Writes Amy Silverstein, in "My Transplanted Heart and I Will Die Soon" (NYT).
१८ एप्रिल, २०२३
"Organ transplantation is mired in stagnant science and antiquated, imprecise medicine that fails patients and organ donors."
"And I understand the irony of an incredibly successful and fortunate two-time heart transplant recipient making this case, but my longevity also provides me with a unique vantage point. Standing on the edge of death now, I feel compelled to use my experience in the transplant trenches to illuminate and challenge the status quo.... Because a transplant begins with the overwhelming gift of a donor organ that brings you back from the brink of death, the entirety of a patient’s experience from that day forward is cast as a 'miracle.'... But this narrative discourages transplant recipients from talking freely about the real problems we face and the compromising and life-threatening side effects of the medicines we must take.
This 'gratitude paradox,' as I’ve come to think of it, can manifest itself throughout the transplant professional communities as well. Without vigorous pushback, hospitals and physicians have been allowed to set an embarrassingly low bar for achievement...."
Writes Amy Silverstein, in "My Transplanted Heart and I Will Die Soon" (NYT).
Writes Amy Silverstein, in "My Transplanted Heart and I Will Die Soon" (NYT).
याची सदस्यत्व घ्या:
टिप्पणी पोस्ट करा (Atom)
पोस्ट्स
७३ टिप्पण्या:
Whatever happened to lab grown organs? The idea was to use a patient's own stem cells to create an organ that is fully compatible with their body and that would eventually become a part of their body and would never need to be replaced.
An even better way to get a new heart or kidney or whatever is to create a clone. Scientists would grow a copy of the patient in someone's uterus and then take the organ out of the clone when it's born. You can see Dick Cheney doing something like this.
Now do one on elective cosmetic surgery such as breast implants.
Now do one on elective transgender surgery.
Dr. Shayne Taylor of Vanderbilt University openly touted the medical industry's conflicts of interest for ensuring long-term profits:
https://www.washingtonexaminer.com/restoring-america/community-family/blackburn-doctor-profits-transgender-surgeries-video
I await new Nuremberg trial after the current Reign of Terror ends.
She's right that it's hard not to dismiss her as ungrateful. She's alive, how does that count as a low bar for achievement? I guess she's right in that there is no lower bar that would do her any good, but still...she's alive with someone else's heart. It's hard to see that as a low bar.
The drugs are a serious problem; the solution is using adult stem cells to grow new organs. Until that technique is viable, it's hard to see how the rejection problem can be solved without immuno-compromising drugs. Is that a low bar? Or an effective solution to a problem without no easy solution?
Life threatening side effects? Of the life saving procedure? Good Lord, talk about ungrateful?
Lemme guess, “women and minorities hardest hit”!?
I would like to read the essay, but it's paywalled unfortunately. I admire her desire to communicate something important. I would not automatically assume it's ingratitude - she's tackling what for her has been a life-determining result. Looking forward to getting access eventually. I know at least one young person that is alive and doing well thanks to one of his father's kidneys.
I share this as it was shared with me... give a listen.
https://sensiblemed.substack.com/p/on-death-and-its-futility-765?utm_source=direct&r=1zorue&utm_campaign=post&utm_medium=web#details
Addendum to Enigma's post...
https://www.thefp.com/p/i-thought-i-was-saving-trans-kids
shes had two transplants, what does she think they are available in vending machines,
She is critical of the transplant drugs, which "cause secondary diseases and dangerous conditions, including diabetes, uncontrollable high blood pressure, kidney damage and failure, serious infections and cancers."
The first heart she received "died of transplant medicines’ inadequate protection of the donor heart from rejection" and the "second will die most likely from their stymied immune effects that give free rein to cancer." She is about to die of cancer (in her 30s).
Both the recipients and the donors deserve better drugs, she's saying.
She's taken 2 hearts and she's still going to die soon. She wants better drugs. If there had been better drugs, the first heart would still be alive and the second heart could have helped someone else.
