| LDO Home | General | Kidney | Liver | Marrow | Experiences | Buddies | Hall of Fame | Calendar | Contact Us |

Recent Posts

Pages: 1 [2] 3 4 ... 10
11
Living Donation in the News / Milestone: 1,000 people in UK have donated a kidney to a stranger
« Last post by Clark on February 13, 2024, 04:43:02 PM »
https://www.organdonation.nhs.uk/get-involved/news/milestone-1-000-people-in-uk-have-donated-a-kidney-to-a-stranger/

Milestone: 1,000 people in UK have donated a kidney to a stranger

NHS Blood and Transplant has announced that more than 1,000 people in the UK have now donated a kidney anonymously to a stranger on the transplant waiting list as a living donor since the law was changed to allow this in 2006. This is known as non-directed altruistic living kidney donation.
Worldwide, kidney disease is the tenth most common cause of death. The number of people developing kidney disease in the UK is growing significantly, driven by risk factors such as diabetes, heart disease and high blood pressure, alongside health and economic inequalities. Despite ongoing work to encourage kidney donation from both living and deceased donors, around six people die each week in the UK waiting for a transplant.
…
12
Living Donation in the News / Insights Into Living Kidney Donor Health, Racial Disparities
« Last post by Clark on February 13, 2024, 04:41:21 PM »
https://www.renalandurologynews.com/news/nephrology/transplantation/insights-into-living-kidney-donor-health-racial-disparities/

Insights Into Living Kidney Donor Health, Racial Disparities
Natasha Persaud

Findings from recent studies have characterized the kidney and fracture risks associated with living kidney donation.

Recent studies provide valuable insights into the health of living kidney donors, including their future risk of chronic kidney disease and bone fractures. Research also finds a high willingness to be a living kidney donor in the United States once long-term health, medical bills, and other issues are addressed. Despite efforts to increase living donor transplantation, racial and ethnic disparities remain.

