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Source: (consider it)
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Thread: Children and Organ Transplants
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New Yorker
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# 9898
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Posted
No matter which side you're on, I would think you would still find this gut-wretching. A child dying of cystic fibrosis who might be saved by transplant of an adult lung.
story here
I can see the family's argument that, "hey, let's try anything to save a child." I can also see the medical establishment's argument that, "we've got the rules and we have to follow them to be fair to all."
Not sure where I come down on this. Any Shipmates have any knowledge of transplant policies that could shed light (or perhaps a different light) on this story?
Posts: 3193 | From: New York City | Registered: Jul 2005
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Galilit
Shipmate
# 16470
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Posted
We just had a case here.
A 3 year old boy fell out a window and fell 3 storeys to his death. (Brain death). His kidneys were able to be transplanted. A transplant was done. Since there were no other suitable children on the list his other kidney was transplanted into a 3 year old boy from Gaza who was on serious dialysis like 5 days a week from birth.
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She who does Her Son's will in all things can rely on me to do Hers.
Posts: 624 | From: a Galilee far, far away | Registered: Jun 2011
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Carex
Shipmate
# 9643
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Posted
quote:
Originally posted by New Yorker:
...Any Shipmates have any knowledge of transplant policies that could shed light (or perhaps a different light) on this story?
What, you don't think we can rely on Faux News to provide fair and balanced reporting of the issue?
I know several people who work in transplants, and have one myself. There are a lot of difficult decisions to make.
To start with, you have to consider the relative probabilities of a successful transplant, and of the transplant helping the recipient live significantly longer. In the case of kidney failure, for example, replacing the kidney can solve most of the problems. My understanding of cystic fibrosis is that lung damage is a side effect, and while a lung transplant may provide some immediate relief, it likely will only last for a limited time before the new lung is gummed up. (But my medical understand may be flawed.)
Then you have to consider the side effects of the anti-rejection drugs on other options for treating the underlying disease: it often means that the body can't fight the disease on its own, so the transplant may actually worsen the other symptoms of the disease.
One issue with pediatric transplants from adults is the physical size of the organ: you certainly don't want to "trim some off around the edges" to make it fit the available space. In some cases the hormone balances are different between children and adults that can complicate matching organs in pre-pubescent transplants.
And then there is the wait for an organ... The US is divided in to several regions, each with its own sources and waiting list. Patients are put on the list in order, but there are several considerations for who gets a particular organ. In the case of the kidney, there are something like 7 or 8 categories, and an organ can go to someone in any region if they match on 6 of them. (Numbers are rough recollections - use as an example only.) With just 4 matches, say, then it is more likely to go to someone locally, because the "out of body time" is also an important factor in transplant success. Mismatches in some factors are more important than others. So being at the top of the list doesn't guarantee you get the next organ, or the one after that: it just means that you are more likely to get one sooner, even if it isn't as good match to your body.
Waiting times vary. I know people who have waited 7 years for a kidney, because they were a difficult match. The Pacific NorthWest is a net exporter of organs, so waiting times are less. In some other areas the supply is much tighter. I was told to expect 6 months to a year, but up to 2 years may be more typical across the country. Obviously if the average waiting time for a lung is anywhere close to that, getting on the adult list probably won't be any benefit in this case, so we may be down to small slivers of probability at several points.
One factor affecting the availability of lungs is that they are more often damaged in the types of deaths such as traffic accidents that account for a lot of donations. (There is a reason they talk about "donorcycles".)
Then you also have to consider the risk of the operation itself: it can very well hasten the child's death if it doesn't go well. (That's one reason why transplants that are likely to need to be repeated are further down the priority list, because the chance of success decreases with each one, while the risk to the patient increases.)
So while I don't know the details of the medical circumstances in this specific case, I can certainly understand why there is an age limit for the adult list, and that, even if this person were put on the list, the chances may still be very small that they would get a transplant in time, or, if they did, that the would survive the process and it would make a significant difference in the progression and long-term impact of the disease.
