Organ Transplants for HIV Patients??????

Came across this article on Yahoo this morning. Im sure there are lots of ethical issues with wasting an organ on a person who has a terminal non-currable disease that is easily preventable but maybe he was an older guy who got HIV from bad blood or whatever.....take it how you will

Tim

Lung Transplant for HIV Patient

Do you know any HIV positive people?

If the person can be expected to live a few years after the surgery then it's worth it, regardless of how they caught the disease. I know if it were me or a member of my family I would want that. If it's only going to extend life for a few months, then it's pointless in my opinion and the lungs should go to someone who can get the longevity out of em.

Thinking about this tho. In non-HIV patients who have transplant surgery it's the bodies Immune system that causes the rejection etc. And the horrendous medications they have to take. So someone with HIV an immune deficiency might actually take better to a transplant than a non-HIV candidate!!!

Turning this into a 'The US Health care System Sucks' argument. If a rich person wants a new set of lungs and is near death from HIV here - No problem. The poor without the $$$ or health insurance are the ones who get screwed. Health Care should not be about how wealthy you are.

So you want a system where political appointees decide who gets what healthcare and who does not.

You want a system where in order to take care of a few poor people, everyone will have to be stuck with low grade, crappy government healthcare.

That's basically what you are advocating.

Maybe we can have a system like England where you have to practically go blind before they even allocate funds to take care of vision problems. Maybe we all would be better off waiting six months or a year in "queues" for our number to come up for a life saving operation.

Government run healthcare sucks. We already have it in many forms in this country and where it exists, it sucks.

If healthcare is so great in England, why the hell did you leave?

Does your current "American style" healthcare suck? I don't think so.

You're just what this country needs in this day and age of massive immigration. You're another immigrant who comes here and tries to tell us that we should be doing things the way it is done back in whatever shithole you couldn't wait to leave.

Who the hell pissed in your cheerios this morning?

He comes out swinging hard huh? Very antagonistic.

How was I swinging hard? What did I say that wasn't true?

Everytime there is anything on this board related to healthcare, all we hear from Rinky is that the healthcare system in this country sucks. Then he proceeds to lie about the system in England.

I want to know how bad his healthcare situation is considering he now lives and works in this country.

Come on Madman.

What you said may have truth to it, but your delivery is a little rough when the guy just voiced his opinion.

How can you say that isn't antagonistic, hell it's borderline personal. So when he responds in kind, this topic will turn into a pure flamefest. He never mentioned politics. He never mentioned his country's healthcare compared to ours etc.

Oh well, I'll butt out now....

I can see where you would think my delivery here may have been rough.

But, it's not like we have never been over this topic before with Rinky.

Based on his previous comments on this topic, I stand by what I said.

I'd still like to know how "bad" his healthcare is here in the USA. He never explains his justification for always disparaging our system.

I'm willing to bet his healthcare coverage is excellent.

He also did put himself out there claiming he was "turning this into a discussion" about US healthcare. Most notably claiming it sucks. As he always claims.

His delivery isn't rough - it's just New York style. Similar to Chicago style, but with a more annoying accent. We should have military style health care here - Motrin and water to treat almost everything, no sick days - you go to the doctor and he tells you if you are sick. He calls your boss and tells him you are sick and should stay home. Your boss then gets to decide whether you come in or not, he takes the risk if you get worse by ignoring the doc's recommendation.

...and if you aren't pulling your load you get dubbed the Sick Bay Commando

HIV isn't the death sentence that it used to be. With treatment, someone with HIV will live a normal healthy life for many years without it ever developing into AIDS, which is what is bad news!

Anyone with such a negative view on it needs to either do some reading or get to know someone who has it so they can learn.

True true.. I guess my 3 year old is just softening my normally thick skin up a bit (wipes a tear from his eye, sniff)...

I remember those motrin days.... Don't miss em!

HeHe and if you hate your boss by him making you work its easy for you to get him relieved!!!!!

To answer the questions???

