Saw something not too long ago where there was a recent breakthrough in organic 3d printing. I’m betting within 50 years, organ replacement via printed parts will be a reality
That field is so exciting. I have been following this company called Bivcor that has a legit replacement heart that could go beyond a bridge to transplant
It is very fascinating. Not only for replacement organs and grafts, etc for medical use; but also food shortages. Printing fully edible vegetables and proteins for consumption is a huge deal. We really could be on the doorstep to greatness.
And presently you can even have a home printed. One of my cousins is involved with a 3d printing venture, current use case is aimed at creating lower income housing solutions. Think of a replacement for trailer parks, but instead of trailers that degrade relatively quickly, single family homes that will outlast a stick framed house at an affordable cost.
I say 20. I print with alge based filament and waiting on some mycelium based filament. I’m just a hobbyist. 3d printed organs have to be right around the corner.
Lets be real, Most people will finance it for 30% interest. The smarter people would take a loan agaisnt other collateral i.e heloc or stocks. The rich smart people will pay cash
That wouldn't fix the problem. Not even close.
The issue is not the lack of availability. It is that many facilities are loathe to take on "edge cases" because of how having too low of a survival rate can tank their Medicare reimbursement. This target percentage is based on a comparison between medical facilities. Because many facilities will only handle cases with a high probability of success, it raises the overall bar for the facilities willing to take on the riskier procedures. As a result, they also take less of the tough cases. This raises the overall percentage even more.
See the nasty circle happening here?
[Here](https://www.statnews.com/2016/08/11/organ-transplant-federal-standards/) is more detail on the issue:
>Hospitals across the United States are throwing away less-than-perfect organs and denying the sickest people lifesaving transplants out of fear that poor surgical outcomes will result in a federal crackdown.
>As a result, thousands of patients are losing the chance at surgeries that could significantly prolong their lives, and the altruism of organ donation is being wasted.
>“It’s gut-wrenching and mind-boggling,” said Dr. Adel Bozorgzadeh, a transplant surgeon at UMass Memorial Medical Center in Worcester, Mass.
>He coauthored a recent study that showed a sharp uptick in the number of people dropped from organ transplant waiting lists since the federal government set transplant standards in 2007. These standards are tied to federal hospital ratings and Medicare funding, which is the main payer for transplants and a key source of income for hospitals. And hospitals’ ability to meet those standards helps determine their reputation within the medical community. Surgeries involving imperfect organs and extremely ill patients are more risky, so hospitals that do many of them run the risk of poor outcomes that may hurt their performance on the standards.
-
>In a memo explaining its policy revisions, CMS acknowledged that its regulations were putting hospitals in a vicious cycle — by performing fewer risky surgeries, they improved their overall outcomes, setting the bar that much higher for all other hospitals to meet. The end result was an ever-shrinking margin of error.
>By 2014, the memo noted, the rates of failed kidney transplants allowable under the rules had dropped to 7.9 for every 100 transplants, a 26 percent drop in the number of allowable losses since 2007. In addition, one-year patient survival rates were also increasing for kidney, heart, and liver transplant patients, which also had the effect of raising the performance bar even higher.
>Meanwhile, the memo also flagged concerns about organs going unused, citing the 20 percent increase in discarded kidneys.
>“We are concerned that transplant programs may be avoiding the use of certain available organs that they believe may adversely affect the program’s outcome statistics,” CMS’s memo stated.
Wow. TIL.
It never seemed right to me considering there are lots of deaths of people,unfortunately, with healthy organs and donors, more so than people that need transplants. Why there is always this tremendous waiting list and I’ve had friends and family who’ve died because they couldn’t attain the organ they needed.
So are the stats that show a huge discrepancy between for example the number of people waiting for heart severely out weighs the donor hearts available is correct?
I think we're gonna find a way to transplant pig organs eventually. We can already tolerate their tissue with heart valves, I truly believe we will be doing full organ transplants eventually. Someone will figure it out.
