harvested from somebody who's alive accidentally, but don't worry. We keep a spreadsheet after the fact. Of course, that's just not the best sales pitch, right?

Jessica Wynn: And organ procurement system officials, transplant surgeons and others, they say that there are strict protocols in place, prevent unsafe organ retrieval from happening.

But there are scandals, you know, there was a congressional hearing that actually triggered a drop in new donors.

Jordan Harbinger: Of course, nothing kills confidence like Congress, right?

Jessica Wynn: But some argue the system being unfairly smeared. I tend to lean that way. That's just way more lifesaving instances than, than these crazy stories you hear.

But others say, Hey, these cases aren't isolated. So there's watchdog groups [00:54:00] like one called organize, and they claim near misses happen a lot more than people think. There was a report of a surgeon who stopped mid surgery when the supposedly dead patient breathed on the table.

Jordan Harbinger: Yeah, that's, that's a living donation.

Yes. You might wanna reattach some tubes and shit over there, doc. Oh, I know. This story's

Jessica Wynn: crazy because the Organ Procurement organization rep wanted to keep going Of course. But the surgeon refused, so it just, yeah, thank you. Raises a whole bunch of debates about defining death and also, I mean, these organizations say it happens a lot more, but I couldn't find, you know, countless cases of this happening.

So, but it does happen. Okay.

Jordan Harbinger: Yeah, I mean it's really the worst trolley problem. Like, do we cut open this maybe a live guy to save three others? That's not medical drama. That's just a horror movie. Yeah. Nightmare and oof. Yeah,

Jessica Wynn: I mean, it's important to remember organ transplantations starts [00:55:00] with good intentions and fascinating medical capability.

So the very first transplant was of a cornea in 1905, which is just Wow, wild. They could do that so long ago. Yeah. And since then we've done everything wos ovaries, even thumbs made from toes to give people a better quality of life. It just seems to me that far more good is done than bad.

Jordan Harbinger: Oh, we're going back to thumbs made from toes, but wow.

Wound transplants. That's like next level surrogacy. I know. The

Jessica Wynn: first successful womb transplant happened in Turkey in 2011. A woman was born without a uterus and she received one from a deceased donor. It worked. She menstruated normally and in 2020 she gave birth to a very healthy baby.

Jordan Harbinger: Wait, so they also moved the ovaries over?

Yeah,

Jessica Wynn: ovaries too. And you can get just the ovaries as well. So in 2007, huh? A [00:56:00] woman received her twin sisters ovary and gave birth a year later. So frozen ovarian tissue has been successfully transplanted after cancer treatments. It's amazing.

Jordan Harbinger: Science is really nuts, man. Okay, tell let's, we gotta talk about this toe to thumb thing.

Jessica Wynn: Yeah. So surgeons take your big toe and they attach it to your hand.

Jordan Harbinger: K.

Jessica Wynn: And it is more common than you imagined. So it's all about function over beauty. One, one guy said it looked like a cartoon. Thumb smashed with a mallet.

Jordan Harbinger: Totally. But

Jessica Wynn: he could work again, so he didn't care. And. It's not the new thumb that causes issues.

Patients normally go through a period of learning to rebalance and figuring out how to shift their weight onto the balls of their feet rather than their big toes. But their hands are fine.

Jordan Harbinger: Man. I'm staring at my hand trying to imagine that, and I do not like it. I do not like it. I can't imagine donating my toe 'cause recipient be like, why is this, why do I have to shave my [00:57:00] thumb?

And what is that smell? Gross? Just so gross. Like, sorry, you gotta use a Gillette Mach three on your thumb every few days, bro.

Jessica Wynn: I think people tend to use their own toes. I'm not sure. I see that makes more sense. Get a stranger's toe, but maybe,

Jordan Harbinger: yeah. Yeah, I mean. That makes sense.

Jessica Wynn: Would you take a penis transplant?

Jordan Harbinger: No. I am good. It's only downgrades from here,

Jessica Wynn: know what I'm saying? God. Well then God, there was a penis transplant that was successfully done in 2006 and it functioned. He could pee normally after he even had sex, but the psychological trauma was too much for him and for his wife, and the surgeon said it was just.