Yes I have known someone who is HIV Postive doesnt really bother me as I know that the disease is very hard to contract.

I feel that anyone who abuses their body ie....drinking too much, smoking too much, or doing needles or having sex with prostitues or other dangerous activities should not benefit from life saving surgery when there are so many others who have done nothing of the sort and are trying to cope with the cards that they have been dealt.

With that being said maybe the guy in the article contracted HIV from bad blood or some psycho stuck him with a needle then he deserves all the help and benefits others who have taken care of themselves have.

You reap what you sow in this life and should stand for the consequences of your actions.

Tim

Oh shit - I was missing out on some fun in here it seems. NY - You are a dick. You know nothing about the healthcare system in the UK, other than the bad shit you read online - Where pretty much all of your dumbass political opinions seem to come from.

No - it's not perfect in the UK. Yes patients are put on waiting lists for non-emergency operations. So my gran for example had to wait 3 years for a replacement knee. But at least she got the knee eventually, rather than hobbling around here for the rest of her life on a bad knee, because she can't afford to pay for the operation and Medisuck are only willing to partially foot the bill.

When my dad was 32 years old he had a heart attack, we were a low-middle class family, pretty much living month to month. The kind of family here who would be unlikely to have health insurance. So here we would have had a $200,000 bill or some pathetically huge bill, that would have sent my family into bankruptcy. You are saying that is right for that to happen NY. That a normal hard working lower middle class families should be thrown out on the street or suffer bankruptcy because hospitals here can basically charge whatever they hell they like?

You truly are a sad individual if you believe that the little / no healthcare that 25% of the population here get is a good thing.

Why not?

Healthcare, like everything else, costs money.

People who have money, therefore, can buy the healthcare. People who don't have money have to find a way to get by and do without - just like in every other aspect of their lives.

It's a cruel world and nothing's free...

Wow - can't believe people actually think like that in the modern world. I assume you have health insurance and are financially stable to think like that!

Because we aren't barbarians?

Socialized health care has problems, which madman will no doubt continue to hammer on. The current US system has a shit pot full of problems too. On balance I tend to think the current system here is probably better than a system such as the UK has, but only a complete dipshit would argue that one system or the other doesn't have a lot of problems.

The only dick here is you. I would also add jerkoff to the mix.

So, basically you are saying that your grandmother waiting 3 years for something she could have had done here immediately is somehow superior medical care. Good argument asshole.

No wonder your home country is so fucked up if what they produce is a lot of people like you.

I know plenty about the healthcare system in the UK and Ireland. One thing it does very well is kill people. Another thing it does very well is make people's illnesses get far worse.

I have several extended relatives who died because of that fucked up system you think is so great. The waiting lists you seem to think is just a minor inconvenience so everyone can have really shitty bottom feeding type healthcare. They were people who would still be alive today if they had lived in this country.

It also doesn't sound like you know a damn thing about the medical system in this country. You just enjoy being an immigrant jerkoff who likes to criticize this country. All the while enjoying the benefits of this country. You ran from the country you are claiming is so much better. Why? Go the fuck back. Some American would love to have the job you hold.

You never answered the question regarding your healthcare here in America. Why have you avoided that question? You claim healthcare here sucks. Then your healthcare must suck. Well... does it?

Does healthcare here suck, or are you just repeating all the socialist propaganda that passes your ears and eyes? Maybe you should contact Michael Moore. Both of you are liars.

Quote:

When my dad was 32 years old he had a heart attack, we were a low-middle class family, pretty much living month to month. The kind of family here who would be unlikely to have health insurance. So here we would have had a $200,000 bill or some pathetically huge bill, that would have sent my family into bankruptcy. You are saying that is right for that to happen NY. That a normal hard working lower middle class families should be thrown out on the street or suffer bankruptcy because hospitals here can basically charge whatever they hell they like?

In this country you would have been covered by a government program if your father was a poor low income worker who didn't have job related insurance.

Instead of trying to push governmental socialism, shouldn't you be trying to push for things that might prevent other people from becoming a low income family such as the one you claim to have come from?