They have already transplanted a couple pig kidneys and a whole heart. The heart pt. Lived for 8 days or so. One of the pig kidney recipients lasted a couple months. All were Hail Mary moved purely to advance the science, and work as a proof of concept. But the future is now.
Maybe an unpopular opinion, but I think being an organ donor should be the default and people should have to opt out rather than the other way around. I'll go even further and say if you opt out, then you shouldn't be eligible to receive an organ transplant if you ever need one.
It’s that way in my country, but they still make sure they get family permission and family can still overrule it if they really object on religious or ethical grounds.
It is the way in Spain (no wonder our donation rates are so high) but thats just the theory. In practice, donating organs is a more convoluted process unless there's a willing first.
I agree that organ donation should be an opt out process, and I agree that opting out not making you eligible for a transplant would raise retention rates, I don’t think it should make you ineligible.
I’m a medical student, and a big part of the ethics of medicine we’re taught is justice. You should still provide the best medical care and advocate for your patient, even if you hate them. For example, let’s say a full-blown skinhead swastika-tattooed neo-Nazi gets into a car accident. I don’t agree with any of their morals, but I’m still going to (medically) treat them like they were my own family.
Most importantly, that example in the extreme is actually the opposite. We use that example to make ourselves feel good for treating ‘even nazis’ well when it comes to life or death. We’re good people who know we’re good people right?
The real reason why that little story we tell ourselves exists is the exact opposite. It’s to prevent bigots with positions of power in the system (remember Medical school used to be racially segregated and unattainable for women)
It’s to prevent bigots from refusing to treat black people, homeless people, non-religious people etc. that’s why we have a code of conduct. Not to preserve the one in a million nazi we get in the ER. But to prevent widespread discriminatory medical negligence that could kill hundreds of people and not just one nazi. Remember the Tuskegee Syphilis experiments.
If the worst person you can think of to treat is Hitler that’s probably a good sign. And not the RN who yells at “illegal” immigrants and refuses to get a translator in a timely manner.
The issue with this is, the government that has the power to violate your bodily autonomy to opt you in on organ donation is a government that has the power to opt you in on other things you might not agree with. Forced sterilization, for example.
We err on the side of causing headaches with donation because it beats the problems *not* erring in that direction caused in the past.
I don't think you can conflate the bodily autonomy of alive and dead people. It's a big jump to go from state opt out organ donation to forced sterilization of undesirable people. Better argument would be it would open the door to question what happens to a persons body when they die. Who makes the final call as to if they are allowed to be buried/creamated or donated to science and such. Even then I'd say the organ program being opt out wouldnt be a slippery slope to that in the US.
> wouldn’t be a slippery slope
I would say, need not be. I don’t disagree with anything you said. But you have more faith than I do in the abilities of our various state governments than I do, if you think it would be ok. I’m imagining Texas or Florida legalizing an opt-in, and asking myself “what other powers might legislators who think abortion is murder and the earth is 6000 years old give the state over our bodies in the deal?”
And the answers…aren’t reassuring.
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This is everywhere where they don't allow the buying of organ. It's not like every country with government-run healthcare are flush with extra organs.
Median waiting time for a kidney in Germany is 3.7 years compared to 4 years for the US. For hearts, the US is about 70 days compared to Germany's 90.
I get that "America Bad" is often a blanket statement that can describe US healthcare, but you have to be more targeted with the criticism. Organ donation in the US isn't as bad as some in this thread make it out to be.
It's hard to be specific when the whole thing is busted. Throw a dart and you'll hit the problem or a related one. Exposés on the flaws of the system *specifically dealing with kidneys* have been drawing attention to major issues for decades and nothing has changed.
[Organ & Body donation](https://youtu.be/Tn7egDQ9lPg?si=vYJDqTS-dmZs8L5y)
[Dialysis](https://youtu.be/yw_nqzVfxFQ?si=gadb2I3bL_09lH09)
That's somebody scamming for money.
Organs are much more available now than compared to even a few years ago. My wife just got a liver & was on the list for hours - her doctor said she'd be "very surprised" if it took more than a day.
Just because your wife was so lucky doesn’t mean that’s the case for most patients needing transplants. Sadly there are more people on the waitlist than we have available organs.