Beyond any of their imagination. And after just 15 days, he had it removed.

Jordan Harbinger: 15 days. Yes. Psychological trauma of having a different penis was too much. So now he has no penis. I'm [00:58:00] sorry. I don't know man. 15 days. 15 days is a dick trial period.

Jessica Wynn: Yeah,

Jordan Harbinger: gross. Okay. And after that, after that, he's just, what? He is just ridiculous.

Jessica Wynn: He that, that was. A better solution for him. So, wow. And if you wanna get even grosser, there are poop transplants.

Jordan Harbinger: Please tell me that's not real. I don't wanna know who volunteers to be a poop donor. Those people are next level kinky.

Jessica Wynn: It's very real. So fecal transplants, treat severe bacterial infections.

Oh, I've heard of this. Yeah, yeah, yeah. Okay. And by restoring healthy gut bacteria, it just, it gives you new crap, you know? And medicine is magic.

Jordan Harbinger: It is. But I bet that's not so popular on the black market. I guess here's the thing though, for poop though, supply virtually unlimited. No, no shortage. Not waiting for no shortage.

Hang around this house for a while, like a few hours and you're, you're in luck. But with this scarcity of other organs, there's gotta be so much shady business. I know we, we kind of touched on this before, [00:59:00] but like Yeah,

Jessica Wynn: I mean there's actually transplant tourism outside the US and wealthy patients are buying kidneys abroad.

This ends up exploiting the poor overseas and fueling more of the illegal organ trafficking. So, yeah,

Jordan Harbinger: exactly What a vacation package, five nights in Beijing and a new kidney. All inclusive.

Jessica Wynn: Yeah. In China, there's a global black market though, and a lucrative, transnational black market thrives on just the desperate need for organs.

I mean, if it's life or death, you're gonna do crazy stuff. And so criminal networks, they profit by exploiting these vulnerable people, especially in impoverished regions. And worse, there's allegations of forced organ harvesting, including from prisoners in some countries.

Jordan Harbinger: Yeah, we've all kind of heard of waking up in a tub of ice, you know, fake horror movie scenario, urban legend.

No.

Jessica Wynn: Yeah. In some instances, individuals have been subjected to organ [01:00:00] removal without their consent. Uh, this seems to happen more outside the US but it can happen here and victims are just unaware of what's happening. Some countries are accused of systematically harvesting organs from their political prisoners.

I mean, it, it does get horrifying when you start to look at those stories, but the desperation, it makes you do crazy stuff and people travel to other countries, but the standards aren't always ethical. You mentioned China before. They are popular for this, and they claim it's all voluntary donations, but the thing with them, they offer no transplant data.

So there's a lot of investigations that suggest prisoners alive and executed are, are targeted for forced organ harvesting.

Jordan Harbinger: Yeah, if I remember, and I did that episode, it was a episode, what is it, 497 or whatever it was. This is years and years and years and years ago. But one of the, the telltale signs was we have an, I think our average [01:01:00] waiting period for an organ was like X number of days or weeks.

And the waiting period for an organ in China was like a day. His investigation, or this NGO investigation from the UN was basically just kind of like the only way that's possible. If X number of people are dying probability wise, and we know that that's not happening because that's like a huge percentage of the population, even in a country like China.

So that means they're finding somebody who is a match. Like you basically can't lie. Once you do the math, it becomes impossible that they're just randomly hol finding dead people that they can harvest these from who have died from natural causes, right? Because it's too short of a period.

Jessica Wynn: And also the thing with that, because they don't have data, how well are they matching?

Like what is the success rate with those donors? I can't really find too much about that,

Jordan Harbinger: I don't know. But if they're selling that, there was a documentary I watched to prep that episode, and I mean, if you have a bunch of prisoners, political or otherwise, and you've got their immune system [01:02:00] tested, their genetic testing done, their blood typing done, if everything's typed in in a file.

Someone needs an organ, they just go, today's your lucky day, pal. I mean, I can't imagine the ticking clock of being on that list, right? They just go, Hey, somebody flew in from Korea. They want your organ. Today is your day to die of natural causes. Sorry. I know. And they just sell it. Ugh. Yeah. God, it's

Jessica Wynn: so freaky.

Yeah, humans do weird things. But

Jordan Harbinger: I mean this is all alleged, but it's a, you know, it was a big investigation. This is not like cery, right?

Jessica Wynn: Oh, no. From what I understand, there's a lot of research that suggests that's happening. And another psychological kicker is that recipients sometimes report personality changes.

So it's all anecdotal as well. But some recipients report they have new cravings, new moods, even feeling connected to their donor.

Jordan Harbinger: You better feel connected to give you my liver bro.

Jessica Wynn: And studies show up to 85% of recipients report some kind of shift, though a. Science hasn't confirmed any of [01:03:00] this.

Jordan Harbinger: Very scientific, some kind of shift.

I've had some kind of shift, right? So what? You get a new heart, suddenly you're into jazz. By the way, I knew having a gay heart would make me a better dancer. Told you, maybe I better stick to hetero organs for now if I don't want any side effects. You gotta be careful whose organs you get. I don't know.

The good news is you're alive. The bad news is now you're a power bottom. Sorry.

Jessica Wynn: Well, you're actually not far off for what people say. So there's a story of some man suing because after his transplant. He claimed he became interested in what he described as feminine hobbies.

Jordan Harbinger: Okay.

Jessica Wynn: Another woman claims after receiving a heart lung transplant from a male donor, she got really into beer and chicken nuggets.

Speaker 3: Okay. So,

Jessica Wynn: I mean, like I said, there's no science to back this stuff up. Right? But I would think that before transplant your life has a lot of limitations due to your [01:04:00] health. A lot of things would be different in your behavior, but

Jordan Harbinger: yeah, the more like,

Jessica Wynn: yeah, come on.

Jordan Harbinger: Because C, come on. Like, oh, I never liked beer before you were dying, okay.

You were allowed to drink. You couldn't go to the bar. Chicken nuggets. No. You were being fed through a tube in your nose, pal. Like of course you're in a beer and chicken nuggets. Celebrate live a little for God's sake. And also this guy who's like, oh, way of feminine hobbies. Give me a break. I think he just, thanks for the liver, bro.

Now I'm into baking. Like you don't need to make an excuse that it's the organ transplant. It's okay to like things that your dude bros with truck nuts think are a little bit effeminate. Dude, he just got caught to fly that flag. Live your life, sir. He

Jessica Wynn: got caught and was like, it's not me. It's, it's

Jordan Harbinger: the I, 'cause I got that lung from that old lady Knittings relaxing.

Okay, get outta here.

Jessica Wynn: I

Jordan Harbinger: think, leave me alone.

Jessica Wynn: I think the more likely explanation seems to be just the sheer emotional weight of the gift. It's not some like yeah. Freaky Friday [01:05:00] situation, but

Jordan Harbinger: Right.

Jessica Wynn: Yeah. There is ongoing research into whether cells carry systemic memory. Even people I, yeah, there was a guy

Jordan Harbinger: collar music.

Like what reason would my liver cells have to be like, oh, by the way, he really enjoys electronic music. Like I, yeah, well there was a,

Jessica Wynn: a guy who was an organ donor and he was shot in the face and killed and the recipient. Who got his organs claimed he would have nightmares about being shot in the face or like had had the memory of the guy being shot in the face and

Jordan Harbinger: it's okay.

But he knew that the donor was shot in the face. So that's like, like

Jessica Wynn: I said, it's all very anecdotal, but yeah, you know,

Jordan Harbinger: I imagine the living donors also face psychological challenges. I just, I think this all starts long before the donation. Just the decision to be a donor could probably mess with you too.

The stress of the surgery, I mean there's all kinds of stuff

Jessica Wynn: like that. Of course, that's why people don't sign up because the, that's where it begins is checking that box, the psychology of it all. And after the fact, donors [01:06:00] can face regret.

Jordan Harbinger: Like if you get fired for your, from your job, for donating your liberty to your boss.

If your

Jessica Wynn: boss fires you well sometimes there's just lack of long-term support for the donor recipients. They get a new life, but donors also are getting surgery and sometimes they just get like a thank you card.

