I would argue against that on a number of grounds:
The clone issue - having a medical system based on clones makes no practical sense. Transplantation is expensive business without paying for a whole new human being to be raised to adulthood as well! If clones were to be used then you'd need a single donor for a single patient. This is where the island and NLMG differ. In the island its explicitly shown that clones exist, in NLMG its just rumours. Seeing as the donors in NLMG usually have a few donations I don't think the donors are clones. Transplants aren't simply used because someone is getting old, they require major loss of function in vital organs. Whilst it is known that failure of one organ can increase stress on the other organs resulting in a multiple transplant (e.g. kidney transplant after heart transplant), this is by no means common. So if a single donor is donating multiple times (as they do in NLMG) it's most likely going to multiple patients, which destroys the clone theory.
Added to this, relatively few people require transplants, so having a clone that can only donate to you is like buying a lottery ticket and hoping it'll pay off. So in this respect, The Island isn't very realistic.
Donors Not Running Away - this is an allegory for livestock or our place in society. You only do what you're taught to do. I know plenty of people who constantly talk about how rubbish the UK is and how they'll escape the next chance they get, but they haven't left yet! This is the same thing, the donors like to talk about their freedom, but when its actually presented to them they are suddenly faced with the unknown and are too frightened to follow through. Even simple things like paying a waitress scares them. So its no wonder they never escape, their upbringing has taught them their place and they're sticking with it.
How can donors be around when there are animal protesters - that's a bit of a harsh criticism! In these sci-fi films you have to accept that some ethical matters may be slightly different in this alternate view of the world. It could be a world where there was no animal rights movement. But in the end this is a stupid question - its like not enjoying 1984 because you can't understand why society would allow such intrusion into privacy!!
Donors walking off after transplant - it doesn't take long to recover from transplant. If there have been no ccomplications then the donor just stays overnight for observations and can go home a day or two later. There's no massive risk of infection.
Stress on other organs after transplant - this is a fair point. Someone can easily survive on one kidney, and only about a third of a liver is required for function, so its perfectly possible to an extent. Donations appear to be fairly close together though (over the course of a few years max?) Which means the donor will die before there's much time for the other organs to give out. It is mentioned that different donors survive different number of donations, so that suggests that it depends on how vital the organs they take are and how well the donor recovers afterwards. Its possible that some die during recovery. And showing Ruth after a number of donations obviously showed she was pretty frail by that point. Although it is only shown in the protagonists anecdotal evidence that most donors die from giving a organ that is too vital to survive, there is no reason to reject the idea that some may die as an indirect consequence of donating.
Realistic Portrayal of Transplantation - at least NLMG *tries* to tackle the idea of donations and what would be taken when. The Island is only superficially about organ transplantation and never even tries to talk about the technicalities of the system. There are clones, they are there for organ donation... and that's it. Plus NMLG tackles the issue of how would humans that are only meant for livestock be raised, and what they would be told. The Island just assumes everything would be normal but they wouldn't be told about the outside world. As someone who works in organ transplantation, I think NLMG does miss a few tricks, but these could easily be argued away since its entirely from the view of the donor so the system is never fully explained. But on the whole NLMG is all possible in a logistical sense, if not an ethical one.
And all in all, if you wanted to have enough donors to meet demand of the transplantation system, raising clones is entirely unnecessary and overly expensive. There's no reason for them to be clones!! Sure clones would make autologous donation a reality and sounds nice and hi-tech for a scifi film, but its WAY too expensive and complicated to be practical on a mass scale when 'normal' people will do fine. The real question is where are the mothers who are giving birth to these donor kids? Is there a human battery farm? Do mothers get paid to be surrogates?
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