Organ Transplantation: Who Gets What, and When?

by on December 19th, 2014
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COMMENTARY | Children’s Hospital of Philadelphia cited transplant policy as reasoning for denying Amelia Rivera a transplant, which requires a specific “quality of life and mental condition” be met before considering transplant. Amelia suffers from Wolff-Hischorn syndrome, which causes physical and mental defects. Seizures, heart problems, and brain abnormalities are some problems associated with the disorder. Chrissy Rivera is an avid blogger and after reporting the incident to her followers has gained much support. ABC News reports that over 20,000 people have signed an online petition to get the girl the kidney.

It is important that people understand the hospital’s reasoning behind this decision before taking either side in the argument. Transplanting of organs is a very serious responsibility for the hospital as well as the recipient.

Transplant List

Transplants are coordinated by the United Network for Organ Sharing. A hospital will suggest placement on the list once patients meet their criteria, they must then meet UNOS criteria. Criteria for either can include overall patient health, antibody production, risks to health following transplant, and reason for the need. These criteria ensure that the person getting the organ will have the best chance of survival post-transplant. A wait for an organ can vary, with Kidney transplants taking about five years. Receiving an organ over another waiter is based on many factors; Blood type match, size/shape match, urgency for the organ, proximity to donor, and time spent on the list are factored in to the decision.

Receiving Transplants

Transplantation is very serious and risky surgery. A person’s body must be able to handle the complete removal of an organ followed by introduction of a ‘foreign’ organ. Immunosuppressant medications are taken for the lifetime of the patient after transplant. These medications can put the patient at risk for developing other infections and other conditions. Even with these drugs, the body can still reject the organ anywhere from an hour after the surgery to 5 years later. Many patients are refused transplant because the benefit to them does not outweigh the risks involved.

If Ameilia receives a transplant the odds are still not in her favor. She would not likely get an organ if placed on the transplant list because others would receive the organ first. An organ directly donated to her without the list would still be risky. Her condition makes it likely that her body will reject the organ and cause more serious problems. She has already had other serious surgeries, putting her in increased bodily stress. She could even die as a result of organ failure. If Ameilia does not receive a transplant it will not be because of her mental condition but because of her physical risk factors. The real issue in this argument, as a parenting blog Friday alludes to, may be the poor word choice and explanations of the CHOP representing doctor.

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