The argument that it's a miracle and you should just be grateful stands in the way of demanding more. Why isn't the treatment better? That's her point.
I see a similarity to the way people defend transgender treatments. They portray the patient as about to die of the condition (because they predict suicide) and then treatments are defended as dealing with a desperate emergency, the alternative to which is death.
She is not in her 30s. She is 60.
"an embarrassingly low bar for achievement"
Except that the low bar was unimaginably high until the day before yesterday.
I empathize with the disappointment of a dying patient. Not sure there's anything embarrassing to complain about.
"She is not in her 30s. She is 60."
Thanks for the correction.
I misread something.
Better drugs are not so easy to develop.
My brother donated a kidney to my sister 15 years ago. She's still doing fine, although the daily anti-rejection drugs are troublesome. She had to take super extra care during covid. Still, it's a miracle, and she's truly grateful, we all are.
Perhaps the heart transplants are trickier? Perhaps with a heart transplant the rejection response is higher than with a sibling's donated organ, the incompatibilities are inherently larger?
I've been in biopharmaceutical research since the 1980's. "Growing" an organ from stem cells is not currently within our capabilities, even for "simple" organs like lungs (a gas-exchange passive machine operated by surrounding bellows). A heart is a complex mechanical device that pumps in a defined and regular sequence through electric and muscle activity, using mechanical valves to direct blood flow with precisely timed choreography. Not easy to do (see ventricular assist devices). As for the drugs, if you suppress the immune system to prevent rejection, you can open yourself up to cancer--any TV commercial for rheumatoid arthritis or Crohn's disease will raise that as a side effect, and we're not talking about the more complicated problem of graft-vs-host disease in transplants. And how do you get those explanted stem cells to multiply and differentiate into an organ? With cocktails of cytokines and growth factors that have long-term effects--growing in a dish is not the same as embryology. Sorry, that is the current state of affairs and for her, but as I near my seventies it's clear that I and everyone else will die of something. Later is better than sooner, but it will happen
"Except that the low bar was unimaginably high until the day before yesterday."
Huh? Heart transplants have been around for a long time. Her complaint is about the quality of the drugs.
of course medicine is not concerned with science, anymore its about equity, and you will never reach the right destination that way,
"But this narrative discourages transplant recipients from talking freely about the real problems we face and the compromising and life-threatening side effects of the medicines we must take."
Shuddup. Without the transplant you woulda been dead. Show some gratitude.
“Both the recipients and the donors deserve better drugs, she's saying.”
Well, for the donor it’s a sunk cost, so they needn’t be too concerned, especially if they’re dead, as is always the case for heart transplants.
It seems to me the best solution is an artificial heart. They’ve been around for decades, but for some reason the technology seems to have stalled in the 70s. Considering the vast improvements in every other aspect of technology I don’t see why we can’t come up with what is effectively just a pump. Maybe we need to get A.I. working on this.
Meanwhile, we need to change organ donation from opt-in to opt-out. The number of organs wasted because people don’t bother filling out a card is ridiculous and unconscionable.
We all deserve better drugs. No one deserves to die of a disease. In most cases, though, the science is what it is.
What's the argument as to transplant drugs that the development of better ones has been held back somehow? In other words, why is this particular instance of no better drugs somebody's fault?
There are many diseases that cry out for better treatments. There are few drugs in the entire armamentarium
of current medicine that do not pose dangerous or unpleasant side effects to some people. For someone who has
a disease like type 1 diabetes insulin is indeed a "miracle" drug. But for someone who has Alzheimer's Disease the
drugs offered give little or no relief and come with often dire side effects. This woman falls somewhere in between.
She has been "given" 35 years of extra life with the burden of some serious health hardships. That was the bargain
she was offered. With the end near she would have liked a better bargain. All of us who come down with a disease that
isn't a marquee disease that has a colored ribbon and prioritized research funding would like a revision of priorities.
