A friend of mine had a kidney transplant this past summer. She was required to be vaccinated against covid (already had it). She also had to lose a significant amount of weight and pass several tests for blood pressure and other medical risks. They told her that they needed to ensure that whoever received a donor kidney would survive long enough to make it worth “spending” the kidney on, since they are in such short supply. That makes sense to me.
If she had been a smoker who refused to stop, could not lose the weight, or not taken measures like getting the vaccine, she would have been considered unqualified.
“Post any transplant, kidney, heart whatever, your immune system is shut off,” Caplan said. “The flu could kill you, a cold could kill you, COVID could kill you. The organs are scarce, we are not going to distribute them to someone who has a poor chance of living when others who are vaccinated have a better chance post-surgery of surviving.”
"Odds of survival have long been factored into prioritizing who will get donated organs. And requiring vaccinations against devastating infectious diseases is also standard. Organ recipients are already generally required to be vaccinated against hepatitis A, hepatitis B, influenza, and tetanus, among others diseases."
None of those diseases have high kill rates. Kill rates aren't the justification being used.
It's about maximizing success of the transplant. This is just one more vaccination in a list of vaccinations.
This isn't surprising to anyone remotely familiar with eligibility requirements for organ transplants. There are all sorts of choices a patient can make that would make them ineligible.
Speaking as a kidney transplant recipient it is most certainly not a walk in the park. I mean that literally; I cannot walk in the park without taking precautions against covid/influenza and my increased risk of skin cancer...
You seem unaware of the many and myriad reasons organ transplants are performed. Like you get that by the time doctors are considering it, it's because the alternative is they think you're either (1) going to die soon when it becomes necessary or (2) is necessary right now.
Did you know there are people who survive COVID and wind up in kidney failure from the stress on their body? What's your answer to them? Oh right: hope you can get a kidney and then enjoy life on immunosuppressant drugs.
But you know, go tell those dialysis patients on the waiting list that actually they're not that important.
I need a transplant, heart and liver and this good news. People need to make good decisions when getting a transplant. There is very little room for error. If someone is going to neglect a simple vaccine how in the world are they going to manage being stewards of an organ, a gift of life.
There is no shortage of people needing transplants. You have to prove to the committee and doctors at every stage you are worth being transplanted or a better candidate will take over your spot in a hurry
That isn't really a fair comparison. There's a selection bias among kidney donors (they must pass some minimal health requirements) and are at a lower risk than the general population.
The screening isn't just for safety, it's for biological compatibility with the recipient - a mismatched organ will not function and will be destroyed by the recipient's (even suppressed) immune system. It's worse than just failing, you damaged the recipient and you wasted an organ that could have gone to a proper match. When I received my kidney transplant I had to acknowledge a risk of contracting an undetected bloodborne illness from the (deceased) donor's history of drug usage. If the primary concern driving screening was simply safety the organ would not have been considered available. The primary concern is compatibility. Other resulting conditions can be managed afterward. The risk of me dying as a result of the aforementioned undetected bloodborne illness was some tiny fraction of a percent - The risk of me dying on extended dialysis is one hundred percent.
just so you know, around 1% of people die in conditions where their organs are elligible for transplantation. then there's the factor that kidneys from living donors generally last longer for the recipient
It would be curious to see the Vox piece and I do hope someone drops a link in here. It would be most interesting to know if they were comparing it to the initial procedure (surgery + complications) or lifetime experience (Additional risk of death due to the remaining kidney failing).
That said, I feel like your points are a bit overstated. We now have 66 years worth of Kidney transplant data to show it's safe for both parties, but a lot of people needed to participate in what was a new, risk, experimental surgery to get us to this point.
At some point people have to be willing to take a little bit of risk to get data that could save untold lives and relieve unquantifiable suffering.
Additionally, if COVID-19 does indeed have some horrible long term effect, the cost us having less data or less valuable data now will have a much larger consequence than could ever be suffered by these volunteers.
Yes. No kidney for her, but flu shots for 10,000 ... saving many hundreds. The reality is that saving lives is now a matter of resource allocation. Procedures such as organ transplantation take resources from far more efficient treatments that can save many more lives.
I wish I had recorded something I saw at the gym years ago. An old and obviously ill man was bragging about how his firm could hire young interns, pay them nothing, and fire them at the drop of a hat. A young man overheard, walked over to him and said "I;ll never have your money or power, I cannot stop you from being a jerk, but when your liver starts failing you aren't getting even a piece of mine." He then ripped up his organ donation card.
What I find disturbing in this piece is the seemingly massive false equivalency being perpetrated. Donating a kidney is not like giving blood. This is a major operation and carries with it an assortment of long-term health risks to both the donor and recipient (though, obviously, the recipient has essentially nothing to lose; long-term followup studies of live donors are still pretty small and not that informative)...yet the entire article seems predicated on "you'd be a monster not to give up at least one of your kidneys!" Where's that attitude coming from, exactly? Why not just toss a lung into the mix as well?
wouldn't be surprised if kidney donor is going to be a job some day. a rich person pays a salary to a compatible potential donor and expects you to live healthy, workout, no alcohol etc. and ... if necessary part ways with one of your kidneys.
I just want something like this for my next kidney transplant, I'm so sick of the meds, yes I'm blessed to be alive and living a really good life, but man the 2nd kidney is starting to give me anxiety. Context: Transplant isn't a cure to my autoimmune disease, it will slowly pick away at the graft and have me needing another. Love reading about this kind of stuff.
My father was on a kidney waiting list for a little over a year. His physician told him that if they were to learn that he had even one alcoholic drink while he was on the list, he'd be moved to the end (he had no history of alcohol misuse, this was just kidney donor boilerplate). So it would appear that lifestyle factors can figure into these medical decisions, although it's not a moral judgment.
Certainly it would be necessary to ensure people are of sound mind and understand the risk they're taking. That said, if we're talking about young, healthy people volunteering, and given they will be monitored throughout the trial, I would guess their risk of death would be on the order of 1/1000, if not better. (Based on recent estimates of overall CFR on the order of 0.5% out of NYC and such.)
That's not a risk I personally would want to take, but it's on the order of the risk people take when donating a kidney. (And of course for most people the process will be much less arduous than a kidney donation.) We consider that acceptable to save a single life, whereas a faster vaccine would save many. So my prior would be that most people volunteering for something like this are simply altruistic, similar to a kidney donor, rather than mentally ill.
If she had been a smoker who refused to stop, could not lose the weight, or not taken measures like getting the vaccine, she would have been considered unqualified.
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