Ethical Debate: Organ Transplants

hoolahan, ASN, RN · Feb 23, 2003

Best Blone, if that is true, that is a SIN!!! To think that people are in those hospitals just waiting for a donor. I admitted a pt to home heath just yesterday who was in the hosp NINE MONTHS getting IV milrinone until he got his transplant. He shared time with many many others who were on that unit waiting for hearts. And please, the typing and xmatching is done long before the actual harvesting of organs, I mean hours prior, isn't it? That was the way it was done when I last participated in a harvest in an ICU.

That just makes me so angry!!!

semstr · Feb 23, 2003

Laurie, MSN, sorry girl, but that is not done in all European countires, only in Austria and Belgium.

But we have Eurotransplant here, located in Leiden in the Netherlands and all the dates and facts of people needing organs or tissues are in the computers there (not all countries are there, but most of them) and when a organ comes, it doesn't matter where someone is from.

I worked dialysis for a while and we had kidneys from Italy, form Germany and from Norway.

Who cares? As long as the patients get their organs, and the list is checked in the right way, I don't mind at all, who gets the organs first.

What I do find revolting, is paying for organs. We have qiute a few of very rich Arabic patients and they like to buy whatever they need. Untill now, I don't know of one, who got his/ her organs earlier, because they paid for it.

But it might be, that I simply don't know about it.

caroladybelle, BSN, RN · Feb 23, 2003

I believe that the time limit from removal of life support from donor to organ reimplantment and returned to functioning in a recipient is a total of four to six hours for heart and or lungs . Really a very narrow margin when figure including removal, the entire reimplantment and reanimation (?) of organ, travel time etc.

Very little of that time is allotted to travel - or so is my understanding. Heart & lung combos are fragile and survive viably a very short time outside a living host.

As I posted on another thread many countries have varying laws regarding death - in those where brain death is not considered death, few heart and/or lung transplants can be done d/t organs not being viable long enough - many Japanese were coming to the US for transplants as organs were not available in Japan for this reason - not aware if this is still true or not.

Lausana · Feb 23, 2003

Originally posted by MishlB
Healthcare SHOULD NOT be based on whether someone is a citizen of this country

Apparently this thought is mutual, and why I get RIPPED off to provide myself and child with healthcare out of each paycheck let alone when we actually need something, I don't have the option of hopping the border and taking myself to an ER and getting free care because "I'm there".

I absolutely LOVE the idea of those incarcerated being asked to donate. Even after eliminated diseased organs, think of how many would still be available :idea:

If we had more people willing to donate and were able to give to our own citizens with organs to spare, sure give them to anyone in need. But sadly, we don't. I feel it's neccessary to give American citizens organs from American citizens. Citizen being the word.

I'm curious to see how other countries feel on the subject, if they do their own transplants, do they on foreigners etc. (besides our Canadian/Dutch mentioned above friends of course!) Guess it's time to head of & surf the web.

Q. · Feb 23, 2003

It would be really interesting if we can some solid facts on the organ transplant processes in foreign countries and figure out why people come here, and why we don't go there, etc.

lee1 · Feb 23, 2003

I would like to ask another question. What happens when nonamerican tourists/ illegal aliens that are in this country have a traumatic event and THEIR organs could be used???? Are they approached also by the sharing network/UNOS??

At my hospital ALL deaths must be reported to the sharing network, info is given and THEY decide if the organs can be harvested and THEY go ask the families.

Also, ANYONE who is to undergo any type of brain death protocol I believe now the sharing network wants to be notified also.

That said----it is my personal belief, that if there are NO American citizens/holders of permanent visa that can benefit from the organ transplant at that specific time/event then YES and only then should the organs not be wasted and given to noncitizens/non holders of permanent visas.

Why is it that a country like Mexico does not perform transplants in its capital city---- Where have all the people who needed transplants gone before? HERE????

Furball · Feb 23, 2003

Didn't a young American die a few years back in Italy and his organs were used there? I vaguely remember a young boy. I'll have to try and look it up. I have early alzheimers so don't quote me on this, ok?

Don't know if this means anything to this discussion

Sally_ICURN · Feb 23, 2003

Originally posted by Susy K
...why people come here, and why we don't go there, etc.

Technology to do the surgery and support the recovery, and the lack thereof.

karenG · Feb 23, 2003

over here, health care is available to all, that includes things like transplants. ok there are issues over people making themselves homeless and claiming refugee status to get the health care that they percieve as a need. we pay for health care though our taxes-not insurance. so the number of us who pay into the system is small compared to the number who access it. I think the issue is partly about the inequity of health care across the world. If my child needed something that wasnt available here, then I would go to where I could fulful that need.........but I'd expect to pay, and wouldnt expect anyone to suffer because of the choice that I had made.

maybe it comes down to the 'is health care a right' thing. dont think that there is any easy answer.

Karen

NurseGirlKaren · Feb 23, 2003

Yes, organs from people here in the U.S. who suffer brain death are used in the process. I was involved in a case a few years ago of an individual who was here working illegally and sending money to his home country for his family. Was pronounced brain dead and the OPO contacted his family and received consent for organ donation. Very interesting, some of the cultural issues that were involved. Plus, I was able to see the surgery to harvest his organs. Wow is all I can say.

Stargazer · Feb 23, 2003

Originally posted by Furball
Didn't a young American die a few years back in Italy and his organs were used there? I vaguely remember a young boy. I'll have to try and look it up. I have early alzheimers so don't quote me on this, ok?

Don't know if this means anything to this discussion

http://www.nicholasgreen.org/

A young boy from California, Nicholas Green, was killed by highway robbers while vacationing in Italy with his family. His parents agreed to donate his organs, which went to seven Italians waiting for transplants. Reg and Maggie Green spoke openly to the media, with no bitterness, about their loss and decision. The world took the story--and the Greens--to its heart. In the first few days after his death, the number of people signing organ donor cards in Italy quadrupled. Donations there last year were more than double the rate they were in the year before he died.

Actually, I was going to post something about this earlier too, because it does speak to the culture in some countries regarding organ donation. I've never been clear on why the Italians did not, for the most part, believe in or choose to participate in organ donation prior to Nicholas Green--but it makes me think that in countries with similar cultures, a decent public service campaign could go a long way towards changing that collective attitude, and persuade people to lobby their goverments for a system similar to UNOS or Eurotransplant.

dana d · Feb 23, 2003

WoW! what controversey, so lets add to it. I die, I'm an organ donor. My grandson needs a heart transplant, he matches mine, But he is not next on the list. Another child who has been waiting, but not more acute, matches, should that child receive my heart. Who should get my heart? My grandson may die before another match is found. Does my family have a say into where my organs go? should my family be paid for my organs?

And if thats not bad enough, let talk baseball. Without mentioning names, who was bumped ahead of the crowd because of his money and status in our society. After years of self destruction he received a liver transplant, while other individuals died. I stop at that.

The whole system needs readjusted. My condolences to the family of the 17 year old - not American - who died. But my condolences also go out to the family and person to whom those organs may have gone to in America. When are we going to start taking care of us. When do we say " no " to lets make another dollar and " yes " to our Country. Other countries don't put Americans first. Why do we put ourselves last?

Proud to be an American, dana d