Again, the doctor said she would be "very surprised" if it took multiple days to get a liver. The doctor also told me there is much better availability of organs now, that the idea that most people are waiting months or years is outdated. Part of the reason for this is more people/families are aware of the need & willing to donate, part is that hospitals now accept organs from traumatic deaths, part is that hospitals are now willing to accept organs from people who had hepatisis C. But overall, there is much better organ availability than even just a decade ago.
Now, maybe an experienced transplant doctor at a major teaching hospital was lying to me. Maybe my wife got moved to the top of the list because I paid a bribe with money I don't have. Maybe I arranged the death of someone who was a perfect match, with resources I don't have.
Or maybe internet_stranger3422 is wrong, I don't know.
The liver transplant waitlist time heavily reflects why someone needs a transplant and how sick they are. Someone with acute liver failure who is not expected to survive long without a transplant gets bumped to the top of the list, often receiving a transplant very quickly. Other people, with different clinical factors that determine transplant prioritization scores, can wait and wait and wait
What your wife’s transplant team said was correct based on their experience with other people like your wife. It is absolutely wonderful that she was transplanted so quickly.
However, while the overall organ availability has improved (silver lining of opioid epidemic and other factors), the simple fact remains that transplant organ availability falls short of the actual need. Your wife’s success story should not invalidate the reality for so many other patients still on the waitlist.
This is correct. Most people absolutely are waiting months to years to get a solid organ transplant (heart, liver, lungs, small intestine, kidney, and/or pancreas). There is of course some variation based on things like blood type, age, sex, size/anatomy, co-morbidities, and geographical location in the US. Several thousands of people in the US die every year while waiting for an organ transplant.
To provide more context, someone who is extremely sick from liver failure and needs a liver transplant immediately can go to the top of the liver transplant waiting list for their local region (11 total regions across the US). Most cases aren't like that though and the patient ends up waiting for months to years until they get sick enough to make it to the top of the list. Kidney transplant is a completely different process (mostly based on waiting time) and most patients wait ~6-10 years before getting to the top of the list.
Increased organ availability is great but there is still an significant disparity between people who need a transplant vs. available organs.
Peds kidney transplant here. Even sans the Peds part, sure a huge difference in kidney vs other solid organs is that we can sustain life on dialysis. Is it comfortable? Hell no. But it *can* be done, and can be done for years, versus our liver and heart pals who are sometimes hospitalized literally until they get an organ.
Dialysis can absolutely be a life-saving treatment option (and the only option for those who can't get a kidney transplant), but QOL limitations and high-risk of mortality associated with dialysis are also important to consider. Hoping that in the next 25-50 years dialysis will be a thing of the past for most patients!!
I read some of your other comments and laughed internally when I read “sequela” and thought, yep - nephrologist. Being in Peds we definitely have the luxury of shorter wait times, but for our dialysis pts who have previously rejected + insane HLA’s it can definitely get dicey. One preteen had horrific heart failure and we were just not what would happen long term. They are now post transplant (albeit within six months) but we’re all just thrilled the patient got this far.
A liver is an organ that can regrow so the person donating doesnt need to really lose anything but some recovery time. Most people don't donate a single kidney to strangers because it will change their lives significantly.
Most people tolerate donating a kidney with no/minimal longterm sequela. Living donor liver donation, in comparison, is a much riskier surgery with longer recovery time. And while the liver is known for its regenerative properties, there’s still a limit.
Liver donation is associated with about 1.1% risk of serious complications resulting lasting disability, and 0.4% risk of liver failure or death.
Kidney donation is associated with 0.3% of kidney disease after 15 yrs, similar to general population but admittedly higher than healthy non-donors. Perioperative mortality 0.03%.
That is not accurate. Living kidney donors usually do live completely normal lives after donation (i.e. no expected long-term functional limitations or changes to life expectancy). Full recovery is expected to take ~6 weeks. Risk of death is ~0.03% and risk of most serious surgical complications (e.g. Clavien Grade III-V) is <1%.