Yes, it's sad that we can't help everyone, and that, as it may be in this case, even a lung transplant might not do more than extend their life for 6 months. From the tone of that particular article it would seem to me that the author (and those trying to make a big deal out of it) are doing so more for political gain regardless of the actual opinions of the experienced medical professionals who have a better handle on the complexities of transplants and allocation of organs. And that is sad, too.
[ 04. June 2013, 20:15: Message edited by: Carex ]
Posts: 1425 | Registered: Jun 2005
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New Yorker
Shipmate
# 9898
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Posted
Thanks, Carex. I have to admit my first reaction was one of casting away rational thought in return for helping this poor little girl. That's normal I think. I hope my own second thought was normal as well. It was one of more realistic medical concerns.
Again, I don't know what's right in this particular case.
Posts: 3193 | From: New York City | Registered: Jul 2005
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Soror Magna
Shipmate
# 9881
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Posted
This is just another Terry Schiavo chew toy for the GOP. They're all worked up and wringing their hands about one little girl's health. At the same time, they just held the 39th vote to repeal Obamacare, which is absolutely and for sure going to help millions of other little girls get health care starting very soon.
quote:
Georgia Republican Rep. Tom Price, a doctor, told Sebelius that he understands the federal policy and appreciates her sympathy about the situation. But, he said, she can save the child’s life by “signing a paper.”
Yeah, just sign a paper and she'll be fine. ![[Roll Eyes]](rolleyes.gif) This guy claims to be a doctor? Does he think Secretary Sebelius can just write a prescription for a lung?
Posts: 5430 | From: Caprica City | Registered: Jul 2005
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cliffdweller
Shipmate
# 13338
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Posted
Yeah, the problem that Faux News is overlooking is the one that is central to all transplant cases-- saying yes to this transplant means saying no (and possibly death) so someone else's. I'm guessing the trade-off here is between giving an adult lung to an adult where there's a greater likelihood of success and giving the lung to a sympathetic child we all want to see live, but possibly with lower odds of successful transplant.
I wonder how it might change the discussion if Faux News were to disclose the stories of some of the adults on the transplant list-- a father, perhaps, or a mother. Maybe a war hero or a cop. Because the decision they are presuming to take on means 2nd guessing those sorts of choices. Myself, I'm glad not to be making that call.
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"Here is the world. Beautiful and terrible things will happen. Don't be afraid." -Frederick Buechner
Posts: 11242 | From: a small canyon overlooking the city | Registered: Jan 2008
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Soror Magna
Shipmate
# 9881
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Posted
Exactly. The options are a) choose recipients based on medical criteria or b) choose recipients by reality show squee factors. I'm sure that Fox has a perfectly ordered list of who would and wouldn't get organs in their fair and balanced world, and yeah, fortunately they're not making the decisions. This really, really bu ![[Mad]](angryfire.gif) rns me because these politicians and media folk have been doing everything in their power to prevent their fellow Americans getting health care. Lying about "death panels". Constantly attacking Planned Parenthood. In their fair and balanced world, dying in the ER is freedom, health insurance is oppression, and they are filled with compassion for one little girl.
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"You come with me to room 1013 over at the hospital, I'll show you America. Terminal, crazy and mean." -- Tony Kushner, "Angels in America"
Posts: 5430 | From: Caprica City | Registered: Jul 2005
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Barnabas62
Shipmate
# 9110
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Posted
There could be some good general outcomes.
This very sad "human interest" story might encourage more people to be prepared to consider organ donation following the untimely death of loved ones, that would be good.
It might also encourage a more rational approach to some controversial areas of medical research, help people to come to terms with the fact that the moral choices involved are not as straightforward as they believe (or have been led to believe).
It might encourage some grown up discussions about the really complex moral and social issues in health care these day. What is surgically (or medically) doable may be neither easily available nor generally affordable. Black and white thinkers may need a wake up call, regardless of which segment of the political segment they belong to.
It might even encourage awareness of some of the distorting effects of "gut-reaction" agitprop politics. Produce some dawning awareness that instant solutions are not always either possible or even desirable. Sometimes hard thinking is necessary.
