Occupy America: Black teen initially denied heart transplant

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Re: Occupy America: Black teen initially denied heart transp

Post by Broomstick »

Simon_Jester wrote:I'm suddenly remembering Larry Niven's "Known Space" stories, where there's an extended period when "organ banks" make transplants very easy by allowing longer-term storage of organs... but the organ banks are filled in large part with organs taken from condemned criminals.

People whose lives depend on a steady stream of spare body parts will always vote to keep the stream flowing. Result? The death penalty becomes much, much more popular.
Fear of just that is one reason some people oppose taking organs from condemned criminals. At present, in the US it is illegal to obtain an organ from someone put to death by the state.
Simon_Jester wrote:
Ralin wrote:Or we could just make organ donation mandatory for everyone.
That might not entirely fix things. Part of the problem is that desirable organs for transplants usually only come from a tiny minority of people: mostly people who die relatively young and healthy.
Correct. It's been about 6 years since I worked down the hall from a major coordination unit for North American transplants, but if I recall correctly even if we moved to presumed consent there would still not be enough organs to fill current demands. It's not enough to die, you have to die in a manner that leaves your organs intact despite you being dead and you have to lack certain pre-existing conditions.
So it's at least worth asking: if the supply of donor organs increased sharply, but not to an unlimited degree, would demand tend to increase to match supply?
It might.

Take kidney transplants, for example – they aren't always necessary to preserve life, dialysis does exist (although it does have some serious problems – then again, so do transplants) but no matter how many deceased donor kidneys are available, no matter how many live donor kidneys are available, no matter how many “pair-exchange” transplants are arranged, the demand never, ever goes down.
PainRack wrote:
Broomstick wrote:There is, of course, the question of bias. Racism and classism isn't supposed to occur in medicine but as medicine is supplied by fallible humans it's a possibility. That doesn't mean it's occurring in this particular case but the question will be raised. The black community is keenly aware that black people are less likely to get organs than white people, but what isn't always understood is that this is an area of medicine where race - or, if you prefer, ethnicity - really does count. Proper organ matching means matching certain compatibility factors and people of the same general descent are more likely to have similar markers. It's not impossible for people of disparate background to be matches but it is much less likely than people of similar background. There are times when a white donor can supply a viable organ for a black (or Asian) recipient but it's much less common than matching with someone of the same race. There are a numerous groups in the US, from major celebrities to individual families, trying to increase organ donation from minorities but the brutal fact remains that simply being a numerical minority reduces your chances of getting a transplant simply because the potential pool of donors is smaller.
I'm waiting for Lady Tevar to comment since she and hubby has first hand experience on this, but isn't compatibility for a transplant separate from matching for a transplant? Race isn't a factor for whether one is eligible for an organ, albeit, I don't know nuts about heart transplant.
Race is not a factor for eligibility, it is a factor for matching. The human leukocyte antigens, which are genetically based, are each statistically more common among some ethnic groups than others. There is also the major histocompatbility complex which is also is a factor in the immune response to transplanted organs, and is also genetically based on genes which, again, vary in different human populations. We are definitely peering over the edge of my world of knowledge here, but it boils down to you are far, far more likely to be able to accept an organ from someone of your ethnic background than someone who isn't of a similar background. Exceptions do exist (largely due to the fact that none of us are purebreds and have someone of dissimilar background in our family trees if you look hard enough) but statistically most donated organs that wind up in black people came from other black people. Actually, African-Americans are more likely to find white matches than immigrants just arrived from Africa, due to the fact most “black” Americans have some white ancestry and thus are slightly more likely to have a HLA and MHC genes matching those most common among white people in the US (who, if their families have been in North American a couple or few centuries, are likewise slightly more likely than fresh European arrivals to find a match outside their race due, again, to interracial crossings in their past.)

So yes, race is a factor and if we want to increase organ transplant as an option for everyone we needs donors from all backgrounds and not just the majority ethnicity. As it stands now, some non-white people in the US are very eligible for organs but wind up dying simply because they don't match the statistical majority of the proper genes and simply never match with an available organ.
The very wealthy - like Dick Cheney - can get on the list within multiple regions because, in addition to simply being able to afford (through either good insurance or personal wealth) a transplant they can also afford to charter a personal air ambulance to meet a new organ halfway. The more regions you can register in the better you odds of getting a new organ.
Steve Jobs in particular gamed the system by choosing WHICH region had a higher transplant rate and then registering in each one. He has a personal aeroplane of course, all he needs is proof that he can get there within a few hours of being called.
Right. Steve Jobs would have been able to access the fastest of private airplanes, one that flew at just under Mach 1, and pay to burn the fuel to get where he needed to be at close to 700 mph. That means he's only 4 hours or less from any point in the contiguous 48 states, and if he hung out in the geographic middle of the country he's only 2 hours away, at most, from any transplant center.

Yeah, that changes the odds. Ask Lady Tevar how long it will take for her to get Nitram to HIS transplant center when the get the call...
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Re: Occupy America: Black teen initially denied heart transp

Post by Broomstick »

Ralin wrote:I don't see how it's significantly different from when my dentist told me I wasn't allowed to keep my wisdom teeth.
Where are you and your dentist located? Because everywhere I've lived in the US you most certainly can keep your extracted teeth, and I know a lot of people who have them. Not to mention that you can reclaim any precious metals in the dental work (and if you don't, believe me, your dentist is cashing in old fillings).
A life is like a garden. Perfect moments can be had, but not preserved, except in memory. Leonard Nimoy.

Now I did a job. I got nothing but trouble since I did it, not to mention more than a few unkind words as regard to my character so let me make this abundantly clear. I do the job. And then I get paid.- Malcolm Reynolds, Captain of Serenity, which sums up my feelings regarding the lawsuit discussed here.

If a free society cannot help the many who are poor, it cannot save the few who are rich. - John F. Kennedy

Sam Vimes Theory of Economic Injustice
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Re: Occupy America: Black teen initially denied heart transp

Post by Ralin »

Broomstick wrote:Where are you and your dentist located? Because everywhere I've lived in the US you most certainly can keep your extracted teeth, and I know a lot of people who have them. Not to mention that you can reclaim any precious metals in the dental work (and if you don't, believe me, your dentist is cashing in old fillings).
Louisiana.

But like I said, it was ten years ago and my memory may be hazy, and back then I wasn't assertive enough to press the issue.
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