Stuff You Should Know - SYSK Selects: How Organ Donation Works

Episode Date: November 25, 2017

In this week's SYSK Select episode, tune in as Josh and Chuck take a detailed look at organ donation -- from the earliest organ transplants to the organ black market. Learn more about your ad-choices at https://www.iheartpodcastnetwork.comSee omnystudio.com/listener for privacy information.

On the podcast, Hey Dude, the 90s called, David Lasher and Christine Taylor, stars of the cult classic show, Hey Dude, bring you back to the days of slip dresses and choker necklaces. We're gonna use Hey Dude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s.

We lived it, and now we're calling on all of our friends to come back and relive it. Listen to Hey Dude, the 90s called on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. Hey, I'm Lance Bass, host of the new iHeart podcast, Frosted Tips with Lance Bass. Do you ever think to yourself, what advice would Lance Bass

and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help. And a different hot, sexy teen crush boy bander each week to guide you through life. Tell everybody, ya everybody, about my new podcast and make sure to listen so we'll never, ever have to say. Bye, bye, bye.

Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple Podcasts, or wherever you listen to podcasts. Hey everybody, it's me, Josh, and for this week's SYSK Selects, I've chosen a January 2010 episode called How Organ Donation Works. We get into the ins and outs of organ donation,

the what you can do and what you can't. And we also talk about the black market for organs, which is something that's been in the news recently. There's been a huge Reuters expose on the secondary organ donation market, for profit market, which is worth reading too, especially if this episode floats your boat. So I hope you enjoy How Organ Donation Works.

Welcome to Stuff You Should Know from HowStuffWorks.com. Hey, and welcome to the podcast. I'm Josh Clark with me as always, is Charles W. Chuck Bryant. Hi. Who I assume has two functional kidneys. I do. Me?

I have one up for you, brother. Wow. Would you really? Well, maybe. I think that's true, Chuck. As a living donor, maybe not. But if I die, then sure, you get up. Thanks, man.

What about your liver? Because I'm pretty certain I'm gonna need somebody's liver. I don't know that you would want mine either, to be honest. Oh, yeah? Yeah. That'd be like getting Mickey Mannell's liver. I need a virginal liver, don't I?

So I can just start over again, wash it in vodka. So what are we talking about, Josh? We're talking about organ donation, Chuck. Perfect. Which I find absolutely fascinating. I do, too. Back in 1954, let me take you back a little bit here. Okay.

The first successful living human to human organ donation took place. It was a kidney. Yeah, it was a great story. Kidneys actually remained the most commonly donated and received organs by a long shot. Right. But this was actually a couple of twin brothers.

One of whom was dying of chronic nephritis. Yeah, Richard and Ronald Herrick and Richard was the one dying and Ronald was in good shape. Right. And Ronald said, well, you know what? You're my twin brother and I don't really want you to die young,

so I'm gonna give you one of my kidneys. Right. And there have been some other transplants before that. They didn't work out, though. Well, some of them did, but it wasn't live human to human. Like, for example, the first, I think the first organ,

the first donation or transplant that ever took place was way back in 1668. Yeah, that's a good one. Where they fused part of a dog's skull under a human's head. Crazy. And that graft worked. We have taken testicles from monkeys

and successfully implanted them into humans. Sure. A pig kidney was successfully transplanted into a human. Vane transplants and a lamb kidney was put into a recipient in 1923 and that person lived for nine days. But 1954 finds the first time a living person donated an organ to another living person

and it was successful. Right. And the reason why they think was because they're twins. There was a very low chance of rejection, right? Yeah, and the story's great because Richard, you know, the dying brother had a moment, a clear moment where he literally,

like the day before said, don't do this, man. Get out of here right now. And the brother said, no, I'm gonna give you my kidney. Like it or not, chump. And he did. And it was a great story.

Yeah, and they actually both lived to ripe old ages, reproduced, so they fulfilled their destiny as humans. Yep, and since then, Josh, there have been more than a half a million of these organ transplants performed. Right, we've gotten a lot better at it. Yeah. As I was rambling off that list of stuff

that took place before 1954, we have gotten exponentially better. In 2003, we successfully transplanted a tongue. Yeah, I saw that. Which I could use a tongue transplant. A slightly thinner tongue would do me a lot better, I think. You got a fat tongue? Yeah.