Well, the system fails donors because two seconds before that heart was cut out of the donor's body, that heart was beating and stopped only artificially. Because if you use only dead-dead donors, rather than "brain-dead" donors (mostly dead, in the words of The Princess Bride), then the heart is not viable.
Yet another case of utilitarian definition changing, changing the definition of death in the opposite direction toward still-living in order to achieve the desired outcome of organ harvesting.
Why isn't the treatment better? That's her point.
Why? Because nature, that's why. Because that's the human condition. Because we are not gods who can just wave our hands and overcome the natural biological order and eliminate disease. Because there are limits to what can be done.
My brother-in-law, a heart transplant recipient, talked of the same issue: the post-transplant drugs that keep you alive may, and probably will, end up killing you. This has been known for a long time, and it is not as if nobody has put any effort into finding more suitable drugs. The strength and combinations of drugs has been tweaked, some drugs reformulated, and others eliminated - but still the fundamental problem of rejection remains. Immunosuppression is a delicate undertaking. So is cancer treatment. Improvements in both areas are marginal and the risks of treatment remain great.
But the "miracle" must be kept in mind: someone who certainly would have died, not far in the past, is alive for a number of years longer than nature wanted to give them. My wife has survived cancer that would have killed her quickly in the past. She has a 50% chance of life expectancy beyond 5 years, and we are just passing the 5 year mark. My brother-in-law expected 10 years from his heart, and he recently died at the 8 year mark. He succumbed to the same thing that will kill the author of the NYT piece. He too sometimes wondered if there might be a better way to deal with the delicate balance of good heart vs. bad immune system, and neither he nor his doctors had any reluctance in "talking freely about the real problems we face and the compromising and life-threatening side effects of the medicines we must take."
There will be a better way, in the future. The author expresses some ingratitude that the cure hasn't been found in time for her, and criticizes medicine for setting "an embarrassingly low bar for achievement." The miracles should not be taken so lightly, and one must not spend one's final days of life-extension criticizing the system that enabled the miracle. Just because it isn't perfect and the result isn't as long-lasting as you would like doesn't mean that "there is no pressure for improvement." That pressure comes from the same source as the original impetus to transplant a human heart: the desire of the medical community to do good.
The first heart transplant patient lived 18 days. The author has lived decades. The difference is the great body of knowledge about immunosuppression that has evolved in the interim. Perhaps there will be a great leap forward someday, but that's unlikely. As with most disease treatment, improvements will be incremental. To expect anything else is unwise, and greater political pressure will not change that fact.
Both the recipients and the donors deserve better drugs, she's saying.
Oh well we'll just ask the Better Drug Fairy to wave her wand and conjure them up.
Is there not a Better Drug Fairy? Oh, well, maybe we can have the drug researchers flogged until their level of innovation improves.
Then Amy Silverstein can complain about how the new transplant drugs are too expensive.
As for me, instead of demanding transplant drugs that don't exist, I'm going to demand medical organ-repairing nanobots that don't exist.
Jesus H Tap-dancing Christ.
An even better way to get a new heart or kidney or whatever is to create a clone. Scientists would grow a copy of the patient in someone's uterus and then take the organ out of the clone when it's born. You can see Dick Cheney doing something like this.
Dick Cheney is not a member of the political party most associated with the harvesting and selling of body parts of infants.
Both the recipients and the donors deserve better drugs, she's saying.
Unfortunately reality doesn't care what anyone "deserves."
It's perhaps not just science - she might be right about that. Funding is necessary too, and when the pool of beneficiaries is relatively small compared with the cost of developing a new drug, well... But the fact remains, as Ben Shapiro says frequently (and at 78rpm), facts don't care about your feelings.
Or it may actually be science. It may actually be that the problems are not currently solvable. Blood transfusions are routine. But until typing, there was literally no way to know whether a transfusion would save or kill a patient.
