A recent study shows that flu vaccination is safe for kidney transplant patients, and possibly lowers the risk of organ rejection among transplant recipients. Previous research has suggested that flu vaccination has the potential to trigger the immune system to reject the new organ.
This is good news for dialysis patients. Considering that dialysis comes with a .20 annual mortality risk for the average renal failure patient – an incidence comparable to metastatic cancer – many dialysis patients make the decision to accept an organ from a donor at increased risk of viral infection than to remain on dialysis, which is correlated to poorer transplant outcomes. For them, eliminating flu vaccine as a significant source of infection risk comes as good news at a time when the digital era may be changing odds, finally, in their favor.
Opting Out of the Kidney Shortage
In the U.S., more than 19 people die each day waiting for an organ to become available on the national UNOS list, for which there is currently an average wait time of eight years or more. As well, most US hospitals have additional wait times of six to nine months, or even longer.
To address the shortage, some experts have proposed mandatory organ donation, persuasively arguing that since volunteer programs do not produce enough organs to meet the demand for transplants, organ harvesting should be as routine as an autopsy is route in the investigation of accidental death.
Currently three states (New York, Delaware, Pennsylvania) are considering opt-out donation program proposals, requiring driver’s license and state identification applicants to be automatically added to the state donor registry unless they have opt out.
Even more radical ideas have been proposed, sometimes by ethicists and doctors themselves, for example the outright sale of kidneys. Dr. Arthur Matas at the University of Minnesota has been quoted saying that “barring kidney sales is tantamount to sentencing some patients to death.”
Ever since UNOS publicized data demonstrating that a transplanted kidney, or “graft” from living donors have better survival odds, patients have turned increasingly to living donors organizations such as LivingDonorsOnline , Matching Donors, Living Kidney Donor Networks, and the National Kidney Registry.
Tweeting, Liking, And Touring For Kidneys
Social networking is playing a part in closing the kidney gap as well; below are links to two stories in which transplant recipients found their donor organs courtesy of the popular social media sites Twitter and Facebook, respectively:
– Former New Kid on the Block Donnie Wahlberg helps find kidney donor for fan in desperate need of transplant by using Twitter
– Facebook Friend Donates Kidney to Virtual Stranger
So-called transplant tourism (medical travel) also provides kidney failure patients with new hope. Evidence indicates that transplant outcomes are superior for patients with less time on dialysis; further, clinical studies reveal that the longer a patient is on dialysis, the greater the risk of cardiovascular damage — an outcome that can negatively impact a transplant patient’s viability as a candidate for kidney transplant.
With pre-emptive (precluding dialysis) transplant improving the opportunity for a successful outcome, medical travel is the obvious solution to the global kidney shortage. Each year thousands of patients from not just the US but around the world – Philippines, Saudi Arabia, and Israel – weigh the risks of dialysis vs. the cost of cash-pay transplantation, and make the decision to travel and pay cash for their transplants at well-regarded five-star medical tourist-friendly hospitals, mostly in India, Costa Rica, Mexico, Singapore and the Philippines.
Impact of Diabesity
We can only expect these trends to continue as the obesity crisis continues unabated; currently, the American Diabetes Association estimates there are ~26 million people (8% of the population) suffering from diabetes in the US today. New cases of ‘diabesity’ are diagnosed at a rate of nearly 2 million per year.
Experts estimate that over the next decade, diabetes will move from 7th to 4th place in leading cause of death in the United States; as the leading cause of kidney failure, the obesity and diabetes epidemic will only deepen the kidney shortage crisis.
Read the New York Times article Flu Vaccine Appears Safe After Kidney Transplant – US News and World Report
Read about the latest fatal condition for transplant hopefuls in Arizona: Death by budget cut.
Read more about how technology is changing medicine.