And do you remember the, what did we do, the face transplant? That woman actually, remember she got her face from a suicide victim. Right. That was in 2005. And in 2006. Oh, I know what's coming.

A cadaver's penis was transplanted onto a living human. Yeah. And that man gave it back? Yes, and I love the reason they gave was because of, it caused psychological problems between the man and his wife. Yeah. Which I can imagine.

Just let your imagination run with that one. Yeah, yeah, that's just, I would say the same thing would happen in my household. Right, so thanks to a better understanding of how the human body works, of blood type, of the development of anti-rejection drugs. Like Chuck said, we've hit about half a million transplant surgeries so far.

Right, right. So Chuck actually is hot and heavy to give out a stat. And this is a very special stat because it's actually most likely going to change by the end of the podcast. Yes, these are, Chuck, take it away. These are current stats.

If you go to the website unos.org, the United Network for Organ Sharing, they actually have up to the minute statistics on who needs what and who's giving what. And what operations are being performed. And I didn't realize this, but it's up to the minute because earlier in the day, I checked on kidneys and the number actually dropped

by three about an hour later. On the waiting list? So three people got kidneys in that like half hour span. That's so awesome. So I'm just going to read a couple now and then we'll check back in for fun in 20 minutes and see if that's changed at all. Okay, I'm going to write this down to Chuck

because we'll never remember it. This is the first time we've ever used a laptop in the studio. And a pen. Usually just us in our mouths. Total Josh, we got 105, 288, 105,288 people are waiting for organs. And we'll do kidney because that's the most popular. 83,012 people are waiting for a kidney as of 2.03 PM.

All right. And we'll check that in 20 minutes. And hopefully those numbers have gone down. Yeah, because that will mean that either the people on the waiting list have died or they received a transplant. I guess we could put those two, we could compare against one another and make her, we could surmise for that.

So Chuck. What are organs? Yeah. I had a feeling you were going to ask me that. Yeah. Go ahead. No. Okay.

Organs are systems of cells, Josh and tissues and they all are in our body for a very specific reason, each one. And what I like about the organs is that they are all over equipped, which is what you're looking for in an organ. You don't want like the heart to be like, boy, if it beats one beat less, you're really screwed. So our heart, actually a 20 year old's heart beats pumps

about 10 times more than the amount of blood we need. And we have this reserve capacity in all of our organs as young lads and lasses. Right. But as Tom Schieve, who you know as my BFF. Yes. Who wrote this article, he points out that the corneas, when you talk about eye transplants,

they're talking about corneal transplants, they actually don't necessarily deteriorate like all of the other organs. Yeah, that's pretty cool. So the corneas of a 75 year old donor are just as good considering, you know, there's not more wear and tear than say a 20 year old. Yeah, you could put a 70 year old person's cornea

inside of a young person and there would be no difference. Right. But for organs, they deteriorate with age. Well, that's the bad news. Right. So eventually you may need one, right? Well, yeah, because what happens is, let's say one organ can deteriorate while the rest of your body remains

pretty healthy. That's actually best case scenario. As weird as that sounds, because that means you can just swap that sucker out and you'll be fine again. Right. Well, that's in a very ideal utopian world. That's exactly what happens. The problem is there is a lot more people in need of organs

than there are organs available, right? Right. There's a waiting list. Some aren't so bad. I think kidneys go pretty quick as you were talking about earlier. The longest wait I found was the old heart lung combo. Right.

That median wait time was 6.7 years. Wow. It's a long time to wait for a heart and a lung if you need it. Yeah, a long time to live. Because nobody goes, I'm probably gonna need a heart and a lung combo eventually. I'll just put myself on the waiting list now.

Right. You need it like the moment you go on to that waiting list and you have to wait 6.7 years until you get it, right? Yeah, and that's why the mortality rate while waiting for a heart is 15%. Which isn't, that's not as bad as I would, I would think it'd be like 90% or something. I would too.

The lungs are 12%. And the liver actually is the worst at 13%. Oh, good. Yeah, sorry. There's two ways you can get organs, from a live person or a dead person. Yes. Traditionally, we don't take organs like the heart

from a live donor because they would be a dead donor after that. Exactly. You can take things like the liver, pancreas, uncommonly, but it can be done a portion of the intestine. Blood. Yeah, sure. Blood stem cells, bone marrow.