Kidney Function
A small proportion of living donors experience kidney function decline after nephrectomy, a new study finds. In a Canadian cohort of 590 living kidney donors followed for a median 8.6 years, 47 donors (8.0%) had a sustained estimated glomerular filtration rate (eGFR) decline to less than 45 mL/min/1.73m2 or moderate to severe albuminuria, Ngan N. Lam, MD, MSc, of University of Calgary in Alberta, Canada, and colleagues reported in Kidney Medicine.1 The incidence rate was 9.2 per 1000 person-years. The median time to the outcome was 2.9 years, using 1 year after nephrectomy as the baseline.
Each 5 mL/min/1.73m2 lower predonation eGFR was significantly associated with a 26% increased risk of postdonation low eGFR or moderate to severe albuminuria, the investigators reported.
With respect to risk factors, donors had a 2.5- and 4.7-fold increased risk of developing low eGFR or albuminuria after surgery if they had predonation hypertension or postdonation diabetes, respectively.
“Further research is needed to determine whether donors with these risk factors would benefit from more diligent follow-up care as well as the effect of low eGFR and moderate-severe albuminuria on donor morbidity,” according to Dr Lam’s team.
The investigators lacked data on donor race, smoking history, and transplant-related characteristics.
A separate study of 103,938 living kidney donors in the US found that 75% of patients experienced a rise in serum creatinine exceeding 35% after donation.2 The incidence rate was 0.09 person-months. Compared with White donors, Black donors had a significant 22% increased risk of a serum creatinine rise exceeding 35%, whereas Asian donors had a significant 12% decreased risk, Ekamol Tantisattamo, MD, of the University of California Irvine School of Medicine, and colleagues reported at the 2023 ERA Congress. Hispanic and multi-racial patients had no greater risks in adjusted analyses. Older vs younger age did not affect this risk among Hispanic, Asian, and multiracial donors. Investigators gathered and analyzed data from the 1972-2022 Organ Procurement and Transplantation Network (OPTN) and Scientific Registry of Transplant Recipients (SRTR) database.
Fracture
Living kidney donors have a theoretical excess risk of bone fractures due to lower kidney mass, lower serum 1,25-dihydroxyvitamin D, and increases in serum parathyroid hormone. In a comparison of survey responses from 2132 living kidney donors and 2014 healthy adults serving as a control group, the overall fracture incidence rate was a significant 11% lower for living kidney donors.3 The rate of vertebral fractures, however, was significantly increased 1.4-fold for living kidney donors compared with healthy adults, Rajiv Kumar, MBBS, of Mayo Clinic in Rochester, Minnesota, and colleagues reported in JAMA Network Open. The risk was higher for men than for women.
“Vertebral fractures would principally reflect deficits in trabecular bone, whereas all fractures, particularly in the axial skeleton, would principally reflect deficits in cortical bone,” Dr Kumar’s team explained.
They concluded, “Treatment of excess vertebral fractures with dietary supplements such as vitamin D3 may reduce the numbers of vertebral fractures and patient morbidity.”
Attitudes Toward Living Kidney Donation
To better understand national attitudes toward living kidney donation in the United States, Amy D. Waterman, PhD, of the J.C. Walter Jr Transplant Center at Houston Methodist Hospital in Texas, and colleagues conducted an online survey in June 2021 of 802 adults aged 25-65 years from the general public.4 Survey questions probed knowledge of living kidney donation and gauged willingness to donate.
Overall, 58.9% and 27.7% of respondents said they might or would consider donating a kidney while still alive, respectively. The vast majority of willing respondents would donate to a family member or close friend. At least half said they also would donate to an acquaintance (60.7%), a stranger with a personal profile (55.2%), or a stranger with no available profile (48.3%). Adults aged 45-54 years were most willing to donate, whereas the oldest adults aged 55-65 years were the least willing.
Barriers to living kidney donation included concern over possible negative health consequences (76.3%), fear of undergoing nephrectomy (72.6%), aversion to any kind of surgery (72.3%), and worries about affording related medical expenses (65.8%).
Transplant-related knowledge, such as kidney-paired donation, increased willingness to donate. Respondents most commonly reported accessibility to a replacement kidney (78.7%); information on the safety of nephrectomy (78.6%); information on health trajectory after donation (76.7%); payment/reimbursement of donation-related medical expenses (76.3%); and transplant success stories (75.2%) as factors that would increase their willingness.
Dr Waterman’s team cited progress in the field, including national efforts to increase federal funding for the National Living Donor Assistance Center, adjust financial thresholds to increase eligibility, reduce insurance discrimination against donors, modify the National Organ Transplant Act to allow government compensation for donors, improve accountability and transparency surrounding organ procurement and transplantation, and solicit public comments on potential improvements.
“These national-level efforts represent opportunities to further progress toward reduced costs for donors and increased rates of living kidney donation,” according to Dr Waterman’s team.
Racial Disparities
More work is clearly needed to improve access to living donor transplantation.
“Equitable access to organ transplantation is a guiding principle of the US organ allocation system,” Vineeta Kumar, MD, a board member of the American Society of Transplantation, said in an interview with Renal & Urology News. “Revisions to the national allocations system have made the rate of deceased donor kidney transplant for Black candidates after listing comparable with that of White candidates. However, Black patients receive living donor kidney transplants less frequently than White patients. Despite higher prevalence of end-stage kidney disease (ESKD), Black patients are less likely to be referred for kidney transplant evaluation and to be waitlisted than White patients.”
In a recent JAMA Network Open study,5 investigators studied 2 race-defined cohorts. Among 394,625 adults on the kidney waitlist, 33.1% were Black and 66.9% were White. Among 57,222 adults who received living donor kidney transplants, 14.1% were Black and 85.9% were White.
From 2008-2018, the racial gap between Black and White adults in living donor kidney transplantation persisted, Lisa M. McElroy, MD, MS, of Duke University School of Medicine in Durham, North Carolina, and colleagues reported. Black adults had a lower yearly median living donor kidney transplantation rate than White adults, ranging from 0.0577 to 0.771 center-years.
“Our findings observed geographic but no temporal variation and suggest that center participation in national programs, such as the paired exchange and voucher programs, may help to mitigate LDKT Black-White race inequities,” Dr McElroy’s team wrote.
In an accompanying editorial,6 Ashley Suah, MD, and Milda R. Saunders, MD, MPH, of the University of Chicago Medicine in Illinois commented, “Transplant centers should increase outreach within minoritized racial and ethnic communities to educate people about kidney health, transplantation, and living donation.”
Low rates of living kidney transplantation among Black Americans is a consequence of individual, interpersonal, and structural inequalities, according to an article in the Journal of Racial and Ethnic Health Disparities.7 Adoption of race-free eGFR equations was a necessary corrective measure. Socioeconomic conditions, poor communication with the provider, and lack of transplant knowledge are some of the remaining barriers.
A study published in the American Journal of Kidney Diseases8 found that Black potential donors are 75% less likely to accept a “medium” risk of kidney failure after living kidney donation compared with White potential donors. The closer the relationship Black potential donors had with the intended recipient, the greater their willingness to accept risk. Transplant professionals have the responsibility to understand a potential donor’s motivations and consider their best interests, according to the study authors.
“Addressing racial disparities in LDKT is a critical, multifaceted issue that demands our continued attention at all levels,” according to Dr Vineeta Kumar.

