For $295 a month, a firm will advertise your need for a kidney, liver or other organ on the Internet.
Another Web site promises overseas coordination of a kidney transplant from a live person within 30 days.
Still another group asks you to join a club where people pledge to give organs to each other upon death.
"We see groups like these pop up," says Joel Newman, spokesman for United Network for Organ Sharing, a nonprofit organization established in 1984 that administers the network set up by Congress to fairly distribute organs. "But they usually don't last."
Entrepreneurs, however, consider these online efforts innovative, aimed at shaking up a system that has nearly 84,000 people waiting for organs nationwide.
Medical ethicists, however, worry that such ventures may prey upon critically ill people and circumvent procedures set up to fairly allocate organs in the United States.
"I find it very offensive," says Laura A. Siminoff, a bioethicist at Case Western Reserve University. "These efforts expose the true desperation of the situation."
Under federal law, it is illegal to buy or sell organs, but it is legal to direct your organs to a specific person. UNOS oversees distribution of cadaver organs based on need. Patients coordinate living donations themselves through transplant centers.
Demand for organs continues to rise, though, which has resulted in new ventures.
One organization stirring debate is LifeSharers. David J. Undis, a Nashville, Tenn., insurance executive, founded the group in 2002.
"Everybody knows donating your organs when you die is the right thing to do," Undis says. "But most Americans haven't gotten around to signing a donor card."
Only about one-third of Americans have signed up to be organ donors, he says. The solution: Offer free, open membership to LifeSharers, a group in which members give organs to fellow members first. This creates an incentive for people to join, thus becoming donors themselves.
To date, Undis says, the group has 2,000 members. It operates on about $3,000 in gifts and personal funds.
Other organizations promise overseas kidney transplants immediately. And while it's not illegal to go overseas for an operation, patients should be aware that U.S. laws do not apply overseas. Often there are fewer safeguards.
In Massachusetts, Paul Dooley has launched MatchingDonors.com to match potential donors with people in need.
Dooley charges $295 a month for people to advertise their cases monthly. In the first month of operation, 17 people signed up to solicit organs, he says. Others expressed an interest in donating without pay.
Robert Hickey, 58, of Edwards, Colo., signed up in hopes of getting a kidney. A former health-care executive, Hickey was diagnosed with kidney cancer in 1997. Doctors removed one kidney. The other one shut down recently.
"It's a touchy subject, trying to find a donor," says Hickey. "You feel uncomfortable saying, 'Would you consider giving me a kidney?'
"This is the first time I've had any tool available to me where I could be proactive but not feel guilty about it," he says. While he undergoes dialysis several times a week, he's working with doctors to evaluate 17 offers.
Dooley sees his idea as a great way to promote living organ donation. And if the Web site attracts paid advertising, he suggests, "we should be able to offer the service for no cost to patients."