Bones. And bones, yeah. Which, given up a bone, that's really something. Yeah. Like, I mean, after that, you just kinda have this floppy arm but somebody else has a bone, you know? I mean, that's pretty nice. You know what I thought was interesting

about the kidney deal? Like, why you can give up one kidney and still be okay? Is that most of the times when your kidneys are affected, they are both affected. Right. At the same time. Right, so one's never gonna go down and you'd be like, oh, I wish I still had my healthy kidney.

Exactly. Because they both would have been unhealthy. Yeah. And all right, I think we've arrived at the liver, Chuck. This is fascinating to me. It is. Where should we start? Well, let's just start by saying that the liver can grow.

It's like the starfish of Oregon. Yeah, it can regenerate itself, which is just friggin' amazing. Sure. So, for instance, let's say you wanted to split your liver in half and transplant that into two different people. You could do that. You could.

And actually, if you're an adult donor, they can cut off a portion, a child-sized portion. Yeah. Which is, I think, the same as like a child-sized meal where you get like three chicken nuggets. Right, right, sure. And give it to a kid and Chuck. This is so great.

It grows along with the kid. Right, to a full-size liver once again. Yeah. But in step with the kid's maturation. Right. That's just mind-boggling. Let's say you needed a piece of your liver, let's say you needed your liver replaced

and I cut half of my liver off and gave it to you. My liver would eventually grow to full-size once again. Yeah. If I lived that long. So mine would grow and yours would grow. And the cool thing is, with the liver, you don't even have to take out the old liver. You can just put in the new one.

I know. It's like the best organ on the planet. It really is. And our favorite organ. Yes. Because of the function that it serves. So Chuck, like I said, you can either be a dead donor or a living donor.

A dead donor can donate anything, right? Oh yeah, including your whole body. Yeah, and your eyes, heart, lung, all that stuff that you can't really take from a living donor. Yeah. But there are some exceptions. If you have HIV or disease-causing bacteria in your bloodstream or tissue,

they're not gonna be taking your organs. No. And if you are a practitioner of the Shinto religion, there's not gonna be a lot of organ donation going on there either, right? Yeah, not only that, but if you are Amish, they might support your donation if there is a certainty, a relative certainty of success.

But they're more reluctant if it's less probable of success. Right, and Tom actually mentioned why the Gypsies don't agree with organ donation. They believe that you need your body for the first year to get around the afterlife. Apparently after that, you got it down pat and you don't really need it any longer. But he didn't mention Shinto, but I looked it up.

They believe that the corpse is impure. The body becomes impure after death, so it'd be like, here, take this rotting piece of flesh that will save your life, but you're going to be impure while you live. Interesting. So as a result, in Japan, donation rates are really, really low compared to the US, say.

Yeah, and Jehovah's Witnesses, we should cover them because we always like to talk about them. They're not opposed to it, but they have one rule, which I thought was interesting. You can donate your organ as long as they drain all of the blood out of the organ first before giving it to someone else. So I guess they're not big on transfusions.

I don't think so. That'd be my guess. Yeah. Okay. Stuff you should know. On the podcast, Hey Dude, the 90s called David Lasher and Christine Taylor, stars of the cult classic show, Hey Dude,

bring you back to the days of slip dresses and choker necklaces. We're going to use Hey Dude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s. We lived it, and now we're calling on all of our friends to come back and relive it. It's a podcast packed with interviews, co-stars,

friends, and nonstop references to the best decade ever. Do you remember going to Blockbuster? Do you remember Nintendo 64? Do you remember getting Frosted Tips? Was that a cereal? No, it was hair. Do you remember AOL Instant Messenger and the dial-up sound like poltergeist?

So leave a code on your best friend's beeper because you'll want to be there when the nostalgia starts flowing. Each episode will rival the feeling of taking out the cartridge from your Game Boy, blowing on it and popping it back in as we take you back to the 90s. Listen to Hey Dude, the 90s,

called on the iHeart Radio app, Apple Podcasts, or wherever you get your podcasts. Hey, I'm Lance Bass, host of the new iHeart Podcast, Frosted Tips with Lance Bass. The hardest thing can be knowing who to turn to when questions arise or times get tough, or you're at the end of the road. Ah, okay, I see what you're doing.

