belladonna , my heart goes out to you. I’m sending as many positive vibes to your young relative as I have.
Now, my credentials - my husband received a kidney transplant 17 months ago, from a deceased donor who made the choice (as did her family) to give life to another person when she could no longer use her organs. His kidneys failed for no known reason - as is the case with about 25% of kidney transplant recipients. It’s not comforting to hear the doctor say “well, sometimes it just happens.”
Watching someone you love die a little everyday from organ failure (we’ll talk about dialysis later on) and knowing that their only hope for living is to depend on someone else to make that decision is enough to make you want to mandate organ donation. I’ve since come down from that particular ledge, but do believe that we need legislation nation-wide that would not allow the family to override the deceased’s wishes. Such legislation is already in place in Indiana.
Sometimes, in order to tell if the organs are usable, the doctors need to know from the family what type of life the donor led - it’s not always apparent from looking at them. See Broomstick’s story about the rabies infections for an extreme example (not that the family would have known, either.) It’s also possible that organs may not be functioning well because of whatever happened to kill the person, but would do just fine in someone else. That’s why I don’t support mandatory donation, or a fee paid to the donor’s family - and I’m not really sure about an opt-out system, my emotions are still too raw to form a reasoned opinion.
Re: the transplant list: At our transplant center, you have to walk the straight and narrow to get on - and stay on - the list. That means a zero-tolerance tobacco policy for any transplant, enforced through random tobacco screenings. Don’t want to follow your doctor’s orders? Off the list. Don’t want to give up your substance-abuse habit? No new organs for you. The transplant team’s stance is that if you won’t take care of it, you don’t deserve it. I do understand that not every transplant program is that rigorous - but I think they should be.
While WinkieHubby was on it, the average wait for a kidney on the transplant list was 20 months. That’s quite a long time, when you figure that many deceased donors have two of them to donate. This organ donation website may have some good information - United Network for Organ Sharing had some good information about organ transplants back when I was searching the web for transplant information instead of sleeping.
Re: insurance: I don’t know what the case is with other organs, but if you are diagnosed with End-Stage Renal Disease you are automatically eligible for Medicare Part B. That will pay for dialysis, transplant, and anti-rejection meds for a period of time. Since we have very good insurance, we are just now learning about this so please don’t ask me many questions.
WinkieHubby was lucky that for kidney failure, there is an artificial process that can keep him alive for a fairly long time. I don’t think most other organ failure patients have a long-term solution like that. And dialysis is no picnic - it only provides about 15% of what normally-functioning kidneys do. That meant that even when he wasn’t at work or undergoing dialysis, getting up off the couch was a major accomplishment for the day. Getting that kidney was like flipping a light switch in him - I can’t even describe how much better her felt as soon as he came out of the anethesia from surgery (ok, the good drugs may have helped a bit 
)
Our transplant team (at least one of the nephrologists on it) thinks that we’ll see cloned organs within the next ten years. I sincerely hope that is the case, and am trying to figure out how I can actively politically support the research to make that happen. Until that time, though, using organs that other people don’t need any more (or choose to donate and just use the one, in the case of kidneys) is the only long-term solution.