References:
13
Living Donation in the News / Fact Check: NO Proof Transplanted Organs Transmit Character Traits From Donor To
« Last post by Clark on February 13, 2024, 04:36:44 PM »
https://leadstories.com/hoax-alert/2024/02/fact-check-no-proof-transplanted-organs-transmit-character-traits-from-donor-to-recipient.html

Fact Check: NO Proof Transplanted Organs Transmit Character Traits From Donor To Recipient
by: Ed Payne

Do transplanted organs transmit character traits from the donor to the person receiving them, as a video on social media claims? No, that's not true: Transplant surgeons and a nonprofit for transplant patients told Lead Stories that no scientific evidence or credible research supports the idea that transplanted organs can transmit character traits from the donor to the recipient. Organ transplantation primarily involves the transfer of physiological functions, and any claims about personality traits being transferred lack scientific basis or validation.
The claim appeared in a video (archived here) on YouTube by Tetragrammaton with Rick Rubin on April 28, 2023, under the title "Dr. Jack Kruse and Andrew Huberman, Ph.D (Part 1)." The video's caption begins with:
Dr. Jack Kruse is a neurosurgeon who had an awakening in 2007 when he suffered a torn meniscus in his knee at 6'2", 357 lbs. This led to his further study of physics, light, magnetism, and electricity. He ultimately concluded that modern medicine lacked a deep understanding of how humans function in relation to the natural world.
The video
During a short segment in the nearly four-hour podcast, neurosurgeon and self-described "optimal health educator" Dr. Jack Kruse mentioned that there have been three instances in his medical career when transplant recipients appeared to pick up character traits from an organ donor. He explained one in detail, starting at about 3:16:23 into the show. A condensed transcript of what he said is available below:
I got a young kid -- 18, 19 years old -- his family to donate his organs. And the way it used to work, we would get a letter letting us know where all the organs went to the different people. No data, you know, this HIPAA stuff, but you knew that this person got eyes, this person got a liver and this person got the heart. And they don't give you names ...
So six months later, I get a lady show up to my clinic who doesn't have a neurosurgery problem. She just wants to come talk to me, and the office girl's like, 'We don't know what this is about.'
She comes in and she says: 'Look,' she goes, 'I don't know who to ask. I've asked my primary care doctor, I've asked everybody else.' She goes, 'Ever since I got this heart. I have this intense desire for McDonald's french fries.' ...
And I just sat there stunned. And I didn't know what to say to her. She had no way of knowing this. The data is not out. You can't get this information ... The kid died at a McDonald's drive-thru when a car plowed into him in a T-bone, and they found McDonald's french fries in the seat next to him. He was eating the french fries when the accident occurred. This is a lady who never ate potatoes.
Transplantation experts
In a February 9, 2024, email to Lead Stories, Dr. Joseph Magliocca, director of the Vanderbilt Transplant Center, said, "There are anecdotal reports of people acquiring personality traits of their donor after organ transplantation." He continued:
The phenomenon appears to be seen more frequently with heart transplantation. However, I am not aware of any scientific evidence to support that hypothesis. Since each person's experience is unique to them, it certainly cannot be dismissed entirely but there is no compelling data to suggest that it does indeed happen. We would welcome further study in this area of research.
Dr. Aleem Siddique, a heart and lung transplant surgeon at the University of Nebraska Medical Center, told Lead Stories in a February 8, 2024, email that transplants don't work that way. He said:
Organs cannot transmit character traits from donor to recipient.
In a February 8, 2024, email to Lead Stories, Anne Paschke, a spokesperson for the nonprofit United Network for Organ Sharing, said the donor-to-recipient claim isn't supported by anything she's seen:
I'm not aware of any research into the phenomenon. As far as I know, there are only anecdotal accounts.
Lead Stories looked at three papers (here, here and here) that considered the purported connection between organ transplants and personality changes. While the articles showed some correlation between having an organ transplant and a shift in character traits, none of them provided proof of direct causation between the two.
Dr. Mitchell B. Liester, an assistant clinical professor of psychiatry at the University of Colorado School of Medicine, authored or co-authored two of those papers. He discussed his findings in a series of emails on February 8, 2024, with Lead Stories.
While Liester believes there is "evidence of personality changes following organ transplants," and has had a patient tell him about such an experience following a transplant, Liester also acknowledged that "more studies are needed." He added:
The causal mechanism remains to be determined.
Lead Stories asked if something else might have triggered the observed personality changes, such as the trauma of facing death or potential death, rather than the transplanted organ itself introducing something from the donor to the recipient. Liester replied:
Good question. We need studies to clarify which factors cause the personality changes.
14
Living Donation in the News / Improving value delivery in living donor kidney transplant through process impro
« Last post by Clark on February 13, 2024, 04:32:27 PM »
https://www.physiciansweekly.com/improving-value-delivery-in-living-donor-kidney-transplant-through-process-improvement/