Do you ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help. This, I promise you. Oh, God. Seriously, I swear.

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Oh, not another one. Kids, relationships, life in general can get messy. You may be thinking, this is the story of my life. Just stop now. If so, tell everybody, yeah, everybody about my new podcast and make sure to listen so we'll never, ever have to say, bye, bye, bye. Listen to Frosted Tips with Lance Bass

on the iHeart Radio app, Apple Podcasts, or wherever you listen to podcasts. Um, how do you register, Chuck? Well, it's pretty easy, actually. In most states, you can do it at the DMV, which I always found interesting. Yeah. You can do it right there when you're

getting your new driver's license. And here in Georgia, actually, we used to have one of the highest donor rates, or I should say, one of the most expansive donor registries in the country. And the reason was when you went to go get your driver's license, as I'm sure you remember, they'd knock $7 off of your driver's license.

I love that. So you were an idiot if you didn't sign up. The problem is that there's not supposed to be any kind of compensation whatsoever for being an organ donor. Even though this was legal under state law, the Georgia Organ Procurement Organization, which we'll talk about in a minute,

they were very hesitant to draw from the Georgia donor list because they weren't sure if the person was just looking for the $7 off, or else if they really wanted to be an organ donor. So actually, the contribution rates were very low in comparison of the size of the registry in Georgia until 2005 when they stopped it. They stopped it.

I think they actually gave you a t-shirt too that says, I sold my lungs for $7. That's illegal. And all I got was this lousy t-shirt. Yeah, no, under a 1984 law, you can't have any valuable compensation for organ procurement. Right, we'll get to that too, the whole black market deal. Oh, OK.

So Chuck, if you're a dead donor, how do you donate? There's two ways, right? Two ways, sure. Two ways of death, brain death and cardiac death. Yeah. Is that what you mean? Right. Sure.

Obviously, cardiac death is a little trickier because you only have a certain amount of time to get the organs from the body. Brain deaths are a lot easier in one sense because there could be weeks to find a match and to prepare the organ for donation and get it carried out. But there's a wrinkle there.

Oh, there's a lot of wrinkles there. Let me say something about cardiac death first, right? OK. There are no laws really governing organ procurement. It's on a case-by-case basis. And basically, everybody involved in the organ procurement process does their best to walk a very cautious line while harvesting organs to try to save other lives, right?

Yeah, because there's families involved grieving, obviously. Right. With cardiac death, there was a board, I think, out of Harvard in the late 90s that established a five-minute wait time from the cessation of a heartbeat, right? So you take somebody off of life support, wait for the heart to stop beating,

five minutes after, and while the heart's winding down, you're prepping the patient for surgery, five minutes after, somebody pronounces the person dead and they cut him open and take the organs. But in five minutes, the heart is useless, pretty much at that point. Some of the other organs like the liver, the kidneys, maybe the lungs can survive that five minutes,

but the heart's gone. So if you have a cardiac death, you have a useless heart, even though the heart might have been perfectly healthy five minutes ago, right? So there was this doctor in Colorado that said, you know what, there's no law whatsoever that says I have to wait five minutes. This guy did a lot of research and found,

in the medical literature, the longest duration between the cessation of a heartbeat and the spontaneous regeneration of a heartbeat, ever recorded, was 65 seconds. So he started a 65-second rule, got the pant suit off of him. Really? It was an unsuccessful lawsuit, and now, all of a sudden, the president has been set,

and now there's a 65-second rule out there that some people adhere to. Really? That is how organ procurement has been established in the US. Somebody pushes the envelope, they get sued. Right. If the case isn't won by the plaintiff,

then you have a new rule. Wow. Isn't that weird? There's like zero guidance for organ procurement, except that the person has to be dead. We don't have any real definition for death. Well, that's where brain death gets really, really tricky. Exactly.

Take it, Chuck. Well, I don't. I mean, you're the expert here. I can't weigh in morally, because I don't know what I think. Really? No, I mean, I know what I might believe for myself, but I don't know about establishing guidelines for others.

But we need them, though, don't we? Yeah, but I don't want to make those rules to you. No, and apparently, the federal government doesn't either. Right. Every once in a while, I think Carter assigned a panel to create a white paper on this. And I guess George Bush did right before he left office, because there was one that came out in 2008.