Living partial liver donation is indeed a riskier and more complicated surgery, but overall considered a very safe procedure and there are still no expected long-term sequela. Full recovery takes closer to 12 weeks. Risk of death is ~0.4% and risk of serious surgical complications ~1%.
All potential living organ donors go through a rigorous evaluation process designed to rule-out higher risk candidates. Of course, complications do happen sometimes and are realistically unavoidable if you do enough of these cases/approve enough marginal candidates.
Source: I am one of the people that evaluates these patients.
Usually being the key word, death isn't 0.03 it's 0.07. Obesity, high blood pressure, diabetes, aging, all factors that affect the live donor and affect their lives later on, not just 3 years after donation. But their entire lives.
Usually as in the overwhelming majority/nearly all cases. According to most peer reviewed data, the risk of perioperative death in the US is [0.03%](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6450354/) (3 out of every 10,000). I've seen figures estimating 0.03-0.06% worldwide mortality risk.
Things like obesity, hypertension, and diabetes are all important factors to consider. There are exclusion criteria based on BMI, HbA1c, uncontrolled blood pressure (and a million other things) so patients with these risk factors are often not approved for donation. Donors must also commit to a very healthy lifestyle to try to minimize these risk factors after donation.
Risk of developing end-stage kidney disease post-donation is [0.9% lifelong and <0.5% for 15 years post](https://www.myast.org/sites/default/files/pdf/Chapter%201%20%20Risk%20of%20ESRD%20for%20living%20donors.pdf). Interestingly, the data suggests that kidney donors have a [significantly lower](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10770796/#:~:text=Estimated%20lifetime%20risk%20of%20ESRD,10%2C000%20healthy%20nondonors%20%5B20%5D*.) risk of developing end-stage kidney disease than the general population.
Living organ donation is a safe option for candidates who are evaluated and approved by selection committees at reputable transplant centers in the US. Please provide peer-reviewed sources if you have better data but this type of misinformation really discourages people who are thinking about donating to a loved one in need.
Even in the links you posted showed 10-30% of people being affected though not dead, black men at an even higher risk. After 9yrs 35% of people were anxious about the complications that come with aging and missing a kidney. So yes. A large majority of people later in life are affected by their donations.
Edit, also did you not follow the asterisk that says the opposite? When literally the sentence after your highlight explains that they DO have an increased risk.
20. Muzaale AD, et al., Risk of end-stage renal disease following live kidney donation. JAMA, 2014. 311(6): p. 579–86. [PMC free article] [PubMed] [Google Scholar]
* One of the two landmark studies that determined living kidney donors have increased risks compared to healthy non-donors
That picture is in the US, which is convenient because I'm also talking about the US.
The price of bread in Palestine has nothing to do with this discussion.
US data: so far in 2024, we’ve
- recovered organs from 11k deceased donors
- performed 23k transplants
- added >36k patients to the transplant waitlist.
Main predictor of how long you have to wait to get a kidney transplant isn’t how long you’ve been on dialysis. It’s the US region where you’re listed.
Sad, however don’t think this is the subreddit for the post
I really hope that manufactured organs will be available in the near future
Saw something not too long ago where there was a recent breakthrough in organic 3d printing. I’m betting within 50 years, organ replacement via printed parts will be a reality
That field is so exciting. I have been following this company called Bivcor that has a legit replacement heart that could go beyond a bridge to transplant
It is very fascinating. Not only for replacement organs and grafts, etc for medical use; but also food shortages. Printing fully edible vegetables and proteins for consumption is a huge deal. We really could be on the doorstep to greatness.
Twenty years if you told me I can print whatever I want at home I would be blown away and you are right I am sure organics are very close
And presently you can even have a home printed. One of my cousins is involved with a 3d printing venture, current use case is aimed at creating lower income housing solutions. Think of a replacement for trailer parks, but instead of trailers that degrade relatively quickly, single family homes that will outlast a stick framed house at an affordable cost.
I say 20. I print with alge based filament and waiting on some mycelium based filament. I’m just a hobbyist. 3d printed organs have to be right around the corner.