Improving value delivery in living donor kidney transplant through process improvement.
CONTRIBUTORS: Jorge Sanchez Garcia, Chloe Tien, Megan Fife, Brittany Dillon, Sean Dow, Zubair Zafar, Donald Morris, Sanjiv Anand

Living donor kidney evaluation has substantial time variations with significant intercenter variation. One-day donor evaluation has shown to be clinically efficient and improve transplant rates. However, patients’ perception of 1-day evaluation is unknown. We hypothesized that 1 day LKD evaluation will improve patient satisfaction and improve living donation rates.
All interested LD candidates from April 2018 to May 2020 were enrolled in the study. Non-directed donors, donors greater than 60 years old, and recipients with more than three donors underwent multi-day evaluation (control group) while the rest underwent 1-day evaluation (intervention group). An anonymous survey was filled by both groups to assess their perceptions on different areas including time, communication, experience, information provided, and their preferences on living donor evaluation.
Donor candidates in the 1-day evaluation group selected that the time from the questionnaire to clinic evaluation took “under 1 month” or “less than 3 months” (62.5% vs. 15.8%, p = .002), with “excellent” for both scheduling process (65% vs. 31.6%, p = .03) and communication (82.5% vs. 57.9%, p = .09) when compared to candidates in the multiple-days evaluation group. One-day candidates felt “very satisfied” with the overall experience (95% vs. 68.4%, p = .02) and felt “extremely well” with the information provided regarding the living donor process (87.5% vs. 47.4%, p = .003) when compared to multiple-day evaluation group. Regardless of the group, 53 (89.8%) patients preferred 1-day evaluation.
We demonstrate 1-day living donor evaluation is efficient, patient preferred, and adds value through improved communication, and better overall patient satisfaction.
15
Living Donation Forum / Did you donate three or more years ago?
« Last post by Clark on January 30, 2024, 05:06:24 PM »
Are you willing to participate in a study of long term consequences for donors? Email your interest to REACHdonorstudy@chop.edu
I just spoke to the intake coordinator, Isabelle. I hope you’ll join me!
16
Living Donation in the News / Organ Transplantation Developing in Kyrgyzstan
« Last post by Clark on January 18, 2024, 11:53:44 AM »
https://timesca.com/organ-transplantation-developing-in-kyrgyzstan/