Either Bush did right before he left office, or it was the first thing Obama did when he came into office. But there was a very recent white paper that came out that said, OK, here's how we feel about brain death, right? Right. Here's the problem. Back in the 50s, I think, we came up

with this thing called the ventilator. And with the ventilator, you can keep somebody who, for all intents and purposes, is dead. Right. You can keep their organs functioning. Right. So you're masking death. We have no idea what would happen

if that ventilator wasn't there, would the person die? Right. And if the person does die, how long do we have to wait? And so we say that that person's dead, right? Sure. So the ventilator made it so we could procure organs more easily in brain death, because we can keep them alive. Right.

But at the same time, it blurred the line between life and death. Right. Well, now they came out with this recommendation that said, brain death is disengagement of, no, the end of meaningful engagement with the rest of the world. Right. Which really widened the scope of who exactly is dead.

Right. And so when you have a brain dead patient and you procure their organs, what you actually do is you have to run them through this battery of tests where you are shining lights in their pupils. Sure. There's ice water injection into the ear canal. Really?

To see if you move toward or away from the stimulus. Wow. And there's this battery of tests to establish brain death. And then here's the clincher. They do an apnea test where they take you off the ventilator for two minutes. And see what happens. And see what happens.

Inevitably, the heartbeat is going to slow down. Right. And then after two minutes, they put the ventilator back on. But that two minutes where your brain was starved of oxygen was enough to create real brain death if you weren't before. Wow. Think about that.

This is why they call you supplementary research man. Right. That's why that's your superhero character. And can you hear people fast forwarding through this part and just like, Josh, Josh, Josh. That's right. Josh. OK.

So we have this new definition of brain death. And when the second apnea test happens and you're declared brain dead, what they, anesthetize you, they inject you with anti-paralytics, will you into the hospital room, and they harvest your organs. So you actually die from a lack of organs present in your body. Wow.

So that's that. It's a ghoulish matter. And these people who are in charge of making sure that people donate and keeping the image of organ donation as a gift of life alive have to battle with this, the fact that it's a very ghoulish process. Right. You're right.

So who's in charge of this stuff? Thanks for that, by the way, for what? For that whole soapbox feel. Sure. Anytime, buddy. Yes, Josh. That would be called an OPO, which is an organ procurement organization.

And they are federally designated nonprofits. And they are local all over the country. There's usually one in the central location of a state and then different satellite offices, obviously, because you need to be close by. You can't be hopping all over the country to get these organs, although that happens as well. And they basically are responsible for awareness,

recruitment, evaluation, organ removal, and transportation. So they're the people that's standing there with a cooler waiting to drop your organ in there and rush it to the recipient. They're also the people that talk to the family, generally. Well, sure. So anytime somebody dies, the hospital is legally obligated to notify the organ procurement

organization. Right. And this is a good point to bring this up. If you want to be an organ donor or if you are, you really need to tell your family this stuff. And you should have it all in your living will because things can get a little ugly. For instance, let's say you are from a very strict religious

background. Maybe your family doesn't want you cut up. They think that would be a bad thing. But you want it. You've got to have that in paper, on paper, in writing. Right. And if you have it documented, in a lot of cases, even if your family's like, no, we

don't want to donate the organs, the organ procurement organization will say, you know what, T.S., sorry. He or she wanted to be an organ donor, so. And the last thing you want after you die is for your spouse, let's say, to have to mount this campaign against your family, like a tug-of-war like that. You've got to have it all spelled out. Nice try.

Sure. So where are we? The United Network of Organ Sharing. That's another group. This is where that's where you've got the kidney statistics we're going to go back on and look at, right? Yeah, they're in Richmond, Virginia. And they are responsible for placing donated organs

and maintaining the waiting list, like you just said. And they never close. No. 24-7, 365, which is how it should be, obviously. We should try calling them right now to see if they're open. No, let's not do that. I'm sure they're open. And then check there's the scientific registry

of transplant recipients, right? Yes, the SRTR. And they basically maintain every amount of data you could possibly want on transplants for policymakers and doctors and drug makers and that kind of stuff. Yes, and in 1984, there was one more called the Organ Procurement and Transplantation Network.