Chemotherapy and radiation treatment for cancer were death sentences in themselves not long ago - they might give you more time, but they'd almost certainly kill you themselves, especially with certain kinds of cancer like leukemia. We didn't have the tools, at first, to target radiation the way we do now; we didn't have the methods to develop drugs that would kill cancerous cells and not healthy ones, instead of just killing everything in a race dependent on how strong the patient was. These tools and methods were, and continue being, developed, thank goodness.
The first "successful" heart transplant was in 1964 - a chimp heart transplanted into a human, who survived for like a minute and a half with the new heart beating on its own. The longest lived human heart transplant patient survived for at least 35 years (having a hard time telling whether he's still alive - it was 34 years, 359 days in 2021). That's an amazing improvement in a very complex procedure in a matter of two decades. And then, just last year, a genetically modified pig heart was "successfully" transplanted into a human, who survived for 2 months.
I suppose someone has to be the asshole and complain about the medical miracle that is organ transplantation. I suppose the transport community should be glad that this woman was willing to stand up and be that asshole. But geez.
An even better way to get a new heart or kidney or whatever is to create a clone. Scientists would grow a copy of the patient in someone's uterus and then take the organ out of the clone when it's born. You can see Dick Cheney doing something like this.
========
would Dick Cheney want to be a Ghola?
An Axlotl tank or Axolotl tank was the "tank" by which the Bene Tleilax reproduced a living human being from the cells of a cadaver, producing type of clone called a ghola. These tanks were also used in the creation of genetically engineered assassins known as Face Dancers. The axlotl tanks were later engineered to replicate the spice melange, previously only available on the desert planet Arrakis where it was created naturally as part of the life cycle of the sandworms.
I suspect if we dig down we'll find that Obamacare has stifled innovation in anti-rejection and transplant maintenance drugs. Not completely, but enough to make it a boutique issue for ingrates who think they "deserve" anything they want regardless of the cost to others.
I guess the question would be, what priorty should we give to better drugs for transplants? And the answer is not top priority.
Millions are sick with cancer,lung disease, diabeties, and heart problems that can't be cured with a organ transplant. Or if they can, there are too many of them and not enough organs to go around. We all can't get someone else's heart or Kidney.
The author wrote this emotion laden piece with a target audience in mind. And I'm not in that target group. I would've liked something more general and statistical. Just going "waah, waah, I've had two transplant and I'm 60, but I'm going to die" seems beside the point. Huge numbers don't make to 60. And we're all going to die, its just a matter of when.
There aren't likely ever going to be good alternatives to the regimen of drugs that inhibit organ rejection. You must suppress the immune system vigorously, and it is that suppression that does most of the damage to the patient over time.
As for growing organs like a heart from stem cells- that isn't likely going to work any time soon. The differentiation of stem cells into the various organs of the body during fetal development is almost a kind of black box magic that we only poorly understand at this point in time. We will probably figure it out at some point, but that point isn't going to be in the next couple of decades. A more likely path to success is going to be develop genetically modified animals, like pigs, that would then carry mostly univerally human-specific antigen markers that are subsequently then modified for a specific patient's more unique markers on an individual basis. The pig is born, allowed to develop long enough, then sacrificed for the new organs. Such a thing might be possible in a couple of decades. There is the alternative outlined above- cloning an individual via an embryo, and then implanting this embryo into surrogate mother, but this would be pure evil in my opinion.
There's always the mechanical trans/plant choice. Or, perhaps, a stem cell product, alien with cancer treatments.
Perhaps, this isn't a problem for the medical community to solve. Maybe it's an issue for the philosophers to address. Maybe we should be working on accepting human lifetimes are finite. At some point it's time to realize our lives are over. There will not be some medical intervention that will give us some more time. A young friend of mine just died in her teens after what was deemed a successful heart transplant a few years ago. Are those of us who loved her grateful for the extra years? Of course, we are. But those extra years came at a great price, and I don't mean money. It was a long good-by filled with as much sorrow for her as for her family and friends. Accepting her life was going to be short, but filled with love might have been a better path three years ago.