Organ Transplantation Developing in Kyrgyzstan
Kyrgyz President Sadyr Japarov has signed a law on the protection of citizens’ health, according to which private and state clinics can now transplant internal organs, but on one condition.
On the instructions of the President, while considering the draft law “On Protection of Citizens’ Health in the Kyrgyz Republic,” the Parliament of the Republic considered additional norms that provide for the removal of organs from a living donor, but only if the donor “is genetically related to the recipient.” According to the law, a genetic link is defined as a relationship between persons who share common ancestors up to great-grandparents.
Despite the fact that this law has not yet entered into force, last week Kyrgyz Health Minister, Alymkadyr Beishenaliev traveled to Turkey, where, according to the press center of the Ministry of Health of the Kyrgyz Republic, he took part in a liver transplant operation. He also discussed the development of bilateral Kyrgyz-Turkish cooperation on liver and bone marrow transplantation in Kyrgyzstan with the rector of the Turkish university where the operation took place. It had earlier been agreed between the presidents of the two countries agreed that Turkey will help Kyrgyzstan in this matter.
“Sadyr Japarov has set a task on the need to solve the issue of liver and bone marrow transplantation in Kyrgyzstan in a short period of time, which has not been solved for many years,” Beishenaliyev said. In turn, his Turkish counterpart noted that Turkey is ready to help Kyrgyzstan organize the work of the transplantology department, train specialists, and conduct joint operations in Bishkek on liver and bone marrow transplantations.
Liver transplant operations have been carried out in Kyrgyzstan before, with Kyrgyz doctors being assisted by colleagues from Belarus, Russia, and Turkey. Since 2016, Kyrgyz doctors have performed around fifty kidney transplant operations.
However, the law on organ transplantation which was adopted in 2001 is outdated. Kyrgyz doctors prepared additions to it, in particular on organ donation and the transplantation of bone marrow, kidneys and liver, but for about five years, the issue has stagnated. It was only in August 2023 that, for the first time, Kyrgyz doctors conducted a successful kidney transplant unaided.
In addition, equipment has now been purchased to analyze the compatibility of donor organs. Previously, patients had to travel to neighboring countries to find out if they were compatible with the donor.
If liver transplants start to be performed in Kyrgyzstan on a permanent basis, the operation will cost about $10,000. Abroad, such an operation costs $50-60,000.

[N.B.: These cost estimates for liver transplant surgery are as much as 20 times too low for US costs.]
17
Living Donation in the News / The ‘‘Securing the U.S. Organ Procurement and Transplantation Network Act’’
« Last post by Clark on January 18, 2024, 11:42:22 AM »
https://www.congress.gov/118/plaws/publ14/PLAW-118publ14.pdf

  T[size=78%]he ‘‘Securing the U.S. Organ Procurement and Transplantation Network Act’’ is law.[/size]
18
Living Donation in the News / Survey: Most adults would consider living kidney donation if certain factors wer
« Last post by Clark on January 18, 2024, 11:30:36 AM »
https://www.healio.com/news/nephrology/20240116/survey-most-adults-would-consider-living-kidney-donation-if-certain-factors-were-met

Survey: Most adults would consider living kidney donation if certain factors were met

Key takeaways:Barriers to living donation included concerns about paying for medical expenses and potential health impacts.[/color]Facilitators to donation included being well-informed about the safety of the surgery.[/size]Results from a recently published U.S. survey show that most adults would consider becoming a living kidney donor, and donation rates could increase with culturally competent education.
“Living kidney donation is promoted as the best treatment option available for people living with kidney failure. Public attitudes ... can be impacted by legislation, scientific innovation, media campaigns and individual experiences,” Katya Kaplow, MPH, of the department of surgery at New York University Langone, wrote with colleagues. “Understanding national trends ... will enable us to identify and address existing disincentives.”