And they're just another network that matches people with recipients and has a waiting list, that kind of thing. Right. So this is actually a pretty lean, mean, streamlined machine, the procurement and donation network. It has to be. Right.

So Chuck, you were saying they can't be hopping all over the country, but they have to sometimes. So what happens with, let's say somebody dies in Sacramento and they have the perfect heart that somebody in Tampa needs. What happens? Well, they will put it into a cooler and fly it to, what was the destination? Tampa.

Tampa, they'd fly it to Tampa. Apparently, the hospital in Tampa, those people will go fly to Sacramento, take possession of it, and then fly it back, unless there's somebody in, let's say somebody in Sacramento needed it and somebody at the Sacramento General Hospital died. That's when that cooler comes in,

which have you seen the one that's at the office? Oh, we have one here? We have an organ transplant cooler. Really? Yeah, it's pretty cool. Does Roxanne Keeper tab in it? Probably. It's gassed.

You know what I thought was really cool is if you were on the organ donation list as a living donor, you were actually given consideration if you need an organ transplant yourself. Right. And they said that they won't bump you to the top of the list, but they will give that a little bit of extra weight, which I think is, that's only right. Did you also see that if you are a living donor

and usually your insurance company won't raise your rates after that, but if you move to another insurer or change like plans, they'll hit you with a pre-existing condition? Yeah. How evil is that? I know. Seriously. You sign up for a list saying, I will give someone my kidney as a living human,

and the insurance companies are like, oh, well, you might have to charge a little extra for that. Don't you think we should start publicly executing CEOs of insurance companies? It should be part of the health care reform package. Right. Of course, we don't mean that. Right.

Thanks for the COH. So Chuck, when you're talking about people running around with coolers and all that, it kind of creates this harried pace in your mind. Yeah. And that's very much true. You have a very short amount of time for an organ to survive. Remember, I said even five minutes can kill a heart once it's deprived of oxygen, once it stops beating.

What happens when you die, too, the body undergoes all these huge changes that happen almost immediately. Like there's this parasympathetic flood of chemicals, which is like kind of fight or flight on steroids. So I guess it's a sympathetic flood. Like dopamine levels increase 800%, epinephrine levels increase 700%, nor epinephrine levels increase 100%. So all these chemicals that are meant to either speed you up or slow you down

or just flooding the body. That's why you have to take the drugs, right? Most times. Right. Well, no, this is when you die. So when they're trying to harvest these organs, they're like trying to get them out of the body before this flood just damages these things that are appropriate.

I thought you meant as a recipient that would happen. No. That'd be pretty awesome, though, to have your dopamine levels raised 800%. Right. But it's not as easy as just throwing the new heart in there either and sewing you up and saying, good luck with your life. No. No, it's not a recipient.

And there's also some expectation that you lead a very healthy life after that. Sure. You're not supposed to be drinking or smoking or swearing. And you have to stay away from call girls and things like that. Well, yeah, you shouldn't get a new liver and then dive into the vodka bottle. No. You're pretty much signing a contract to become Ned Flanders after you get your organ donation. Yeah, actually, just over Christmas,

heard of a friend of a family member that was a candidate for, I think, a liver transplant. And they would not do it because he wouldn't enter rehab. Really? Yeah. Wow. So that's hardcore. Yeah. That guy's dedicated to the booze, isn't he?

Yeah. Pretty much. And also, if you are a recipient, there's some expectation that you pay for the lodging and travel expenses of the person who donated. Yeah, it's kind of an unwritten rule from what I understand. Well, it'd have to be real. You know, it's kind of against the law, really. Well, but it makes sense, though, because if you're, let's say, you want to donate a kidney to someone that lives across the country and you're spending money off from work and flying out there and putting yourself up. Right.

It's going to cost you some dough and a kidney. Yes. You'd have to be a really nice person to just be an anonymous living donor. Yeah. That'd be cool. On the podcast, HeyDude, the 90s, called David Lasher and Christine Taylor, stars of the cult classic show, HeyDude, bring you back to the days of slip dresses and choker necklaces. We're going to use HeyDude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s. We lived it, and now we're calling on all of our friends to come back and relive it.

It's a podcast packed with interviews, co-stars, friends, and non-stop references to the best decade ever. Do you remember going to Blockbuster? Do you remember Nintendo 64? Do you remember getting frosted tips? Was that a cereal? No, it was hair. Do you remember AOL Instant Messenger and the dial-up sound like poltergeist? So leave a code on your best friend's beeper, because you'll want to be there when the nostalgia starts flowing.