Why isn't the treatment better? That's her point.
I understand the question, but it's a fact that some things are HARD. Your body wasn't designed to allow organ transplantation so the necessary drugs are trying to overcome an immune system that's evolved over a few hundred thousand years and usually does a pretty good job.
Immunosuppressants are expensive for a reason and if her complaint is that we're (collectively) not spending enough on research for medicine I'd mention that the large majority of the country thinks the usual driver of innovation (the profit motive/capitalism) is wrong/immoral/unacceptable when it comes to medicine. As a class of drug they're difficult to test since reactions vary so widely across populations so even when novel treatments are discovered the roll out can be very slow. Transplant science as a whole might be a good area for X-Prize style awards--I'm not sure if we'll get to the point where we can "print"/grow whole organs from host tissue/DNA before we make transplants of foreign organs easier, but it could be worth working on both.
It bothered me a lot when the hospital told us, in very apologetic and thankful terms, that our daughter was too young to be an organ donor, I think she would have wanted to help others if she could have. I hope everyone here signs up to be a donor--my state makes it easy when you renew a driver's license.
The quality of the drugs? Yeah, your body is designed for your own body parts and the work around is tricky and imprecise. Man is not God.
The US system has increased organ donation twelve years in a row and leads the world in donation rate. Few people die in a manner suitable for donation to take place so each opportunity is precious. Word is that some tech bros from the Obama administration are interested in getting the contract to take over the system. Folks should be on the lookout for the MSM to grease the skids there...
Huh? Heart transplants have been around for a long time.
Fifty-six years isn't all that long. There are only 3,500 transplants performed each year, world-wide. We aren't talking mass production here. Most of the current research is about growing a new heart from the patient's cells, thus eliminating all of the anti-rejection drugs.
Both the recipients and the donors deserve better drugs, she's saying.
Aren't the donors, you know, dead?
I read her piece and was touched by her honesty and her gratitude for the extra years of life she's been given. And yet, what she talks about, and what those of us who have no experience with organ transplantation should understand, is that this new gift of life comes with something like a ball and chain. We don't hear about that, because the technological "miracle" is all we pay attention to, not the ways that our technology falls short of restoring a normal life to organ recipients. Organ rejection and the dire effects of the drugs recipients must take to stave it off demonstrate the shortcomings and limitations of our efforts to push back against our built-in mortality. We're curing some cancers, we're extending life through amazing things like heart transplants, all wonderful, but there's always a cost and there are heartbreaking limits to our healing arts.
I read the article and while it's awfully hard to strip away my natural sympathy for a dying woman, Ms Silverstein gave it a damn good try.
It's not the point she makes about transplant drugs, it the way she goes about making it.
The idea was to use a patient's own stem cells to create an organ that is fully compatible with their body and that would eventually become a part of their body and would never need to be replaced.
=========
if the original need replacement why not the lab-grown one also [require replacement after disease/ageing?] unless there can be mods done in lab!
I find it's interesting that there are suddenly many articles suggesting that expensive medical treatments aren't all that. I don't get behind the NYT paywall, but I just read an article linked in Instapundit about attempts to develop a blood test to detect early stage cancers which several times suggested that finding early cancers may not be helpful because then there would have to be follow ups. There does seem to be a weird exception for sex change surgeries for some reason I don't grok.
Joseph Mengele nods?
Human ingenuity takes time. It took her time to flesh out the “gratitude paradox.” This is only an idea, which would be the first step in developing a drug.
Alzheimer’s treatments seem to be frozen; cancer still exists. Resources are limited; technology is limited.
Everyone wants their particular problem addressed, but all of the world’s medical problems cannot be solved simultaneously.
Althouse,
Both the recipients and the donors deserve better drugs, she's saying.
"Deserve's got nothin' to do with it."
What an absolutely clueless of view of drug development (or any other technology for that matter.)
Meanwhile, recipients and donors are often required to take the experimental covid jabs or no deal.