But how much, if any, of the above is likely to happen in 24/7 newsworld in general, and Fox in particular? I'm pessimistic about that. It will be yesterday's news tomorrow. Something else will be found to generate fresh anxiety, anger, frustration and fear.
And that may be the biggest concern of all.
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Who is it that you seek? How then shall we live? How shall we sing the Lord's song in a strange land?
Posts: 21397 | From: Norfolk UK | Registered: Feb 2005
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cliffdweller
Shipmate
# 13338
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Posted
quote:
Originally posted by Soror Magna:
Exactly. The options are a) choose recipients based on medical criteria or b) choose recipients by reality show squee factors. I'm sure that Fox has a perfectly ordered list of who would and wouldn't get organs in their fair and balanced world, and yeah, fortunately they're not making the decisions. This really, really bu rns me because these politicians and media folk have been doing everything in their power to prevent their fellow Americans getting health care. Lying about "death panels". Constantly attacking Planned Parenthood. In their fair and balanced world, dying in the ER is freedom, health insurance is oppression, and they are filled with compassion for one little girl.
this.
![[Overused]](graemlins/notworthy.gif)
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"Here is the world. Beautiful and terrible things will happen. Don't be afraid." -Frederick Buechner
Posts: 11242 | From: a small canyon overlooking the city | Registered: Jan 2008
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cliffdweller
Shipmate
# 13338
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Posted
quote:
Originally posted by Barnabas62:
There could be some good general outcomes.
This very sad "human interest" story might encourage more people to be prepared to consider organ donation following the untimely death of loved ones, that would be good.
It might also encourage a more rational approach to some controversial areas of medical research, help people to come to terms with the fact that the moral choices involved are not as straightforward as they believe (or have been led to believe).
It might encourage some grown up discussions about the really complex moral and social issues in health care these day. What is surgically (or medically) doable may be neither easily available nor generally affordable. Black and white thinkers may need a wake up call, regardless of which segment of the political segment they belong to.
It might even encourage awareness of some of the distorting effects of "gut-reaction" agitprop politics. Produce some dawning awareness that instant solutions are not always either possible or even desirable. Sometimes hard thinking is necessary.
But how much, if any, of the above is likely to happen in 24/7 newsworld in general, and Fox in particular? I'm pessimistic about that. It will be yesterday's news tomorrow. Something else will be found to generate fresh anxiety, anger, frustration and fear.
And that may be the biggest concern of all.
Yes, exactly. It's a missed opportunity.
IF Faux News really cared about sick and dying children, they would (in addition to supporting universal health care and other life-giving measures as noted above) frame the discussion differently. They could feature the same child, but with a far different headline decrying the lack of organs available, the need for more donors, and particularly, sadly, pediatric organs.
Instead, they are framing it in their typical right-wing hysteria as some sort of clever left-wing socialist plot and/or inept government bureaucracy (love their ability to hold these two mutually exclusive ideas together) to deprive a child of life. The end result will likely be only more resistance to organ donation (why donate a lung when the inept/socialist gubbermint will only give it to some crack whore/ welfare queen instead of a sweet little kid?).
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"Here is the world. Beautiful and terrible things will happen. Don't be afraid." -Frederick Buechner
Posts: 11242 | From: a small canyon overlooking the city | Registered: Jan 2008
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PaulBC
Shipmate
# 13712
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Posted
If this story doesn't make you want to have a good cry nothing will. And there is little chance of a transplant. My heart breaks for the family .
As for the rigfht to lifers , GOP ,FOX NEWS types . This is not Schivo case again . There is NO government conspiracy .
Just remember the young lady and her family
in your prayers . ![[Votive]](graemlins/votive.gif) ![[Angel]](graemlins/angel.gif)
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"He has told you O mortal,what is good;and what does the Lord require of youbut to do justice and to love kindness ,and to walk humbly with your God."Micah 6:8
Posts: 873 | From: Victoria B.C. Canada | Registered: May 2008
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