Sun. Apr 2nd, 2023
Currently, more than 106,600 people in the US are on the nation’s transplant waiting list, each hoping to soon learn that a kidney, lung, heart, or other essential organ is identified as suitable for transplants. patients. It is not only the promise of a new organ but also of a new beginning.

Before being added to the pool, transplant candidates, as they are known, undergo a variety of tests and exams to make sure they are not infected and that all of their organs and tissues are in good health, and that all vaccinations are up to date. Today, the COVID vaccines, as well as the reluctance of some people to them, have transformed what was a routine preparation into a controversial topic.

In January, the month of January 31, a couple from Boston decided not to undergo the vaccine against COVID-19, as well as officials from Brigham and Women’s Hospital, removed him from the heart transplant waiting list. Similarly, in North Carolina, a 38-year-old man requiring a kidney transplant has said he, too, had his organ rejected by refusing the vaccine.

Two of the latest cases. Decisions by transplant centers to exclude patients from the waiting list have sparked an international debate among ethicists, family members, physicians, patients, and others. In social media and conversation, the question remains: is it unfair to remove them from the nature and cruelty list? Is it simply the normal course of action to ensure that the patient is as fit and healthy as possible and to make the transplant as successful as possible?

Two recent tweets summarize the discussion.

“The persons who are responsible should be prosecuted for attempted murder,” one Twitter user suggested. Another suggested that the best method of writing the headline about a potential donor who is refusing COVID-19 vaccination would be “Patient willingly forfeits organ donor. 

Experts in medicine and ethics as well as patients on waiting lists declare it’s a healthy medicine. require the COVID vaccine and various other requirements before transplantation.

Transplant Protocols

“Transplant Medicine has long been a major advocate for vaccination,” says Silas Prescod Norman, MD, clinical associate professor of nephrology as well as internal medicine, at the University of Michigan, Ann Arbor. He is also a kidney specialist and is who is also known as a nephrologist. He is employed in an in-hospital transplant facility.

In the event that COVID is required it’s a prerequisite. It is important to note that the COVID vaccination is in line with the requirement to receive additional vaccines. says. “Promoting COVID to our transplant candidates and recipients is a matter of course. COVID vaccine to our transplant candidates as well as recipients is the extension of our regular routine. “In transplantation, the safety of the patient is paramount,” says Norman. “And we have learned that patients with a solid organ transplant are significantly more at risk of contracting COVID than people who haven’t received the transplant.” Following transplantation patients receive immunosuppressive medications, commonly referred to as anti-rejection drugs. These drugs can reduce the immune system and decrease the body’s ability to oppose transplanted organs.

“We are aware of this now as there is evidence-based research regarding the vaccine that shows patients who are taking transplant medications have a lower chance to create antibodies that can be detected after the vaccine,” says Norman. Norman serves as a physician advisor for the American Kidney Fund, a non-profit organization that offers kidney health information as well as financial assistance for dialysis.

This shouldn’t be surprising due to the effects of immune suppression the doctor claims.

“So it makes sense to immunize people prior to transplantation,” says Norman.

The study examined cases that comprised more than 17,000 patients who received organ transplants. They had to be admitted into hospitals from April to November 2020, whether due to COVID (1,682 of them) or other health issues. COVID sufferers were at a greater risk chance of suffering from complications and were more likely to suffer complications or even be admitted to hospitals as compared to people who did not have COVID. Vaccination Guidelines, Policies

Federal COVID-19 guidelines for treatment released from the National Institutes of Health state that patients who have taken post-procedure immunosuppressive medication are a greater chance of developing serious COVID in the event of infection.

In the joint statement issued by the American Society of Transplant Surgeons along with the American Transplant Society and the International Society for Heart and Lung Transplantation, The three groups say that they “strongly suggest that all adults and children who are eligible for transplants and recipients get vaccinations against COVID-19 and boosters that have been approved or licensed in their respective jurisdictions. If possible, vaccination must be administered prior to the transplant.”

It is suggested to do it within two weeks in advance of when the transplant date is set as per the guidelines.