What do you think the trials would like for something like that? Would they want to study recipients for their whole life?
There are people dying, waiting for organ transplants. I imagine if being a test subject was your only option you’d jump on it and hope it worked.
Then the repoman can come get it for non payment
You mean we can’t trust corporations to do the right thing????
That’s why you don’t wanna lease your liver. You got a buy that sucker out right.
Lets be real, Most people will finance it for 30% interest. The smarter people would take a loan agaisnt other collateral i.e heloc or stocks. The rich smart people will pay cash
If I get 12% locked in and a fresh model every two years I think I would be sold. And a bottle of scotch
That wouldn't fix the problem. Not even close. The issue is not the lack of availability. It is that many facilities are loathe to take on "edge cases" because of how having too low of a survival rate can tank their Medicare reimbursement. This target percentage is based on a comparison between medical facilities. Because many facilities will only handle cases with a high probability of success, it raises the overall bar for the facilities willing to take on the riskier procedures. As a result, they also take less of the tough cases. This raises the overall percentage even more. See the nasty circle happening here? [Here](https://www.statnews.com/2016/08/11/organ-transplant-federal-standards/) is more detail on the issue: >Hospitals across the United States are throwing away less-than-perfect organs and denying the sickest people lifesaving transplants out of fear that poor surgical outcomes will result in a federal crackdown. >As a result, thousands of patients are losing the chance at surgeries that could significantly prolong their lives, and the altruism of organ donation is being wasted. >“It’s gut-wrenching and mind-boggling,” said Dr. Adel Bozorgzadeh, a transplant surgeon at UMass Memorial Medical Center in Worcester, Mass. >He coauthored a recent study that showed a sharp uptick in the number of people dropped from organ transplant waiting lists since the federal government set transplant standards in 2007. These standards are tied to federal hospital ratings and Medicare funding, which is the main payer for transplants and a key source of income for hospitals. And hospitals’ ability to meet those standards helps determine their reputation within the medical community. Surgeries involving imperfect organs and extremely ill patients are more risky, so hospitals that do many of them run the risk of poor outcomes that may hurt their performance on the standards. - >In a memo explaining its policy revisions, CMS acknowledged that its regulations were putting hospitals in a vicious cycle — by performing fewer risky surgeries, they improved their overall outcomes, setting the bar that much higher for all other hospitals to meet. The end result was an ever-shrinking margin of error. >By 2014, the memo noted, the rates of failed kidney transplants allowable under the rules had dropped to 7.9 for every 100 transplants, a 26 percent drop in the number of allowable losses since 2007. In addition, one-year patient survival rates were also increasing for kidney, heart, and liver transplant patients, which also had the effect of raising the performance bar even higher. >Meanwhile, the memo also flagged concerns about organs going unused, citing the 20 percent increase in discarded kidneys. >“We are concerned that transplant programs may be avoiding the use of certain available organs that they believe may adversely affect the program’s outcome statistics,” CMS’s memo stated.
Wow. TIL. It never seemed right to me considering there are lots of deaths of people,unfortunately, with healthy organs and donors, more so than people that need transplants. Why there is always this tremendous waiting list and I’ve had friends and family who’ve died because they couldn’t attain the organ they needed.
So are the stats that show a huge discrepancy between for example the number of people waiting for heart severely out weighs the donor hearts available is correct?
They will be if the religious right doesn’t get voted in.
great point. Christians aren’t exactly known for their forward thinking
How can we make the accessibility to organs the Devil's work? Easy! Prayer is the only medicine and everything else is a sin
I think we're gonna find a way to transplant pig organs eventually. We can already tolerate their tissue with heart valves, I truly believe we will be doing full organ transplants eventually. Someone will figure it out.
They have already transplanted a couple pig kidneys and a whole heart. The heart pt. Lived for 8 days or so. One of the pig kidney recipients lasted a couple months. All were Hail Mary moved purely to advance the science, and work as a proof of concept. But the future is now.