Her complaint is about the quality of the drugs.
As someone straddling class I and II heart failure ('You're fucked', as my doctor golf buddy says) I concur with some of her sentiment. For me it is the antiquated medicine while many other scary death sentence ailments have seen progress, even cure. I mean the whole class thing is decades old without update or refinement. Yah, there's now Entresto and kinda sorta Farxiga, both buy some time before transplant protocol but really there's been no progress on stimulation of heart muscle, which would make transplant less necessary and prolong both lifespan and quality of life. The Mass General team thought they were on to something with the stem cell thing but no. Then COVID took priority over everything and kind of killed rational medicine...maybe forever...
I'm older than Ms Silverman but watched a friend in high school survive to transplant and is still here decades later. For me, the drugs are great and I'm still fortunate at the moment...but ask me again tomorrow. It all looks barbaric, even the resync device that statistically won't save my life or extend it but will 'help my symptoms' as the clinic says. So far Dr Cardio is letting me ride every six months. Maybe not so lucky next time...
Her complaint is about the quality of the drugs.
Does she allege that the drug companies and researchers have been slackers? The unfortunately fact is that this is the state of technology. Of course it would be good if there were better drugs, but it would also be good if there were better drugs for lots of other medical problems too. I'm not sure what makes this any different or a higher priority.
I remember reading about the first heart transplant by Dr. Barnard in 1967. It was certainly seen as a miracle of science. I didn't realize until later how much of a Hobson's choice transplant surgery was and is.
1. "Heart transplants have been around for a long time. Her complaint is about the quality of the drugs."
Yep. I'm amazed how many miss that point, like this guy:
2. "Shuddup. Without the transplant you woulda been dead. Show some gratitude."
That's pretty fucked up. Nobody is complaining about "the transplant" at all. I didn't even read the whole article and I could feel the gratitude and hesitation in her voice. She was so concerned about not seeming ungrateful she waited until her death bed to try and save others from the same fate, if possible.
She didn't say but I will, if current medicine and research wasn't wasting so much time and money unnecessarily mutilating healthy but confused children maybe they could devote some energy to working on the immunology issues that loom large over many fields in medicine. We don't even know exactly how to finesse a transplant given the highly complex nature of our immune system and the heart is part of an especially delicate system.
Many people facing death feel anger at their fate. Criticizing the currently possible treatments to delay the end is one of them. But it says more about the person than the science to offer advice like that. Believe me, the research scientists, surgeons, and all the rest of the teams toiling against these conditions are well aware of their shortcomings.
She is not wrong. My brother was a dual transplant recipient - kidney and pancreas. He had been a type 1 diabetic from age 10. He lost his vision at 35 and had begun to lose feeling in his hands and feet.
The regime of drugs he took had an incredible toll on him. The steroids changed his appearance-making his face round and darker, he had cardiac issues from cyclosporin-the anti-rejection drug, his blood pressure was difficult to control and required extensive medication. He developed eczema which was rampant from the immunosuppression. He had lost sensation for urination and had to catharize himself several times a day. He required daily anti-biotics to prevent UTIs from the catherization.
He was given a miracle of 15 more years of life. He saw his kids graduate HS and college, he held his first grandchild. But it does come at the price of hospitalizations, constant clinic visits, vigilance, insurance nightmares, pain and suffering, too.
My family and he were truly grateful to the family of the donor and to medical science. That doesn't mean his quality of life was great, it meant he got a life for some time. He passed away undergoing dialysis as his transplanted kidney had begun to fail. The drugs literally changed his blood and tissue chemistry, and I, as his sister, could not donate to him. His transplants were in 1988. Medical science has come much farther, but there does need to be improvement in the maintenance of the transplants and patient quality of life.
Aren't the donors, you know, dead?
After harvesting they are.
rehajm here's hoping for an indefinite renewals of your 6-month clearances!
