wedrifid comments on Consequentialism Need Not Be Nearsighted - Less Wrong
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Then I have an "easy" patch: let the entity that does the spotting and killing be incorruptible and infallible. Like, an AI, an army of robots, or something. With that, I don't see any obvious flaw beyond the fact that, with this level of technology, there are very probably better alternatives than transplantation. But the idea of creating a machine for the explicit purpose of killing people might be even more creepy than the police state we're vaguely familiar with.
Compare with the comment I saw somewhere with this dilemma:
Let die? As in wait until they die by natural(ish) causes then eat the corpse? This sounds like a no-brainer. (Cryonicists might have some concerns about the meaning of death, however. Hopefully the patients agree that they are dead at the time!)