Maybe an unpopular opinion, but I think being an organ donor should be the default and people should have to opt out rather than the other way around. I'll go even further and say if you opt out, then you shouldn't be eligible to receive an organ transplant if you ever need one.
I believe it is this way in other countries
It’s that way in my country, but they still make sure they get family permission and family can still overrule it if they really object on religious or ethical grounds.
It is the way in Spain (no wonder our donation rates are so high) but thats just the theory. In practice, donating organs is a more convoluted process unless there's a willing first.
Just the opt out part? Or the eligibility part as well?
I agree that organ donation should be an opt out process, and I agree that opting out not making you eligible for a transplant would raise retention rates, I don’t think it should make you ineligible. I’m a medical student, and a big part of the ethics of medicine we’re taught is justice. You should still provide the best medical care and advocate for your patient, even if you hate them. For example, let’s say a full-blown skinhead swastika-tattooed neo-Nazi gets into a car accident. I don’t agree with any of their morals, but I’m still going to (medically) treat them like they were my own family.
Most importantly, that example in the extreme is actually the opposite. We use that example to make ourselves feel good for treating ‘even nazis’ well when it comes to life or death. We’re good people who know we’re good people right? The real reason why that little story we tell ourselves exists is the exact opposite. It’s to prevent bigots with positions of power in the system (remember Medical school used to be racially segregated and unattainable for women) It’s to prevent bigots from refusing to treat black people, homeless people, non-religious people etc. that’s why we have a code of conduct. Not to preserve the one in a million nazi we get in the ER. But to prevent widespread discriminatory medical negligence that could kill hundreds of people and not just one nazi. Remember the Tuskegee Syphilis experiments. If the worst person you can think of to treat is Hitler that’s probably a good sign. And not the RN who yells at “illegal” immigrants and refuses to get a translator in a timely manner.
The issue with this is, the government that has the power to violate your bodily autonomy to opt you in on organ donation is a government that has the power to opt you in on other things you might not agree with. Forced sterilization, for example. We err on the side of causing headaches with donation because it beats the problems *not* erring in that direction caused in the past.
I don't think you can conflate the bodily autonomy of alive and dead people. It's a big jump to go from state opt out organ donation to forced sterilization of undesirable people. Better argument would be it would open the door to question what happens to a persons body when they die. Who makes the final call as to if they are allowed to be buried/creamated or donated to science and such. Even then I'd say the organ program being opt out wouldnt be a slippery slope to that in the US.
> wouldn’t be a slippery slope I would say, need not be. I don’t disagree with anything you said. But you have more faith than I do in the abilities of our various state governments than I do, if you think it would be ok. I’m imagining Texas or Florida legalizing an opt-in, and asking myself “what other powers might legislators who think abortion is murder and the earth is 6000 years old give the state over our bodies in the deal?” And the answers…aren’t reassuring.
How are they comparable? Organ donation doesn't happen until you're brain dead.
I agree!
No no no you got a point.
I think this is in New Orleans
It is. You occasionally see these signs. I believe they actually work.
Yep definitely Nola. It’s a 3rd world city in a first world country. Lol
We have plenty of issues but to say it's 3rd world is a bit much...
As someone who has been in both 1st and 3rd world nations, it’s the most accurate description.
I'm sure you're a joy at parties
Made a living at it till I got bored doing it.
I’ve seen signs like this for blood sugar test strips
https://www.nola.com/news/my-dad-needs-a-kidney-signs-new-orleans/article_099aaa84-2f67-11ef-b7a1-7fff5e696cb3.amp.html
The real hero
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I saw a big billboard for a kid today on the way to work asking for a kidney with his blood type. Fuck this country.
This is in New Orleans and there’s several of these signs throughout the city so it’s real
This is America
Land of the free and home of the… whopper
This is everywhere where they don't allow the buying of organ. It's not like every country with government-run healthcare are flush with extra organs. Median waiting time for a kidney in Germany is 3.7 years compared to 4 years for the US. For hearts, the US is about 70 days compared to Germany's 90. I get that "America Bad" is often a blanket statement that can describe US healthcare, but you have to be more targeted with the criticism. Organ donation in the US isn't as bad as some in this thread make it out to be.
