lung transplant policy

[halekulani]

---

Members do not see this ad.

not sure if i'm allowed to post this topic in this forum (please move or delete if it is violating rules), but i'd definitely like to hear thoughts on the current case regarding organ transplants and government intervention

http://vitals.nbcnews.com/_news/201...-wont-intervene-in-girls-transplant-case?lite

while sebelius is getting grilled, i don't think it's entirely fair. she is not a doctor and she chose to consult experts in the transplant field. it's almost like she is put in a position to fail.

 

[Dr.LeoSpaceman]

not sure if i'm allowed to post this topic in this forum (please move or delete if it is violating rules), but i'd definitely like to hear thoughts on the current case regarding organ transplants and government intervention

http://vitals.nbcnews.com/_news/201...-wont-intervene-in-girls-transplant-case?lite

while sebelius is getting grilled, i don't think it's entirely fair. she is not a doctor and she chose to consult experts in the transplant field. it's almost like she is put in a position to fail.

There are two issues here for me:

1) The issues regarding patient age and who is listed on which list.

2) Whether a judge should be able to overrule UNOS policies.

On the first, I honestly am not sure.

On the second, I think the answer is a clear "no". While we should certainly evaluate policies for organ allotment, treating this as a "special case" is not the way it should be done. I understand that the parents want to save their child, but people are now using emotions to manipulate the system. If the system needs to be changed, that's fine. And if his girl dies waiting for a transplant, it's tragic, but not unique. There are thousands of people that die waiting for a transplant every year. What makes her different? If the answer is because she's the one that can generate enough press coverage to get an exception, then we have a problem.

 

[wholeheartedly]

What makes her different? If the answer is because she's the one that can generate enough press coverage to get an exception, then we have a problem.

👍

This, she's not the first to be in this position. The story is heartbreaking, but the precedent we risk setting here is scary. Is it worth reevaluating policy,* absolutely.

*edit-evaluate it based on the best medical evidence.

 

[thedrjojo]

👍

This, she's not the first to be in this position. The story is heartbreaking, but the precedent we risk setting here is scary. Is it worth reevaluating policy, absolutely.

we discussed this on the sociopolitical forum, but this is no good. UNOS has well defined policies regarding listing and comes up with it from a large panel of individuals including physicians and other individuals involved in transplantation. While I don't know much about thoracic transplant, there is likely a good reason for having it set at age 12 (likely size issues as well as outcome based), and to think this judge thinks he knows more than the transplant professionals who established the criteria is a joke.

Plus, i read an article that mentioned that at CHOP alone there are 3 more children in a similar situation (including an 11 year old hispanic kid)... I wonder if they are going to get a similar political outcry and if he will get a similar exception... I just hope this girl doesn't have a major complication or die, because that's going to look bad for all involved, and I'm a little saddened that UPenn's transplant team went along with the judge and accepted lungs for her...

 

[wholeheartedly]

Finally found a good reason for the rule.

The rules are based on statistical models built on years of data that take into account death rates among people waiting for lungs and survival rates after transplantation.

Dr. Stuart Sweet, a pediatric pulmonologist at Washington University in St. Louis who helped formulate the rules, said the death rate on the waiting list had dropped sharply for patients of all ages since the changes were made.

The rationale for the two-tier system, in addition to organ size considerations, is that the criteria used to rank adults on the list often don't work for children, who generally suffer from a different set of diseases.


That's kind of an important point.

http://www.latimes.com/news/science/la-sci-organ-transplant-kids-20130613,0,2926236.story?page=1



People forget the allocation system isn't set up to benefit one person, followed by another and then another. It's set up to achive maximum benefit for as many as possible ad a whole system.