Is there a fair way to decide who gets donor organs?

No. For many of it, this is a painful subject. Ethicists have told me with straight faces that alcoholics and heroin shooters are no more responsible for their ruined livers than children born with terrible birth defects. "fair?" the problem is lack of donor organs, due largely in turn to our dysfunctiona us tort law system. An "opt-out" system as is coming into use in europe might help. Good luck.