Each episode will rival the feeling of taking out the cartridge from your Game Boy, blowing on it and popping it back in as we take you back to the 90s. Listen to HeyDude, the 90s, called on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. Seriously, I swear, and you won't have to send an S.O.S. because I'll be there for you. And so my husband, Michael, and a different hot sexy teen crush boybander each week to guide you through life step by step. Kids, relationships, life in general can get messy. You may be thinking, this is the story of my life. Just stop now.

If so, tell everybody about my new podcast and make sure to listen so we'll never ever have to say bye, bye, bye. Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple Podcasts, or wherever you listen to podcasts. Alright, so Chuck, you want to talk about the black market? Yes, the black market does exist. Isn't that crazy? Um, yeah, but not surprising. No, but it's pretty interesting. Um, it obviously exists typically outside of the United States, although there have been some cases inside the United States.

Usually it's like, and this is what's so sad, usually it's impoverished nations. And what'll happen is there will be a couple of countries involved. You'll take someone out of a really poor country, offer them like $5,000 for their kidney, and then the middle man will get, you know, $100,000 for that kidney. And, you know, it's not like these are done in professional surgical rooms. It's a lot of times, it's the back room, if you know what I mean. Sure, and that's actually exactly what happened in 2003 in South Africa. Yeah.

They were importing people from, I guess, the city of God in Brazil. Yeah, slums of Brazil. Yeah, and giving them $5,000 for their kidney, and then turning around and selling it for $100,000. Yep. That's nuts. Yep, and where else did it happen? Villagers in India sold their kidneys. Yeah, they weren't getting nearly as good.

No, they were getting about $800 for their organs, which is just unbelievable. And at one time, the Israeli organ brokers were obtaining these from Soviet block nations. Yeah. And doing the operations in Turkey, and this one guy made a middle man, made about $4 million before he was caught. Which is not bad. Harvesting organs. Although I imagine being an illegal organ broker is a fairly stressful job.

Yeah. And it happens in the US too, although customarily it's an organ broker and a nefarious funeral director who harvests organs before cremation. Did you know this happened? No. I didn't either. No. And I saw all of the six feet under.

Of course you did. Did you see the movie Turistas? No. That wasn't very good. That was the deal there though. These kids are like captured in the jungle. Oh, was that an Eli Roth movie? No, but it was like an Eli Roth movie.

Okay. It was like hostile except they were harvesting organs. Gotcha. Basically instead of just blind torture. Nice. And speaking of that, Turistas, that actually does happen in the world. It's not just old wives tales. Poor Mohammed Saleem Khan.

Kidney theft does happen. It really does. Mohammed, what do you say his name was? Saleem Khan. Yes. He lived in Delhi, India, and he was looking for a day's work and agreed to go to a house under the premise that he would get about $4 a day for performing work there, construction work. All is on the up and up so far.

Then he's held at gunpoint for several days, along with two other day laborers, they were taken to an operating room, drugged, and they awoke with a horrific pain in their side and minus one kidney. Yeah. And when they took him to the hospital, when he went to the hospital, he checked him out and he had indeed been down one kidney. Not an urban legend. No.

That really happens. Although it makes me wonder if the urban legend gave rise to the actual practice. Oh yeah. You know? Maybe so. And Josh, the one U.S. case that was in here was really interesting too. Yeah. Yes.

Michael Mastomarino is an oral surgeon in New York and he opened a company called Biomedical Tissue Services with an embalmer, which should have been a real red flag that he partners up with an embalmer. And this was in the year 2000, not even that long ago. Actually, it was 10 years ago. I'm old. For many years though, they harvested human tissue provided by funeral homes and sold it to research facilities.

And one of those bodies belonged to who? Alistair Cook. Alistair Cook, famous host of Masterpiece Theater. So he was chopped up and given to unwitting recipients. But they did harvest some of his tissue. Yeah. Yeah. How about that?

It's pretty awesome. So where are we now? We are, I think we're at the point where we check those stats. I have them written down here as of 2.03 p.m. What time is it now? Chuck's got to get out of his blank screen. Josh, it is 2.31. OK, 2.31.