Jordan Harbinger: You know, bruh, with no financial reward, man, donors are really unsung heroes. But where do we go from here?

It seems like you could incentivize this without sort of introducing corruption, but maybe not. Yeah, I

Jessica Wynn: mean, reform is on the table for sure. So the United Network for organ sharing is pushing for automated donor referrals, mandated in cabin airline transport for organs, and just modernized tracking to prevent waste.

Jordan Harbinger: Wait, we don't at least have like a fricking air tag on every liver, heart, kidney that's flying. Dude. The friendly skies, it's just checked luggage. No,

Jessica Wynn: this donation process in the US especially is way behind the technology. Yeah. We make organs get [01:07:00] checked in the undercarriage of planes.

Jordan Harbinger: Dude, they don't even make me check my luggage where they're like, like, Hey, it's carry on size.

Yeah. Hey, you with the liver and the cooler? Belly, just come wait in line and check that thing like everybody I know. That's insane. They let me

Jessica Wynn: put my guitar in the flight attendant closet and yeah,

Jordan Harbinger: they're like, it's, it's fragile and valuable. Oh yeah, Chuck that kidney in the, no, get rid of that thing.

Jessica Wynn: I mean, just in the US we should have so many hoops within the health insurance system for patients too.

But that being said, Sweden's already transplanted a synthetic trachea lined with a patient's stem cells. Wow. No rejection drugs were needed. So that kind of tech, I hope, I think will expand to kidneys, hearts, and livers eventually.

Jordan Harbinger: So are we 3D printing organs now? Like Control P, new kidney? 'cause that's remarkable.

Jessica Wynn: Pretty much. Yeah. Except instead of ink, it's your own cells. So we're not at full organs yet, but we can print skin and cartilage. And [01:08:00] the big challenge with this is building the blood vessels that actually work.

Jordan Harbinger: So the future is pigs printers. Poop can't be. Science is remarkable and a little bit disgusting.

Jessica Wynn: I know, but it means fewer wasted livers and fewer people dying on the list. You know, it's weird and disgusting, but. That's better than death, right?

Jordan Harbinger: Definitely, yeah. And the bottom

Jessica Wynn: line is every donor can save at least eight lives and help dozens more with tissue donations. So it's just a chance to help another human, even though the system's not perfect.

Jordan Harbinger: If you take anything away from this episode, make sure, make sure it's not my lung. I'm still using it, but this is so interesting, Jessica. I know.

Jessica Wynn: I know, I know. But organ donation works. I just really wanna emphasize that it saves lives. Yes. Thank you. And it's terrifying for everyone involved, but we just need to talk about it.

You know, it's interesting to think about and let it force us to ask the big questions. What do we really owe each other? [01:09:00]

Jordan Harbinger: Well, Jess, I don't want your womb, but if I die, my family should auction off my uh toes. Learn how you all can make a life changing difference through living donor organ transplantation.

The link will be in the show notes. Jess, thank you so much. This is, uh, this is really just, it's fascinating and it's, it is heartening, no pun intended, that you can do this kind of stuff and it's that it's getting easier. It's just, uh, man, the human body's amazing. Science is amazing.

Jessica Wynn: I know, I know. It's freaky to talk about, but it helps for sure.

Jordan Harbinger: And thank you all for listening as well. Topic suggestions for future episodes of Skeptical Sunday to me, jordan@jordanharbinger.com. Advertisers, deals, discounts, ways to support the show all at Jordan harbinger.com/deals. I'm at Jordan Harbinger on Twitter and Instagram, or just hit me on LinkedIn.

Jessica, you can find on her substack Between the lines and Where Shadows Linger. We'll link to those in the show notes as well. This show is created in association with PodcastOne. My team is Jen Harbinger. Jase Sanderson, Tadas Sidlauskas, Robert Fogarty, Ian Baird, [01:10:00] Gabriel Mizrahi. Our advice and opinions are our own.

I might be a lawyer, but I'm not your lawyer. We also try to get these as right as we can. Not everything is gospel, even if it's FactCheck. So please consult a professional before applying anything you hear on the show, especially if it's about your health and wellbeing. Remember, we rise by lifting others.

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