Tina848 I'm sorry your brother's treatment took such a toll but I'm glad he got to spend so much "extra" time with his family. I'm sure you wish you could have done more to help but it sounds like you gave him plenty of love and care.
MJB,
"She was so concerned about not seeming ungrateful she waited until her death bed to try and save others from the same fate, if possible."
Whoa.
It's not at all clear to me either
(a) what "fate" she was trying to save anyone from, nor
(b) how her whining in the media would help bring about that saving.
Having not read the article and knowing next to nothing about it, I'll camouflage my unsupported assertion as a question. Doesn't exactly everybody in the entire process get paid? Except, of course, the donor's family, because that would be wrong.
Unrelated to my previous assertion, I wonder if transplant surgeons skimp on their malpractice insurance?
"Huh? Heart transplants have been around for a long time. Her complaint is about the quality of the drugs."
Huh? Depends on what you mean by a "long time." Not longer than my lifetime. Incredible progress on very difficult questions in an historically very short period of time--hence the "day before yesterday." The "quality of the drugs" confronts an inherently difficult problem and the survival of many more patients shows that they have improved. For an outsider to say that someone "deserves" better, without any notion of how to do it, is pointless. As others have noted: deserving has nothing to do with it.
Why are the donor organs free? Why doesn't the health care industry (!) pay for the donor's organs? The health care industry makes a ton of money performing transplants. I'm sure the donors' families could use the money for the donated organs. It's for that reason why I and others do not have a "Donor" sticker on our driver's licenses. (And I could tell you other stories about hospitals greedy for donor organs, but I won't here.)
I've had fireman friends tell me flat out that car crash victims with organ donation ticked "yes" get fast tracked to being declared brain dead. Much less heroic measures are taken to save them. Anecdotal, sure, but it gives me pause...
Medicine becomes stagnant when it's financed by the government. Dialysis has had almost no improvement since the 70's. The dialysis companies paid by Medicare and Medicaid like it just fine the way it is.
If the state can force women to use their placentas to keep a fetus alive, then it should be possible to force other people’s organs to be donated to keep legal persons alive.
Unless of course you think that pregnant women should have fewer rights than anyone else or that fetuses should have more rights, as conservatives seem to believe.
Allocation of assets
That's the principle at work.
Thankfully, there aren't that many transplants. Not enough to generate the economy of scale needed to create affordable rejection drugs. Having the govt subsidize, more than they do already, only makes is worse. $billions spent for no progress at all. Its not fair to assume the scientists in the labs aren't interested, but a decision has to be made on how to allocate assets. Denying research on other important medical needs, risks even more lives put at risk.
It could be argued, money spent on transplants would be better funneled into medical issues affecting a much larger population.
Dialysis has had almost no improvement since the 70's.
This is completely false. I just read an Instapundit link to a guy who had a kidney transplant 29 years ago. His description of dialysis is vastly different from the way it works now, as seen in the comments. Being able to keep a regular job and doing dialysis while you sleep is a vast improvement.
Mark yesterday at 3:24"
Aren't the donors, you know, dead?
After harvesting they are.
Donors are pronounced dead prior to harvest. There is a ~10 step protocol that physicians go through before pronouncing the patient dead, which determines that there is no functioning brain activity, including complete loss of brainstem function. At this point, the patient's heart is beating only because a machine is forcing oxygen into his otherwise lifeless body, and extracting CO2.
The physician pronouncing the patient dead has no financial motivation to pronounce death- indeed, he or she gets paid for every day care is provided, so there is motivation to keep the patient alive rather than pronouncing death. This statement is true to the extent that the physician is working for him/herself. If the doc is employed by the hospital, all bets are off with respect to financial matters. In my experience, families often request that the pronouncement be delayed until family members arrive to say goodbye. This request is typically granted for a limited time, usually 24-36 hours, whether or not the organs are to be donated.
Well, speaking from horrifying experience, all that money the dialysis monopoly showered on legislators like GA DHHS "hero" Jim Martin didn't hurt.
