Smokers lungs used for transplant

[Dedworth]

The lungs that Jennifer Wederell was given to save her life brought only agonising death

A young newlywed was never told that the organs needed for her transplant had come from a heavy smoker

http://www.telegraph.co.uk/health/9747128/The-lungs-that-Jennifer-Wederell-was-given-to-save-her-life-brought-only-agonising-death.html

I don't like the sound of this

[Doc Alan]

This is very sad news. I can understand concern that a positive smoking history in a lung donor could adversely affect survival in a recipient. The unfortunate reality is that exclusion of donors with such a history would also compromise survival of patients waiting for a transplant.


• Lung transplantation IS a clinical reality for a select group of patients with advanced-stage lung disease. Organ shortage is one of the main issues restricting development of this treatment.



• The Lancet article quoted (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60160-3/fulltext ) unfortunately requires payment to read in full. In this study of adult lung transplants done in the UK over 10 years, the authors concluded that use of lungs from donors with positive smoking histories does have a net benefit to the potential transplant recipient. Such donors provide about 2/5 lungs for transplantation. Although lungs from such donors are associated with worse outcomes, the individual probability of survival is greater if they are accepted, than if they are declined and the patient chooses to wait for a potential transplant from a donor with a negative smoking history. Of course consent should be fully informed !



• It’s hard to detect early lung cancer in patients, hence its poor outlook ( http://filipinaroses.com/showthread.php/37067-Lung-cancer-update ), never mind donors.



• In the UK, for all the NHS’s hard work to boost organ donation, around 1000 people die each year for lack of a transplant, although in the past year over a thousand lives were saved through a heart, lung, liver or combined heart/lungs, liver/kidney or liver/pancreas transplant.




• A potential donor has to enrol on the Organ Donor Register. Only 1/3 Britons have signed up. Spain, and most EU members, have some form of presumed consent – in the UK ( and USA ) it’s an “ opt-in “ regime. The UK needs a better informed public, better donor identification and referral, and more efficient organ retrieval. See http://www.organdonation.nhs.uk/ .


For the record :-



* There is a worldwide shortage of organs such as kidneys for donation. About a tenth of kidney transplants round the world are the result of trafficking. Wherever transplants are carried out, there must be informed consent and – arguably – no payment to donors. Operations also need to be performed in specialised units, after thorough health checks – including HIV / hepatitis status - on the donor.



* The Philippines market in kidney transplants is related to poverty in urban slums and outlying rural areas. “ Organ brokers “ target inhabitants of poor communities. Trafficking in persons and organ brokering is illegal. Commercial organ transplantation is facilitated by the internet. Although the Philippines Government has banned foreigners paying for organs from filipino donors ( or even filipinos from non-related donors ), the law may well not always be enforced.

[Dedworth]

Thanks Doc - I can understand about organs being in short supply but it's terrible that this girl was never told the full story of the lungs.

Anyone wishing to opt in and donate their organs can do so here https://www.organdonation.nhs.uk/how_to_become_a_donor/registration/consent.asp

[Doc Alan]

Of course it’s “ terrible that this girl was never told the full story of the lungs “ - also hard to believe she didn’t ask, or, if she did, that she wasn’t told before she was about to undertake a major operation which, thanks to an unselfish donor, offered her only chance of survival.

This sad outcome would have been much less likely had there been a choice of ( apparently ) healthy lungs sufficient to meet demand. Hopefully one outcome of this thread will be an awareness among members and a decision to “ opt in “ to organ donation.

I understand fully that such a forum as this is not primarily concerned with medical matters and didn’t raise the topic.

For those who are interested, the true story of a grateful survivor of double lung transplantation is an inspiration – all the more so to me as the recipient was in my year at medical school and worked with me when we were junior doctors in Glasgow. Sam Galbraith – neurosurgeon turned politician - is, to my knowledge, the world’s longest surviving lung transplant patient ( http://www.guardian.co.uk/politics/2007/mar/18/scotland.devolution

http://www.thesun.co.uk/sol/homepage/news/scottishnews/4001934/.html
) .

It’s of interest to note that as recently as 1990, when he had his transplant, he never met the family of the anonymous donor who saved his life. He said “ That’s how it was then. Now I can see the benefits that contact could bring if that’s what both sides want. In my day, knowing who the donor was, or even thinking about making contact with the family, was frowned upon. Death and transplants were kept separate. There was no information passed between the two. That wasn’t thought to be appropriate, so I never asked and don’t know anything about my donor…. From my own experience and speaking to others, I know how much comfort bereaved families get from hearing from those who received their loved one’s organs. “


Sam had a lung condition ( fibrosing alveolitis ) of unknown cause and through no fault / “ lifestyle choice “ of his own. His sister also had a transplant for the same condition, but died two years later. BOTH owe a debt of gratitude to their anonymous donors.


To ALL members looking forward to Christmas, with their own very real problems, count your blessings and be thankful for organ donors, emergency service and health workers, and everyone else who will be working over the festive season !

[andy222]

Very well explained doc. I dont think anyone realises this until it happens to us or someone close.

[Doc Alan]

Very well explained doc. I dont think anyone realises this until it happens to us or someone close.

Thanks Andy - and Dedworth :xxgrinning--00xx3:

Time to prepare my posts - 3 hours

Time to fill in Organ Donor registration form - 3 minutes

To other members - please at least read Dedworth's thread and think about your New Year's Resolution(s).

Merry Christmas everybody :smile:

[mickcant]

At my age of 68 would there be any parts usefull for transplant still?

Mick.:cwm25:

[Doc Alan]

Age should not matter in the case of eyes and some other tissue. For other organs it is the person's physical condition, not age, which is the deciding factor. Specialist healthcare professionals decide in each case which organs and tissue are suitable. Organs and tissue from people in their 70s and 80s can be transplanted successfully.


This link provides frequently asked questions and answers :-
http://www.organdonation.nhs.uk/

[Dedworth]

Thanks for all the info Doc. On a related issue I received this email on Monday :-

As a regular blood donor, you already know that you are helping to save and improve lives every time you give blood. Thank you for your generous support.

We also face a challenge to find new donors every year if we're to ensure there's always enough blood, and that challenge is now a particularly pressing one.

We've recently launched a 100 thousand new donors in 100 days campaign to encourage more people to come forward, and we're asking all existing donors to please spread the word in support of that campaign.

If you have a friend or family member who might be interested in giving blood, please forward this email to them or ask them to register as a blood donor by calling us or visiting our website as detailed below.

Call us on 0300 123 23 23
Visit us at www.blood.co.uk

[mickcant]

At my age of 68 would there be any parts usefull for transplant still?

Mick.:cwm25:

Thanks Doc,
I was a blood doner for many years and carried a donor card, but had to stop giving blood when I was put on medacation for high blood pressure.

I wlll re sign for being a donor though:xxgrinning--00xx3:
Mick.:smile: