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Showing posts with label kidney. Show all posts
Showing posts with label kidney. Show all posts

Friday, March 30, 2012

Live Donor Donation: Kidney donated by Rabbi Chaim Soloveichik

I am proud to be friends with some of the family of the late Rabbi Ahron Soloveichik.
Rabbi Ahron Soloveichik was renowned for his kindness and sensitivity towards all human beings...especially towards people who in reality had problems or people who were just considered by society as lowly, poor, ill, downtrodden, handicapped, unusual, or just plain different.
To give only a very small vignette about his extreme righteousness and piety, a mentally disturbed woman once pushed Rabbi Soloveichik onto the NY Subway tracks in front of an oncoming train. Rabbi Soloveichik jumped out of the way and saved himself. But the story goes on. The disturbed woman fell onto the tracks as she was pushing Rabbi Soloveichik in front of the train. She was unable to get herself away from the oncoming train under her own power so Rabbi Soloveichik risked his life and also pulled this women who had just try to kill him to safety.
With such an illustrious lineage, I am not that surprised that Rabbi Chaim Soloveichik of Ramat Beit Shemesh,Israel, who is the youngest child of Rabbi Ahron Solloveichik, made an altruistically donated one of his kidneys to a women in need of a kidney a few weeks ago. A short article about it is found here.

I hope Rabbi Soloveichik and the women are both feeling well.

Tuesday, February 21, 2012

Update: Hospital Relents: Little Amelia Has Hope for Life - She Can Get a Kidney Transplant !

We have a nice update to a post from a few weeks ago. The post is found here. Basically, the family of 3 YO girl, Amelia Rivera, understood after meeting with their physician that their daughter was being denied a kidney transplant because of her "mental retardation."

CBSNews reported here that The Children's Hospital of Philadelphia issued a joint statement with Amelia's family that "as an organization, we regret that we communicated in a manner that did not clearly reflect our policies or intent and apologize for the Riveras' experience." Amelia's parents said in the joint statement that "despite an unfortunate encounter a few weeks ago, we hold The Children's Hospital of Philadelphia in high regard. Our hope is that this experience will heighten the medical community's sensitivity to and support for the disabilities community."

Let's hope that a suitable donor kidney is found for little Amelia expeditiously and that the transplant goes as smoothly as possible.

Kudos to everyone who inundated the hospital with comments and complaints which surely helped encourage them to get their act together and not to deny a transplant to one of the most vulnerable members of our society.

Friday, February 10, 2012

Raising Awareness for Live Donor Kindey Donations through Social Media

How can the power of social media and multimedia be utilized to increase live donor kidney donations?
Some random thoughts...
1. A youtube channel where people who need a kidney tell their story to the world in hopes of finding an altruistic donor.
2. A reality show about the apprehension and angst of an individual and their family as they wait on the kidney transplant waiting list hoping to get a kidney before it is too late.
3. A reality show/youtube channel dedicated to following a person on dialysis who then gets a transplant and compare the drama relating to the transplant surgery and also to compare their (quality of) life before and after the transplant.
4. There already is a twitter feed to monitor all things related to ESRD and kidney transplantation here. Dr. Robert Hickey, a great hero and advocate for all things related to kidney transplants, constantly tweets all types of info and links to articles related to ESRD (fyi, he also tweets strong political stuff there so you'll either hate it, love it, or you can ignore it.)


Anyone else have suggestions???
Dr. Hickey's comment:
Robert F. Hickey, Ph.D.Feb 17, 2012 12:04 PM

We would be well served by implementing every option available to encourage human organ transplants as long as they are legal and ethical. However, unbelievably, there are those, individuals and so-called non-profits, doing evrything they can to discourage patients from advocating for themselves. More on that issue below.

A reality show focusing on the frustration, anguish, and fear of patients waiting for organ transplants and their families would be extremely revealing. CBS attempted to bring a weekly show, Three Rivers, to the audience. It didn't catch on!

The show was set, ironically enough in Pittsburgh, considered by some to be ground zero in the transplant world. It also happens to be the town where the University of Pittsburgh kidney transplant center was recently shut down. Patients were given contaminated organs. The show was stilted and not a reflection of what actually happens from a patient/family perspective.

The transplant establishment has engaged in unfair and unethical efforts to minimize the impact of social networking by patients to find living donors. This week I received 2 calls from patients who were told they could not get kidney transplants if they found donors through www.matchingdonors.com or any other such Internet site!

Two weeks ago, Dr. F. Coors, at University of Colorado made a public statement indicating that social network sites were dangerous because you never know what you're getting. Nonsense! A prospective donor and Transplant recipient will go through 6 to 9 months of testing and intrusive interviews before any transplant will be approved. I've been through along with my donor in 2004.

Some transplant centers claim they will accept prospective donors who are identified through social media while not being sincere about their intentions. This happened this week to 2 patients at Cedars-Sinai in LA. Both presented with altruistic, non-related, living donors for kidney transplants. One was told Cedars transplant team would not accept any donor without insurance. The other was told no donor who had to travel to the hospital would be accepted. First, in the case of kidney transplants, Medicare/Medicaid will pay living donor medical expenses. This includes any medical issue arising from the transplant for several years. Many recipients also have private insurance in partnership with the government coverage. Secondly, there is no valid or ethical reason to disqualify a prospective donor based on where they live within the USA. These are smoke screens.

The point is, we can do all we can to promote organ donation. However, if the powers that be in the transplant industry don't stop erecting manufactured hurdles to transplantation, nothing is going to help. The so-called non-profit structure of the US transplant system is a complete sham. UNOS and the 58 Organ Procurement Organizations across the country and their managers have become millionaires on the monopolistic system they control. When that monopoly is broken innovation will come and the transplant waiting list will be resolved within 24 months.

As long as we have Organ Procurement Organizations making $50 million to $140 million annually on procurement fees, organ sales prices, the system will not change! As long as executives at UNOS and the OPO are being paid $500,000.00 to $700,000.00 per year, the system will not chgange.

Monday, January 16, 2012

Scarcity of Kidneys: A Physician Making a Child Ineligible for A Kidney Transplant because of "Mental Retardation"

Read this mother's heart wrenching story here of how a transplant physician at the Nephrology Department at Children’s Hospital of Philadelphia has reportedly denied a little 3 YO girl with a rare genetic disorder the chance of getting a kidney transplant because she is "mentally retarded."
Here is a partial transcript of the emotionally charged conversation according to the mother's account:
(Start Transcript)
[Mom]“So you mean to tell me that as a doctor, you are not recommending the transplant, and when her kidneys fail in six months to a year, you want me to let her die because she is mentally retarded? There is no other medical reason for her not to have this transplant other than she is MENTALLY RETARDED!”

[Transcript Surgeon] “Yes. This is hard for me, you know.”
(End Transcript)

Nobody should pretend to be omniscient, or to "play God", and certainly, nobody should revel in "playing God."
While I certainly understand the mother's position, I can see the physician's position although I vehemently disagree with it. I hope to write an extensive post on why I feel this way.
But, the mother reports she offers to find a live donor.

[Mom]“Oh, that’s ok! We plan on donating. If we aren’t a match, we come from a large family and someone will donate. We don’t want to be on the list. We will find our own donor.”

[Doctor] “Noooo. She—is—not—eligible –because—of—her—quality– of –life—Because—of—her—mental—delays”
If the family finds a live donor match from their family, surgeons are able to implant even an adult kidney into a child's body by implanting the kidney into a different part of the child's abdomen. (See here to read about cutting edge research being done at Stanford's Lucile Packard Children's Hospital where they have pioneered a method to keep adult kidneys alive even in small children where blood tends to pool and clot in the relatively large kidney causing the organ to stop functioning.)

Assuming the family is able to obtain its own donor, the transplant surgeon should keep his opinion completely to himself... the family is not getting involved with the transplant waiting list so he should not "play God" and pretend to be omniscient...he should allow the parents of this little girl to do everything they want to keep their child alive.

Thursday, January 12, 2012

Morality: Is it Moral to Outlaw the Exchange of Money to Obtain a Kidney Transplant?

The bottom line is this: While some may argue it is immoral to buy and sell organs, I argue it is much more immoral to cause people who would otherwise be alive to be dead because less organs are available to the market. Let's keep more people living and reform the market for organs. A well regulated market will allow people to buy and sell organs and thus increase the supply of organs available and help everyone....because for every organ that a richer person bought, a poorer person will now have access to one more organ that is now available to the market.
Sometimes, the most moral decision is made not because it is not without any moral ambiguity or taint, but rather because it is the best option among many bad options.

Case and Point: The U.S. and the U.K.'s treating the evil Stalin as an ally in order to defeat an even greater evil, Hitler, in order to save Europe (and possibly the world) and defeat Nazi Germany.

But, clearly, to destroy Hitler, morality dictated we cut a deal with Stalin to carve up post-war Europe in order to saving the world from Hitler's ambitions of a 1,000 year rule where he would purify the world from everyone except those of the Aryan-race.

When Al Gore and Orrin Hatch promoted the passage of the National Organ Transplant Act of 1984 (NOTA), its purpose was "[t]o address the nation's critical organ donation shortage and improve the organ matching and placement process." See here.
It also outlawed the buying and selling of organs for transplantation.

This piece of legislation constantly causes the death of people who are unable to receive an organ for transplantation before they die.


The are not a finite number of organs available for transplantation in the U.S. that we have already reached. Putting aside deceased donor donations, there is plenty of room for live donors to supply many kidneys to people on the waiting list and thus alleviate the shortage to some extent. If we rely on altruism alone, a certain quantity of kidneys will be supplied to the market. If live donors could be compensated for their very valuable donation (dialysis for people with kidney failure can easily cost $70,000 per year and Medicare [AKA the taxpayers] covers all people with ESRD regardless of age) then the quantity of kidneys supplied to the market would increase and the shortage can be decreased or possibly even be wiped out. See an old post here where I discuss a possible government policy where live donors are given a $50,000 tax refund for their kidney.

NOTA must be reformed to save lives!!!

Saturday, August 13, 2011

Ethical Dilemnas in Directed Kidney Donations

Should a person be able to donate his or her kidney to whomever they prefer, or should all kidneys go to the next person on the waiting list?

This is a major ethical dilemma. Basically, with one possible caveat, I feel that a person should be able to direct their kidney donation to whomever they see fit. I explain my opinion fully below.

Basically, Douglas Hanto, M.D., a Harvard Medical School physician, is quoted to have said “Organs should go to the person who needs them the most, not to people because they are members of a club.” See Dr. Sally Satel's article about one example of Dr. Hanto's action to try to stop directed kidney donation
here.

Robert F. Hickey, Ph.D. is a big advocate of live donor kidney donation. Dr. Hickey's life was saved by a live donor donation and he zealously advocates for the right of people to direct their live donor organ donation. He debated Dr. Hanto on this topic recently at Harvard University.

Robert F. Hickey asked me about my reaction to a situation that was raised at the debate at Harvard. A certain Rabbi who was in attendance said that he advocates for his congregants to donate their organs [exclusively] to other Jews and (I think) to only accept organs from other Jews. Below is my response to the Rabbi's approach.

"This is what I feel about a Jew, or any other segment of the population directing their donation to their own group. While I feel that their motives may not be completely pure, I care about pragmatic results, not some theoretical morality or utopian concept of altruism. If a Rabbi encourages his congregants to donate organs only to other Jews, I feel he is doing a morally just thing anyways b/c Jews are on the waiting list like everyone else so if he encourages his congregants to give directed donations and thereby increasing the pool of organs available for transplantation, there will be a net gain in organs available for transplantation and therefore it will, in final analysis, help Jew and non-Jew alike by that Rabbi encouraging his congregants to donate their organs to Jews."
"Now, a morally troubled outgrowth from such an approach that may arise would be if there was a non-Jew on the waiting list who would certainly die today without the transplant and a Jew who can still live for a while as he awaits a transplant. I would recommend in that situation to give the organ to the non-Jew (pay the organ forward) and then give the next organ that becomes available on the waiting list to the Jewish person on the waiting list."
"Besides for these reasons, I believe that the Rabbi can legitimize his approach from a personal autonomy/libertarian perspective as well."
"Personally, though, I feel the best thing to do would be to take a different approach. I think that the Rabbi may be misguided because his approach can be interpreted with a xenophobic connotation so I think he would be better off to teach his congregants the economics lesson I shared above so that his congregants will understand that by donating organ, they will help everyone on the waiting list, which will definitionally move all of the Jews on the list closer to getting their transplants as well."

I do think, however, that people will tend to donate organs in greater numbers for people they fell a greater kinship for (like family, friends, coworkers, etc.) so from a behavioral economics perspective, there would probably be an increased number of organs available for transplantation if we encouraged more people to give directed organ donations to people they are close with socially. This would, in final analysis, cause more lives to be saved so I think the Rabbi is doing a positive thing - saving human life.

Thursday, March 24, 2011

Confronting the Intrenched Organ Donation System: It is possible

Below are examples of some blogs, websites, and articles which all confront the reality of the current (possibly semi-dysfunctional) organ transplant disbursement system and attempt to shine light on it, study it, and offer ways to improve it. Or, they break with the current system altogether and blaze alternative paths to increase the supply of organs available for transplantation.
I don't attest to the veracity of the claims made in these links. Make your own judgment. But the current system can most assuredly be improved. It will take people and organizations similar to those linked to below who aspire to improve the current system to create the change necessary which will lay the foundation to increase the supply of organs and thereby save lives.

For a live kidney donor recipient's personal outlook on the entrenched interests opposing live-donor donation see this website.

For a blog about alternative methods to increase the supply of organs available for transplantation see here.

For a website that attempts to link live organ donors with people in need of a transplant see this website.

For a press release about a grant awarded to study the outdated organ disbursement method and how it causes unequal access to donated organs based on where a person live see here . Also see here for an old post on the issue where I propose a study designed partly to determine the effect of a person's distance to a transplant center and the time it takes for the person to receive an organ. Yes, its a very technically worded post so don't say I didn't warn you.

And finally, see this link for a book titled, "The U.S.Organ Procurement System" where the authors, David L. Kaserman and A.H. Barnett engage in a thorough economic analysis of current U.S. organ transplant policy, the problems with it, and a proposal explaining how organ markets would operate in a manner which would save lives by increasing the supply of organs available.

Tuesday, March 1, 2011

Jonas Salk created the Polio Vaccine...Lessons for Kidney Transplantation

"Hope lies in dreams, in imagination and in the courage of those who dare to make dreams into reality."
The preceding statement comes from a memorial at the Salk Institute which captures
Dr. Salk's vision.
Dr. Jonas Salk prevented millions and millions of deaths when he created and engineered the polio vaccine in the 1950's. I am keenly aware of the human suffering he prevented...my grandmother grieved the rest of her life for her 17 year old son, Martin, who died of polio in September, 1954 - while Salk's new vaccine was being tested on one million school children.
Presently, in California, there is the Salk Institute which carries on the legacy of Dr. Salk which researches various phenomenon ranging from cancer, diabetes and birth defects to Alzheimer's disease, Parkinson's disease, AIDS and plant biology. See the Salk Institute's description here.

I was thinking about the quote..."Hope lies in dreams, in imagination and in the courage of those who dare to make dreams into reality."
Until their are enough courageous people willing to attempt to find a solution to the current shortage of kidneys available for transplantation, the hope to solve the problem is like a fleeting and illusory dream - and not a very hopeful dream on the cusp of being turned into reality.