Toni
Contributor
- Joined
- Aug 10, 2011
- Messages
- 19,896
- Basic Beliefs
- Peace on Earth, goodwill towards all
Jahryn, I used to work in a lab that performed testing for blood donors and organ donors. A close friend is an organ recipient. You are absolutely WRONG here.And either way, even 10% of a 100% (a wildly high percentage) increase of orgain donations ending badly due to missed screens would be preferable.Loren, I’m certain that you are aware, but prior to transplantation, blood is screened for transmissible disease in addition to the testing typing and cross match, and HLA groups, If the donor is known to have had a malaria infection, a highly sensitive test is performed to determine if there is any remaining plasmodium. If you’ve been properly treated you should not still have any plasmodium burden.I would like to see multiple changes:Or we could make a change in some places that is already implemented: changing the default of consent to "yes" rather than "no" and continuing to have a volunteer situation but with "opt-out" rather than "opt-in"
1) Default-in.
2) The transplant list is sorted by what % of your adult life you have not been opted out. Children get the average of their parents. The 0/0 case (medically invalid before reaching 18) is treated as 100%.
3) The ability to put notes on the status. I have my driver's license marked no, not because I'm opposed but because 40 years ago a malarial mosquito bit me. In theory it was wiped out--but it returned after more than 20 years. Is it still lurking there? Who knows? They certainly shouldn't be transplanting any organs without the medical team knowing that piece of information!
if everyone became a donor unless they opted out, not everyone would be a suitable organ donor, depending on age, cause of death, where the person was when they died, and of course if they carried any number of transmissible viral disease or had other conditions.
All organ donors are screened for transmissible viral diseases and increasingly for some parasitic diseases as well. These tests must be carried out and results reported in a very short time frame or the organs are useless.
This sort of testing is highly regulated to ensure the safety of any organs or blood used in transplants or transfusions.
In reality the numbers will be closer to 1% and 1000%, but it would take an inverse to the increase in tainted vs available to be a bad thing on net, a completely unrealistic outcome. You would need the increase in tainted to outstrip the fulfilled demand.
Far more people would still be dying of no organs than tainted ones even were we to increase the supply at the expense of higher taint.
There is no available world where opt-out hurts people more than opt-in. Not even concerted trolls trying to taint the supply on purpose would yield such an outcome.
There is no world where it is medically ethical to transplant organs or transfuse blood that has not been thoroughly tested and screened for viral diseases and now, some parasitic diseases as well as typed and cross matched and thoroughly testing of HLA groups.
Organ transplantation is extremely expensive in terms of dollars and time and expertise. Whatever you see on television or in movies, transplants are not performed at every hospital or with the staff of an ER. Organs are harvested by experts. They are transplanted by experts. The toll on the recipient patient is enormous-and worth it if they survive the post op period and do not face any rejection issues--which can occur even with excellent matching. Healing is lengthy. Several months after receiving his organ, my friend nearly died from a post op infection that his immunosuppressed body could not clear despite complete compliance with post op care. He had to be rehospitalized for a couple of weeks in order to clear the infection and to get his original incision sites to hearl. There are more scars now than before. BTW, his donor was the ideal donor: early 20's, non-user of any substance, died in a motorcycle crash (Everyone: Wear your helmets!!!).
After a transplant, the patient is ALWAYS immunosuppressed and must be extra vigilant to avoid any type of infection. This is not a casual undertaking. Recovery is arduous. It is a big fucking deal.
I DO agree that organ donation should be the default but not everybody IS a good donor. Not every recipient who needs a new organ is a good candidate for a recipient. At my age, it is doubtful that I would make it to the UNOS list. Some people simply opt out and choose not to consider transplantation for a variety of reasons.
Doctors, UNOS and the medical community are NOT going to reduce their standards for screening because transplanting an organ that is not well matched or not properly screened to ensure it is not carrying certain diseases doesn't just mean that the recipient is likely to die some weeks or months after their surgery: they will die a difficult, painful, expensive death. The time and effort and the organ will have been wasted.
My response to Loren was merely to assure him that his corpse would be properly screened if he did want to become a donor. Of course he should speak with his medical providers and not take medical advice from some random old lady on the internet.
Another consideration: there is a short time frame between death and transplantation: a matter of hours. Donors should have died in a hospital which has the capacity to maintain the body on life support until a transplant team is able to remove the organs. So if someone passes away in their home and isn't discovered for 10 hours, then they will not be an organ donor, no matter how many cards they signed giving their consent. And even if you have signed a donor card, if your family objects, it is possible that they will elect not to use your organs. Delays in convincing the family can make the question moot.