I've got to tell you I'm going to be disappointed if this number hasn't gone down. I think all of our listeners will be too. So we started out, Chuck, with a total of 105,288 on the waiting list. What are we at? 105,288. OK. Nothing has changed in 20 minutes. With the kidney, we are at 83,012.

Well, it would be the same because that was the master stat. So the kidney didn't change either. Let's just hope Jerry didn't put a drum roll in anywhere. Right, but I will say though, don't be disappointed because like I said earlier this morning, three people received kidneys that were in search. That's awesome. Or else they died waiting. Yeah, let's like to think the other scenario panned out.

Are you a donor? I don't remember. I was at one point in time. I went for that $7 off. I did too. But I think I'm going to go ahead and do it. Yeah, this article inspired me because I'm of the belief that the human body after you die is like worm dirt.

So I have no problem with donating my entire body or all my organs. None of that. Yeah. Well, if you want to learn more about organ donation, you can read Tom Sheave's article on howstuffworks.com. You can also check out the, what is it, Chuck, the organ procurement network? Yeah. For their side of the story.

But I think you should also check out the Life Guardian Foundation. They have a very much opposing view of organ donation. So this is such a controversial topic. You should probably get all of the facts before you make the very important decision of whether or not you're going to be a dead donor. And if you decide that you want to be, like Chuck said, let everybody know. Tell everybody. Tell strangers on the streets.

Just any time you meet a doctor, go, I'm going to be an organ donor. You may want to make the decision with your loved ones as well. Sure. Even though ultimately it is, it is your call. Right. So good luck with being a rag doll in the afterlife, which leads us, of course, to listener mail. Yes, Josh. I am going to call this interesting kleptomania story from Sarah.

Okay. Hi, Josh, Chuck and Jerry. And she even spelled it correctly. Wow. I think that deserves a t-shirt, don't you? Oh, actually, she didn't. Sorry, two Rs. Okay.

Close, though. Here's a story that I always think of when I hear anything about kleptomania. A while ago, I was working in a large independent bookstore that had been a city institution for years, like any retail establishment they had experienced about 10 to 20% theft loss a year. Nothing too unusual. However, one day in the late 80s, they received a thick, densely written journal, which detailed to the day, hour, moment, weather condition, etc. Every single book this person ever stole from the bookstore.

Wow. And this guy turned it in. They showed it to us in sales training. It was written in a cramped hand, all pages front and back, which is really creepy. When you're writing on front and back, you're either really green or you're like a serial killer. Yeah. That's what I think. Sometimes a clipping or a picture from one of the stolen books is taped to it.

So, of course, the bookstore said, huh, maybe we should prosecute since they confessed, basically, to stealing over a period of 20 years, adding up to thousands of dollars. His work is interesting. They contacted the people that returned address, and it turned out the person who wrote in was a son or daughter, a very prominent local family, active in politics and big charities and the like. The kind of family they named wings of hospitals after. Huh, Sarah said. So, of course, they didn't want their good name dragged through the mud and apparently

settled out of court for an undisclosed sum. Money can do that, I guess. That journal was something to behold, though. So, um, that's what Sarah says. That is definitely a pretty good- That's a mania story. Big time. That's awesome.

Yeah. Cool. Well, if anybody's ever sent you a cryptic or disturbing journal and you want to tell us about it, or if you just want to say hi, you can send us an email at stuffpodcastathowstuffworks.com. For more on this and thousands of other topics, visit howstuffworks.com. Want more howstuffworks? Check out our blogs on the howstuffworks.com homepage. On the podcast, Hey Dude, the 90s called David Lasher and Christine Taylor,

stars of the cult classic show Hey Dude, bring you back to the days of slip dresses and choker necklaces. We're going to use Hey Dude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s. We lived it, and now we're calling on all of our friends to come back and relive it. Listen to Hey Dude, the 90s called on the iHeart radio app, Apple podcasts, or wherever you get your podcasts. Hey, I'm Lance Bass, host of the new iHeart podcast, Frosted Tips with Lance Bass.

Do you ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help. And a different hot, sexy teen crush boy bander each week to guide you through life. Tell everybody, everybody about my new podcast and make sure to listen. So we'll never ever have to say bye, bye, bye. Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple podcast, or wherever you listen to podcasts.