Quote:

You truly are a sad individual if you believe that the little / no healthcare that 25% of the population here get is a good thing.

Stop your fucking lies. 25% of our population is not without medical coverage. You get that bullshit from whatever socialistic crap you read. Those people also include illegal immigrants in their numbers.

We already have programs that poor people are eligible for regarding healthcare. You choose to ignore that because you don't know a fucking thing about this country.

You're just an ingrate immigrant who feels happy complaining about this country. For some reason you feel this country should become the same as the shithole of which you left.

This country doesn't need people like you Rinky. Maybe some of these illegals would make better citizens than you. Many of them don't complain and disparage this country as much as you.

LOL - Don't hold back dude. Say what you feel.

I'm not complaining about my healthcare here in the US. I'm complaining about the healthcare system in general. Where lower class people get fucked and where hospitals can charge pathetic rip off prices to the uninsured / under insured.

After I make my wealth here in the US I probably will go back to England, when I can afford to live there. Not sure how my friends manage - At least they don't have to worry about the bill for getting treatment at a Dr / Dentist or a hospital in the event of an accident.

This country doesn't need law-abiding, tax paying immigrants eh! Nice. May as well just let all the illegals in who don't pay taxes or obey the laws - That would be a nice place for you citizens to live in!!!!

Was thinking about this some more on my drive home. So what you are really saying NY is that you are communist and that everyone should agree with the government and not have our own opinions about things. If I disagree with the way the US health care system is run, then I should be repressed and my freedom of speach taken away?

Is the US not based on freedom of speach and the right to maybe once and a while have our own opinions about such things as say - Sucky healthcare for the poor?

Ya know I thought you were Republican through and through, but you're sounding more and more like a communist the more you argue. Maybe it's you who should move to North Korea or somewhere where speach is repressed and the people are forced to act like Zombies and not have their own opinions. I think you'd be right at home! Although I think they might have a government paid healthcare system too, so you might have to just put up with that.

Yes and yes... but... think like
what, exactly?

I'm a backwards barbarian because I don't want to fork over 30% of my paycheck so that your grandma can have a new liver?

Screw that. I say get the government completely out of it, get rid of ALL health insurance, place reasonable caps on malpractice suits, and watch prices plummet to reasonable levels that we can all afford.

ETA - being the SO of a veterinarian, I've been amazed at the price differences between human medicine and animal medicine. She broke her foot a couple years ago and it cost her about $4000. The EXACT SAME procedure (basically X rays and a splint) on a dog would have been a couple hundred bucks at a vet clinic.

Yes, yes, YES!!!

Finally, someone gets it.

I too look forward to sidewalks made of chocolate, rain in the form of beer, magical pills that turn the numerous ugly fatties in America into supermodels, and a job that pays seven figures yet doesn't require any actual "work" on my part.

Hey, if you can dream so can I, right?

Try an MRI. When my dog had back problems, they mentioned if rest didn't fix it, they would want to do an MRI. Nearly the same price as if I was getting the MRI myself.

I'm sorry, but I don't feel that health care should be a given for everyone. If you want it free, join the military. We're short handed as it is. If you eliminate all the "poor people" who are not able to join through their own fault - either criminal past, drugs, or some other stupid act, what percentage of the population doesn't have health care? I'm more willing to bet that it comes down to laziness.

What makes you think lower class people get fucked over? Are you just repeating the typical propaganda regarding this issue or do you know anything about the issue at all?

About 53 million people in this country are already covered by Medicaid. That's government provided insurance if you didn't know.

That's better than one out of six people and counting. A few states even allow you to enter the Medicaid program with an income of about $60,000 for a family of four, and still be eligible. That's almost three times the so-called poverty level income. That's a pretty generous system that the taxpayers are paying for.

There are options here for poor people. Are we supposed to fuck up the entire system just for a few people?