Researchers surveyed a cohort of 802 U.S. adults (aged 25 to 65 years) in June 2021. Investigators developed summed, scaled indices to assess potential links between living kidney donation awareness (nine survey items) and inclination to donate (eight survey items), as well as self-reported demographic characteristics and other variables of interest. The survey captured various aspects related to living kidney donation, including knowledge about the process, as well as barriers and facilitators to donation.
According to the findings, most(86.6%) respondents said they "might" or "would definitely consider" donating a kidney while still living.
While many showed willingness, respondents identified several barriers affecting their decision to become living kidney donors, including concerns about the risk of the operation, the cost of medical expenses and potential health impacts.
Facilitators to living kidney donation included being well-informed about the safety of the donation operation, feeling assured that donors would not bear medical expenses and being familiar with success stories of living kidney donation. Awareness regarding participation in kidney paired donation was a significant factor that positively correlated with higher willingness to donate, according to the researchers.
The findings suggest “there are potential living kidney donors who have not yet presented to transplant centers and that further growth of living kidney donation is possible,” the authors wrote. “Culturally competent educational campaigns, outreach initiatives around the opportunity for kidney paired donation and national-level policies that reduce financial disincentives to living kidney donation are important next steps.”
Published by:

Sources/Disclosures

Source: Kaplow K, et al. Kidney Med. 2023;doi.org/10.1016/j.xkme.2023.100788.
19
Living Donation in the News / Illegal Organ Trade Is More Sophisticated Than One Might Think - Who's Behind It
« Last post by Clark on January 18, 2024, 11:27:40 AM »
https://menafn.com/1107729991/Illegal-Organ-Trade-Is-More-Sophisticated-Than-One-Might-Think-Whos-Behind-It-And-How-It-Could-Be-Controlled

Illegal Organ Trade Is More Sophisticated Than One Might Think - Who's Behind It And How It Could Be Controlled
Author: Frederike Ambagtsheer
(MENAFN- The Conversation) Every now and then the trade in human organs makes national, even international, news.