Them.
Leora's right, you ignorant shitbag Birches. Yeah, the libertarian lights of Instapundit. A very few incredibly wealthy people can afford what you describe, but the Medicaid and Medicare dialysis clinics are the seventh circle of hell.
Did you know, for example, patients are strapped down so they can't get help if a fellow patient is dying? Did you know Fresnius lobbied both Democrat and Republican and of course doltish leftitarians to keep an exception to the nursing code so virtually untrained aides may administer dangerous drugs to very frail dialysis patients, though they would be arrested and their employers sued for doing the same to non-dialysis patients? Many die tethered to a machine because Fresnius also won the fight to have fewer nurses per patient than allowed with any other type of patient. You ignoramus. We treat these people like sub-humans, and the transplant system is a vile mess.
Tina848. Sorry for your loss and the utter ignorance of several other commenters. No, Old and Slow, they don't take organs from patients without previous, multiply confirmed brain death. Your friend is either feeling important by lying, or he knows what a permanently crushed brain looks like.
No, Iowan II, transplants aren't so rare as to be an orphan disease. Maybe you'll change your mind if your child needs one, or a grandchild is born with an orphan disease, pal. And we actually would have plenty of research dollars if we stopped subsidizing the useless parts of academia -- administrators, students needing remedial classes, DEI, most community colleges, subsidies and tax breaks for private schools with huge endowments, tenured professors sucking up cash teaching two classes a year, and so on.
My brother with type 1 died last year after decades of dialysis and then all the horrors of anti-rejection drugs and horrors of losing the transplants and developing mental problems and bone and liver cancer from his suppressed immune system and the massive doses of steroids needed to keep him alive. Thought it all, he tried to hold a job to not be a burden.
If you haven't lived this, shut up. Just shut the hell up. Maybe Ann can cheer us up by figuring out how much money is being diverted from people who did nothing to make themselves sick to psychos who want to "change genders" or catch monkey pox or AIDS by screwing serial strangers decades after billions of dollars in "public health interventions" and billions in free and often ineffective or not-used PReP drugs haven't changed their behavior.
Unless of course you think that pregnant women should have fewer rights than anyone else or that fetuses should have more rights, as conservatives seem to believe.
We believe that women have the same rights as everyone else. No one has the right to kill their children. We also believe that fetuses have the same rights as everyone else, which includes the right to life.
The main reasons to oppose mandatory donation of organs upon death have to do with religious freedom.
Also, Old and Slow, doesn't that make your imaginary fireman pal culpable in murder?
I have obviously witnessed this subject close-up and also worked in public health, much of which is wasteful bullshit.
The writer is correct. If we had not abandoned a great deal of promising medical research and dollars for sheer garbage studies about psychedelics and sex change and repeatedly reviving addicts, treatments for premiere athletes (a huge field), and weight reduction, for which we already know the answers, we would have more than enough research dollars for chronic and genetic diseases. If we stopped hospitals like Emory who game the transplant system to make their outcomes look good, we would lose far fewer donated organs. If we stopped letting the Chinese take over our medical schools and stopped blocking our best white and Asian-American students from proceeding to research, and if the AMA wasn't allowed to block the addition of more chairs in medical schools so every pimple-popper can be a multi-millionaire, we'd have a more free and productive medical system.
We need to start moon-shotting like we used to do and stop wasting so many medical dollars. Throughout Europe, every GP has an ultrasound: here it can cost thousands to get one test. But the machines are cheap. It's not just transplants: our entire system needs overhauling.
Tina Trent yeah keep telling yourself you're right. You don't know anything about me or my experience with dialysis or kidney transplants. And you're an angry person. About everything.
Tina Trent yeah keep telling yourself you're right. You don't know anything about me or my experience with dialysis or kidney transplants. And you're an angry person. About everything.
Tina Trent yeah keep telling yourself you're right. You don't know anything about me or my experience with dialysis or kidney transplants. And you're an angry person. About everything.
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