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Unformatted text preview: Organ Transplantation
www.unos.org United Network of Organ Sharing Waiting for organ transplants How many people receive an organ transplant a year How many people die each year b/c of a shortage of organs? How many people die each year waiting? Candidates on waiting list? Number of people saved a day Number that die a day Human to Human Organ transplants Demand Long wait list What's out there to help Artificial Hearts Abiocor Abiomed Xenografts Fetal cells Computer chips Artificial Kidneys/Blood vessels Black markets Blurring of boundaries Life & Death Biotech Engaged in saving lives Dabbling w/ forces beyond our comprehension Elements of both Potential Raises Concern about the ethical treatment of animals & humans Risk of environmental & biological contamination Loss of individual rights & privacy Loss of human dignity Advances In Organ Transplantation Improved surgical techniques Better understanding of immunology Drug Therapy New Antirejection drugs Organ preservation techniques Live transplantation What do we transplant? Heart Lung Kidney Liver Pancreas Intestines Stomach Corneas Multiple organ transplants Heart vavles Tendons Skin Bones Bone marrow Connective tissue Concerns over equity in organ distribution Persistent shortages long waiting lists Ban sale of organs Given rise black market Cont. 1998 sale of corneas Ebay 1999 Urban Legend Advertise on billboard/web site What are your thoughts on advertising? Cross species transplantation Live organ Donor Swaps Advances is the field have raised a host of issues Social, ethical, economical & political Questions What are and what should be the sources of organs? How can we increase the # of organs? How can we make sure that organs are allocated in a fair & equitable manner? What criteria do we use to establish the need? If you received one transplant should you be allowed to get a second? Questions cont. Should an alcoholic be given a liver transplant, a smoker given a lung transplant, etc? Are all transplants worth the economic cost involved? Should laws in cadaveric donation require consent of the donor and/or family member? Should a family member be able to override an organ donor's wishes? Questions cont. Should animals be bred & cloned for organs? Should humans beings be cloned for harvesting organs? People have children to save other children Need to address these issues International: China Resistance 1984 passed law permitting organ harvesting from executed prisoners Sale & transplantation w/o consent International: Japan Opposition 1997 legalized organ transplantation from brain of dead donors International: European Countires 1990 Opting Out Now voluntary system US Public Policy Brain Death 1990 New Policy sickest no longer receive national priority Locally, regionally, nationally US divided into regions Largest Transplant areas Age requirement to donate PA US Public Policy Cont. 1998 proposed new federal law Public concern Equity & Fairness Allocation People of Color
Few donate Better chance of success person of same race Large campaign African Americans make up 12 % of population 35% of pt. waiting kidneys are African Americans Public Support Few truly donate approached at the time of relative's death refuse Why? Factors that hinder donation Failure to sign written directives by individuals Lack of knowledge regarding circumstances Failure of medical personnel to recover organs Failure to approach family members Inefficiency of organ procurement agencies Failure to communicate pronouncement of death Failure to obtain adequate consent from family Proposals to address shortages 1. Conscription System 2. Mandated Choice 3. Rationing 4. Organ Swapping/Trading 5. Change the Definition of Brain Dead Univ. of Pittsburg Proposals cont. 6. Presumed Consent 7. Financial Incentive Conclusion Each proposal carries pos./neg. Should we follow any of these policy proposals? Would any eliminate the problem of shortages Would increase in organ supply come at a price? Are we willing to pay that price? Depends on one's view ...
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- Fall '07