In March 2023, a Nigerian politician, his wife and a medical middleman were found guilty of an organ-trafficking plot after they brought a man to the UK from Lagos to sell his kidney. Several months later in Kenya, following the arrest of a televangelist on charges of a mass killing of his followers, autopsies on the corpses revealed missing organs , raising suspicions of forced organ harvesting. And, in 2020, researcher Sean Columb exposed how numerous African migrants sold their kidneys in Cairo, Egypt, in hopes of using the earnings to pay smugglers to take them across the Mediterranean into Europe.
These reports and cases are part of a global proliferation of the organ trade that started in the late 1980s. It coincided with advancements in transplantation. Until the 1980s, transplantation was regarded as a risky and experimental procedure. Since the introduction of immunosuppressive drugs in the 1980s (which help to prevent the body from rejecting organs), it has become standardised practice. Organ transplants are now conducted in hospitals in more than 90 countries.
Transplantation has however become a victim of its own success, with demand for organs far outpacing supply. Despite strategies to enlarge the donor organ pool, the worldwide organ shortage grows every year.
I am an organ trade and trafficking researcher . I've investigated many aspects of the activity including transplant tourism, the buying of organs, experiences of transplant professionals and police and prosecutors working on criminal cases and how trafficking networks operate.
I've found that claims are made about the organ trade in the absence of factual data. These have strengthened popular notions of the issue as an underground crime , organised by mafia-like criminals and“rogue” doctors who perform transplants clandestinely.
The reality is starkly different. The nature of the organ trade is far removed from these mythical depictions. In all criminal cases reported to date, illegal transplants took place in medical hospitals and clinics with the involvement of medical staff. Organ trafficking networks are highly organised with close collaborations between the legal“upperworld” (medical doctors, notaries, lawyers) and the criminal“underworld” (recruiters, brokers).
While it's likely that there are also unreported, hidden cases that do not take place inside medical institutions, the available knowledge indicates that the medical sector is helping to organise and facilitate the trade in human organs.
The organ trade is a complex crime and is fuelled by the high demand for organ transplants and rising global inequalities. The root causes of the trade need to be addressed, and stronger responses (not necessarily laws) are needed to tackle the more organised and exploitative forms of the trade.
What is the trade in human organs?
Organ trade constitutes the sale and purchase of organs for financial or material gain. The World Health Organization (WHO) first prohibited payments for organs in 1987. Many countries subsequently codified the prohibition into their national laws.
Although reliable figures are lacking, the WHO estimated in 2008 that 5% of all transplants performed worldwide were illegal. Living donor kidneys is the most commonly reported form of organ trade.
The WHO has further estimated that the total number of transplants performed worldwide is less than 10% of the global need. Of all organs, kidneys are highest in demand. About 10% of the world's population suffers from chronic kidney disease. Between two and seven million of these patients are estimated to die every year because they lack access to proper treatment.
Under these circumstances, desperate patients seek illegal ways to obtain organs outside their home countries. The increased value of organs makes them more profitable. This fuels the desire of some people to trade and sell.
Global developments and catastrophes such as the widening gap between the rich and poor, conflicts, famine, climate change and forced migration further increase the risk of organ sale and exploitation among the world's vulnerable populations.
Addressing a complex crime
How then can responses to the organ trade be improved? A first step would be to reach agreement on what types of organ trade we find condemnable. This requires an understanding of the trade's complexity.
Some studies demonstrate that the organ trade can constitute serious organised crime. It can involve physical force, even torture, and the execution of prisoners. But these reports don't describe the organ trade as a whole.
The organ trade involves a variety of practices which range from excessive exploitation (trafficking) to voluntary, mutually agreed benefits (trade).
These varieties warrant different, data-driven responses.
For example, organ sellers are reluctant to report abuses because organ sales are criminalised and sellers will be held liable. Although many can be considered human trafficking victims and be offered protection, this rarely occurs. Law- and policymakers should therefore consider decriminalising organ sales (removing penalties in the law) and offer organ sellers protection, regardless of whether they agree to provide evidence that helps to dismantle criminal networks.
Countries should also allow medical professionals to safely and anonymously report dubious transplant activity. This information can support the police and judiciary to investigate, disrupt and prosecute those who facilitate illegal organ transplants. Portugal and the UK already have successful organ trafficking reporting mechanisms in place.
Finally, a contested example of a possible solution to reduce organ scarcity and avoid black market abuses is to allow payments or other types of rewards for deceased and living organ donation to increase organ donation rates. To test the efficacy and morality of these schemes, strictly controlled experiments would be needed.
Trials on incentivised organ donation schemes have been proposed since the 1990s by transplant professionals, economists, lawyers, ethicists and philosophers who point out that there may be good reasons to allow payments under controlled circumstances.
While such experiments are currently forbidden by law, national surveys have found various degrees of public support for different types of incentives. In the US, for example, a recent study found that 18% of respondents would switch to favouring payments for sufficiently large increases in transplants, provided that recipients didn't have to pay out of pocket and that allocation of organs would occur based on objective medical criteria. In short, rather than exclusively focusing on stricter laws, a broader range of responses is needed that both address the root causes of the problem and that help to disrupt organ trading networks.
20
Living Donation in the News / Alberta, Canada, pauses participation in national kidney donor matching program
« Last post by Clark on January 18, 2024, 11:23:33 AM »
https://www.stalbertgazette.com/beyond-local/alberta-pauses-participation-in-national-kidney-donor-matching-program-because-of-surgery-capacity-shortage-8117799

Alberta pauses participation in national kidney donor matching program because of surgery capacity shortage
Patients temporarily pulled from program run by Canadian Blood Services
Carrie Tait

Alberta has partially paused its participation in a national program that matches people in need of a kidney transplant with prospective living donors because a shortage of anesthesiologists is causing a strain in the province’s surgical capacity.
Canadian Blood Services operates the country’s kidney paired donation (KPD) program, which includes a database of transplant candidates and potential donors. CBS uses an algorithm to find potential matches in the registry three times a year. Alberta’s provincial health authority, however, withdrew from the winter matching run, according to the charitable organization.
“Alberta Health Services informed Canadian Blood Services that it will not be participating in the KPD matching cycle in February,” CBS spokesman Paolo Oliveros said in a statement on Monday in response to questions from The Globe and Mail. “The KPD match cycle in February will still proceed as planned with other participating provinces.”
Mr. Oliveros did not answer questions about how many transplant candidates and potential donors were removed from the cycle.
Kerry Williamson, a spokesperson for Alberta Health Services, said potential kidney donors and recipients in the province’s northern transplant program were temporarily removed from the national program because operating room capacity is being squeezed by a shortage of anesthesiologists at the University of Alberta Hospital and the backlog of local and national pairs waiting on Edmonton’s KPD list.
“AHS is experiencing recruitment challenges across the province, and we are actively working to recruit health care professionals,” Mr. Williamson said in a statement. “This is not unique to Alberta and is being experienced nationally and internationally.”
Mr. Williamson said the decision will not affect KPD participants who have already found transplant matches through the program, although he confirmed there is a backlog of donors and recipients currently waiting for surgery.

“Surgeries will proceed for anyone already matched, and living donors will continue to be accepted into the living donor programs, including KPD,” he said in a statement Tuesday.
Kelly Konieczny has been searching for a kidney donor for about four years and has been enrolled in the KPD for about three. She said her transplant co-ordinator called her Jan. 11 with the news – and an explanation.
“We were not going to be put into the February run because of the anesthesiologist shortage,” said Ms. Konieczny, who lives in Mannville, about 170 kilometres east of Edmonton.
Kathy Tachynski, another person hoping to match with a living donor, said she received a call from AHS on Monday, informing her that she would not be in the February matching cycle.
“The reason being is there is a shortage of anesthesiologists,” Ms. Tachynski said. The Edmontonian said she was told transplants from deceased donors are still proceeding.
Alberta Premier Danielle Smith rose to power in part by questioning AHS’s management of the health care system, particularly with respect to the coronavirus pandemic. She believes the health authority is bloated with middle managers who are straining resources and stymieing front-line workers. The United Conservative Party is redesigning Alberta’s health care system and has pledged to cut wait times for operations in part by expanding the use of privately owned surgical centres, where patients receive care at the expense of the provincial government.
The revelation that Alberta pulled back from the KPD program indicates the health care system may be under more stress than previously understood.
Transplant candidates in the KPD program are enrolled alongside people who want to give them a kidney but with whom they are incompatible. The willing donors agree to give up one of their two kidneys to another transplant candidate in the pool, in exchange for their loved one receiving a kidney from someone else. An algorithm then searches for the most suitable matches for the swaps.
Alberta’s decision to opt out, “was kind of startling,” said Ms. Konieczny, who pumps her blood through a dialysis machine at home four times a week. “I was feeling like we were maybe expendable.”
Ms. Konieczny and Ms. Tachynski are among the transplant candidates with the slimmest chances of finding suitable donors because they both have antibodies that would clash with roughly 100 per cent of the population.
“It is not that I will never get a transplant. But my chances of getting one are basically a needle in a haystack,” Ms. Tachynski said.

Sean Delaney, a two-time kidney transplant recipient with two decades of experience working in the organ-donation system, said Alberta’s KPD pause is especially worrisome for highly sensitized patients such as the two women.
Patients develop antibodies from past blood transfusions, pregnancies or organ transplants. They can then spend decades waiting to find a transplant match, he said. Given their slim chances, Mr. Delaney, who has a master’s degree in public health, questions why this cohort was removed from the KPD list.
“Even with low probability, why take them off? That doesn’t make any sense.”
Some decision-makers, he said, consider living transplant surgeries “elective,” a categorization he rejects.
Ms. Tachynski was not told whether other types of surgeries were also frozen in light of the anesthesiologist shortage and the Alberta pause in the KPD program.
“Organ donation, whether it is deceased or living, is life-saving,” she said. If other surgeries are not life-saving, “why are they allowed to go ahead and organ donation is not?”
Pages: 1 [2] 3 4 ... 10
Copyright © International Association of Living Organ Donors, Inc. All Rights Reserved