There is no doubt the system here has some problems and is expensive. Most of these problems are directly due to government and government regulations and interference. The system needs reform, not more government involvement. The current levels of government involvement have already created a lot of waste. For every doctor and patient, there are about 3 or 4 other people involved doing paperwork.

The system here is still far better than the system in that runaway socialized garbage dump that you come from. Healthcare is "rationed" in the UK. People here don't have to wait 6 months for a TB test. That includes people with no health insurance at all. We don't let our old people die from lack of care because they are just too expensive to keep treating in their advancing years.

In England, even former members of Parliament can't get good healthcare and are allowed to go blind because of the crappy government healthcare system. If former MP's don't have a chance in the shitty English system, the average person has even less.

Quote:

After I make my wealth here in the US I probably will go back to England, when I can afford to live there. Not sure how my friends manage - At least they don't have to worry about the bill for getting treatment at a Dr / Dentist or a hospital in the event of an accident.

Those are the key words..."when you can afford to live there". They take all of your money and in exchange you get to wait in line 6 months or a year for crappy healthcare.

Good luck when you get old over there. You are going to need it.

You can't even purchase a television set in that country without paying an expensive "television tax" to the government every year.

It's good to hear you will be moving back to England. That will be one less ingrate immigrant living here.

Quote:

This country doesn't need law-abiding, tax paying immigrants eh! Nice. May as well just let all the illegals in who don't pay taxes or obey the laws - That would be a nice place for you citizens to live in!!!!

I never said we don't need tax paying law abiding immigrants. What we don't need is immigrants who come here complaining that our systems suck and should be changed to the even far worse socialized systems in the dumps they decided to leave.

Quote:

Was thinking about this some more on my drive home. So what you are really saying NY is that you are communist and that everyone should agree with the government and not have our own opinions about things. If I disagree with the way the US health care system is run, then I should be repressed and my freedom of speach taken away?

Is the US not based on freedom of speach and the right to maybe once and a while have our own opinions about such things as say - Sucky healthcare for the poor?

Ya know I thought you were Republican through and through, but you're sounding more and more like a communist the more you argue. Maybe it's you who should move to North Korea or somewhere where speach is repressed and the people are forced to act like Zombies and not have their own opinions. I think you'd be right at home! Although I think they might have a government paid healthcare system too, so you might have to just put up with that.

Yeah sure, I'm a communist.

Where have I ever said that everyone should agree with the government? Don't put words in my mouth or say ridiculous things and attribute those things to me.

I'm advocating for the government to get out of the healthcare business. Almost everything government touches they fuck up and make worse. We have enough government dependency in this country. I certainly don't want to see a system where all citizens become complete slaves to government from cradle to grave. Europe is crumbling because of that mindset.

You have all the freedom of speech that you want. What you don't have is the freedom from someone else calling you on your bullshit.

X2.

Here's my slant. Everybody that's born is going to die, someday. If you're rich enough to prolong your life, then good for you. If you're not, nothing was "taken away" from you; you just couldn't afford the luxery of expensive healthcare. Oh well.

I don't know why there are people that think "helthcare" is in the Bill of Rights... Last time I checked, there is no unalienable right to have a $50,000+ medical procedure done on your broke ass. If you can pay, then great!

If not, then great! There are plenty of things in this world that if you can afford it, you can have it. Health care is a luxury, not a necessity, and most definitely not a right. It's no different than real estate, cars, or any other luxury items people pay.

Caveat: I think there ought to be some form of basic health care available to all children under the age of 18, as it's not they shouldn't miss out of the opportunity of health care just because someone else can't afford it (their parents). I know, I know, that sort of goes against my overall line of thought on the whole thing, but still, that is my thinking, anyhoo. Deal with it.

I knew it.

Okay, let's get back to the meat and potatoes of the post; transplant recipients who are HIV positive.

Each organ transplant program has their own patient selection process that every potential transplant candidate must complete. The staff members at these hospitals want people who receive transplants to get better and have an improved quality of life. The intent of the procedure is not to make a transplant recipient, who by their underlying organ failure is critically ill, sicker or start a series of events that result in their death.