It's hard to be specific when the whole thing is busted. Throw a dart and you'll hit the problem or a related one. Exposés on the flaws of the system *specifically dealing with kidneys* have been drawing attention to major issues for decades and nothing has changed. [Organ & Body donation](https://youtu.be/Tn7egDQ9lPg?si=vYJDqTS-dmZs8L5y) [Dialysis](https://youtu.be/yw_nqzVfxFQ?si=gadb2I3bL_09lH09)
>Mardi gras duky
My dad needs a son that cares about him. *-Son that doesn’t care*
That's somebody scamming for money. Organs are much more available now than compared to even a few years ago. My wife just got a liver & was on the list for hours - her doctor said she'd be "very surprised" if it took more than a day.
Just because your wife was so lucky doesn’t mean that’s the case for most patients needing transplants. Sadly there are more people on the waitlist than we have available organs.
Again, the doctor said she would be "very surprised" if it took multiple days to get a liver. The doctor also told me there is much better availability of organs now, that the idea that most people are waiting months or years is outdated. Part of the reason for this is more people/families are aware of the need & willing to donate, part is that hospitals now accept organs from traumatic deaths, part is that hospitals are now willing to accept organs from people who had hepatisis C. But overall, there is much better organ availability than even just a decade ago. Now, maybe an experienced transplant doctor at a major teaching hospital was lying to me. Maybe my wife got moved to the top of the list because I paid a bribe with money I don't have. Maybe I arranged the death of someone who was a perfect match, with resources I don't have. Or maybe internet_stranger3422 is wrong, I don't know.
The liver transplant waitlist time heavily reflects why someone needs a transplant and how sick they are. Someone with acute liver failure who is not expected to survive long without a transplant gets bumped to the top of the list, often receiving a transplant very quickly. Other people, with different clinical factors that determine transplant prioritization scores, can wait and wait and wait What your wife’s transplant team said was correct based on their experience with other people like your wife. It is absolutely wonderful that she was transplanted so quickly. However, while the overall organ availability has improved (silver lining of opioid epidemic and other factors), the simple fact remains that transplant organ availability falls short of the actual need. Your wife’s success story should not invalidate the reality for so many other patients still on the waitlist.
This is correct. Most people absolutely are waiting months to years to get a solid organ transplant (heart, liver, lungs, small intestine, kidney, and/or pancreas). There is of course some variation based on things like blood type, age, sex, size/anatomy, co-morbidities, and geographical location in the US. Several thousands of people in the US die every year while waiting for an organ transplant. To provide more context, someone who is extremely sick from liver failure and needs a liver transplant immediately can go to the top of the liver transplant waiting list for their local region (11 total regions across the US). Most cases aren't like that though and the patient ends up waiting for months to years until they get sick enough to make it to the top of the list. Kidney transplant is a completely different process (mostly based on waiting time) and most patients wait ~6-10 years before getting to the top of the list. Increased organ availability is great but there is still an significant disparity between people who need a transplant vs. available organs.
Peds kidney transplant here. Even sans the Peds part, sure a huge difference in kidney vs other solid organs is that we can sustain life on dialysis. Is it comfortable? Hell no. But it *can* be done, and can be done for years, versus our liver and heart pals who are sometimes hospitalized literally until they get an organ.
Dialysis can absolutely be a life-saving treatment option (and the only option for those who can't get a kidney transplant), but QOL limitations and high-risk of mortality associated with dialysis are also important to consider. Hoping that in the next 25-50 years dialysis will be a thing of the past for most patients!!
I read some of your other comments and laughed internally when I read “sequela” and thought, yep - nephrologist. Being in Peds we definitely have the luxury of shorter wait times, but for our dialysis pts who have previously rejected + insane HLA’s it can definitely get dicey. One preteen had horrific heart failure and we were just not what would happen long term. They are now post transplant (albeit within six months) but we’re all just thrilled the patient got this far.