Someone who is HIV positive would have to have a very low viral load, high CD-4 count, and be pretty well off from an infectious disease stand point to even survive the transplant and massive immunosuppression that will be required post operatively.

As of 5:10 PM today, there are 96,534 persons on the transplant waiting list in the US. The number of persons on that list who are also HIV positive is very low. Stop the immature ranting people...

Be a donor, save several lives, be a hero.

Hey I feel bad...i started this mess as a public service announcement to see what others thought now it is a mess about all health care.

X2 on the organ donor issue....my DL and my Military ID both have me as an organ donor...if it helps another person who needs it then so be it!!!!

Tim

takes 10-20 years for a patient to go from HIV positive to full blown AIDS.

with new treatment (and treatment compliance!!), this patient, even though he has HIV now, can look forward to theoretically living another 20+ years. With possible new advances in the coming years, maybe more.

say the guy is 50 years old right now...then that means his life has now "theoretically" been prolonged another 20 years...up to 70...

btw...remember what the treatment is following transplants in normal patients?? they get their immune systems nuked to prevent host-vs-graft reactions....

i think someone said it already on the first page...this guy is probably a 'better' candidate for transplants due to his already-deficient immune system.

Lots of interesting posts here. Obviously an ethical dilemma for some. Even more good discussion on the public health system.

I suppose you could call me an expert in both categories. One, this weekend marks the one year anniversary of my liver transplant. I had a genetic disease, so there weren't the same ethical issues that surround this case, but the organ transplant experience did teach me a lot about the process. The process works as it is designed. It certainly was interesting.

UNOS (United Network on Organ Sharing) changed the Liver criteria in 02 or 03 for how patients wait on "the list", which is the actual list of persons waiting for organs. The list is broken up into regions, and organs are allocated state, regional, and then nationwide. This means that the donor's organs go to the state they are in (in my case, Oklahoma), then if no match, go to the patients waiting in the region (in our region, its Oklahoma and Texas).

The change made the wait time change from "time" waiting, to acuity, or how sick the patients are. The old way had patients dying from how sick they are, rather than treating the sickest. The liver list now goes by what is called a MELD score (Measurement of End Stage Liver Disease), which uses lab work to indicate who is sickest, and the sickest move to the front of the line.

In my opinion, as a nurse, a health professional, and a patient, this is the correct method, and if the criteria are followed, it shouldn't matter what the patients background is. Clinically, this should be the end of it, but these hospitals make a lot of money on transplants as well. The only distasteful part of the process was having to work with the financial people to get "clearance" for the surgery. They made it clear they would not "list" me until the finances were in order. I believe this is wrong. I believe we need to morally take care of the patient, and then send them to collections if they do not pay. All that being said, now try to wrestle with a convicted criminal, murderer, child abuser, etc, getting a liver transplant. It could happen. There are lots of inmates in prisons with liver failure from hepatitis.

The payment comment, I believe, also comes from where I work, and our philosophy on taking care of patients. I work in an Indian Health Service facility, and we take care of Native American patients regardless of ability to pay. We do not offer everything, only the basics- primary care. We do some surgery, have a screening cardiologist, and do some basic orthopedics. We do bill patients if they have insurance, medicare, medicaid, etc. We also do all labs, radiology (no MRI), and dispense lots of drugs (few new medications, primarily generics), for the patients needs. Its as close to the socialized medicine that the country offers. We have been to a lot of VA hospitals, and ours is more similar to a community hospital and clinic due to OB and peds, things the VA does not routinely offer.

Is it perfect - No, we can do lots of things better. Does it work for our population ? Absolutely.

So, in closing, I suppose I would say this:
1. Transplants for HIV patients. If UNOS set the criteria, and they were going with the sickest patient first, then I would be OK with that.

2. A socialized medical system is not perfect by a long shot. It leaves most of the specialty care out. However, I do feel it works in the right setting with the right people running the show.

Comments from the 'Donor. Thanks for playing!

Kaiser Johnson is right!