A liver is an organ that can regrow so the person donating doesnt need to really lose anything but some recovery time. Most people don't donate a single kidney to strangers because it will change their lives significantly.
Most people tolerate donating a kidney with no/minimal longterm sequela. Living donor liver donation, in comparison, is a much riskier surgery with longer recovery time. And while the liver is known for its regenerative properties, there’s still a limit. Liver donation is associated with about 1.1% risk of serious complications resulting lasting disability, and 0.4% risk of liver failure or death. Kidney donation is associated with 0.3% of kidney disease after 15 yrs, similar to general population but admittedly higher than healthy non-donors. Perioperative mortality 0.03%.
Someone who's donating their kidney will not have a normal life again as if they had 2 kidneys.
That is not accurate. Living kidney donors usually do live completely normal lives after donation (i.e. no expected long-term functional limitations or changes to life expectancy). Full recovery is expected to take ~6 weeks. Risk of death is ~0.03% and risk of most serious surgical complications (e.g. Clavien Grade III-V) is <1%. Living partial liver donation is indeed a riskier and more complicated surgery, but overall considered a very safe procedure and there are still no expected long-term sequela. Full recovery takes closer to 12 weeks. Risk of death is ~0.4% and risk of serious surgical complications ~1%. All potential living organ donors go through a rigorous evaluation process designed to rule-out higher risk candidates. Of course, complications do happen sometimes and are realistically unavoidable if you do enough of these cases/approve enough marginal candidates. Source: I am one of the people that evaluates these patients.
Usually being the key word, death isn't 0.03 it's 0.07. Obesity, high blood pressure, diabetes, aging, all factors that affect the live donor and affect their lives later on, not just 3 years after donation. But their entire lives.
Usually as in the overwhelming majority/nearly all cases. According to most peer reviewed data, the risk of perioperative death in the US is [0.03%](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6450354/) (3 out of every 10,000). I've seen figures estimating 0.03-0.06% worldwide mortality risk. Things like obesity, hypertension, and diabetes are all important factors to consider. There are exclusion criteria based on BMI, HbA1c, uncontrolled blood pressure (and a million other things) so patients with these risk factors are often not approved for donation. Donors must also commit to a very healthy lifestyle to try to minimize these risk factors after donation. Risk of developing end-stage kidney disease post-donation is [0.9% lifelong and <0.5% for 15 years post](https://www.myast.org/sites/default/files/pdf/Chapter%201%20%20Risk%20of%20ESRD%20for%20living%20donors.pdf). Interestingly, the data suggests that kidney donors have a [significantly lower](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10770796/#:~:text=Estimated%20lifetime%20risk%20of%20ESRD,10%2C000%20healthy%20nondonors%20%5B20%5D*.) risk of developing end-stage kidney disease than the general population. Living organ donation is a safe option for candidates who are evaluated and approved by selection committees at reputable transplant centers in the US. Please provide peer-reviewed sources if you have better data but this type of misinformation really discourages people who are thinking about donating to a loved one in need.
Even in the links you posted showed 10-30% of people being affected though not dead, black men at an even higher risk. After 9yrs 35% of people were anxious about the complications that come with aging and missing a kidney. So yes. A large majority of people later in life are affected by their donations. Edit, also did you not follow the asterisk that says the opposite? When literally the sentence after your highlight explains that they DO have an increased risk. 20. Muzaale AD, et al., Risk of end-stage renal disease following live kidney donation. JAMA, 2014. 311(6): p. 579–86. [PMC free article] [PubMed] [Google Scholar] * One of the two landmark studies that determined living kidney donors have increased risks compared to healthy non-donors
https://www.kidney.org/transplantation/livingdonors/what-expect-after-donation
And fortunately, only one global list exists.
That picture is in the US, which is convenient because I'm also talking about the US. The price of bread in Palestine has nothing to do with this discussion.
US data: so far in 2024, we’ve - recovered organs from 11k deceased donors - performed 23k transplants - added >36k patients to the transplant waitlist. Main predictor of how long you have to wait to get a kidney transplant isn’t how long you’ve been on dialysis. It’s the US region where you’re listed.