The groups “support the creation of institutional guidelines for pre-transplant vaccination. We believe that this will be in the greatest interests of the candidate for transplant and maximizes the chances of surviving the post-transplant and perioperative periods without a severe COVID-19 infection.” “. particularly during times of greater incidence for infections.” The officials at Brigham and Women’s Hospital, where the father of 31 was removed from waiting lists, published an announcement that contained the following information “Our Mass General Brigham health healthcare system requires the application of various vaccines as recommended by the CDC including COVID-19 and other procedures for transplant candidates to offer them the greatest chance of success in the surgery and to also make sure that the patient is the healthy patient after the transplant because their immune system is severely compromised. Patients shouldn’t have to wait for their turn on the waiting list due to this.”

Ethics Amid Organ Shortage

“Organs are rare,” according to Arthur L. Caplan, Ph.D. director of the Division of Medical Ethics at the Langone Medical Center and the NYU School of Medicine in New York City. This is why choosing the best competent candidates for success is all the more important.

“You strive to increase the chance that the organ will function,” says the doctor. A pre-transplant vaccination option is available. The largest shortage of kidneys is seen in kidney transplants. According to statistics from the federal government, there were more than 91,000 kidney transplants are required however only 23,000 transplants were completed. In 2021, 41.354 transplants were completed, nearly six percent more than in the previous year. The figure includes kidneys, the heart, the lung, and various organs, with kidneys accounting for more than 24,000.

Despite the rise in transplants, the number of organs isn’t enough to meet the demands. According to data of the federal government, 17,017 people across the US die every morning waiting to receive an organ. Every nine minutes someone adds themselves to the list of waiting patients.

“This isn’t and shouldn’t be a battle regarding COVID. COVID vaccine.” Caplan states. “This isn’t about penalizing people who do not receive a COVID vaccine. It’s about choosing who will be the first to get an organ that is rare.”

“A number of people [who are against taking the vaccine-free from the list] believe that they’re killing people who aren’t getting COVID.’ COVID vaccination.’ But that’s not the reality.”
The person who is undergoing the transplant should be in the highest overall health, Caplan and the doctors are in agreement. Smokers who are heavily cigarette-addicted or drink a lot of alcohol or takes frequently on drugs are probably not on the top list of priorities, Caplan says. For other procedures, for instance, bariatric surgery or knee surgery, certain patients have to shed excess weight before they are able to perform the procedure, Caplan says. There are some side effects that sufferers have described as causing worry, but it’s not the situation, Caplan says. The thing that transplant candidates who refuse the COVID vaccine do not consider could be the reality that they’ll have to undergo major surgery and will require several anti-rejection medicines, which may cause adverse side effects following the procedure.

“So being concerned about the adverse consequences of the COVID vaccine is absurd,” says the doctor.

Transplants: The Process

Patients who are recently taken off the transplant list are able to be treated and receive the possibility of a transplant at an alternative facility, according to Anne Paschke, a spokeswoman for the United Network for Organ Sharing (UNOS) that is a non-profit group that is governed by a federal agency. This is known as the Organ Procurement and Transplantation Network (OPTN) is also operating on a national scale.

“Transplant hospitals choose the patients they will add to their waiting lists according to their individual criteria and their medical judgment in order to maximize the chances of a positive outcome from a transplant,” she says. This is done with the hope that patients aid in their medical treatment. Thus, if a particular facility does not admit a patient, a different facility might. If the patient is refused at one place because they refuse to accept the COVID vaccine, and then goes to an alternative establishment and receives the vaccine, policies in that facility might be similar to those she has said.

OPTN manages its list of hospitals for transplants. The list was updated on January 28. there were a total of ten transplant centers according to UNOS in charge of managing the waiting list, which connects donors and recipients. It is dedicated to ensuring fairness as well as other things.

Pre-Transplant Refusers Not Typical

“The cases we’re seeing aren’t typical,” Caplan says of the small number of individuals who chose not to be vaccinated. Caplan suspects that the majority of people consult their doctors on what they should do in order to live, and then adhere to the prescriptions.

Norman shares his opinion. The majority of kidney patients he cares for who are looking for transplants are dialysis patients, Norman states, “which they don’t like. They’re doing all they can to ensure that they don’t have to go back to dialysis. As a whole, they are extremely compliant and cautious and aware of the risks they face and the blessing they received or will receive through transplantation. They are determined to do all they can to honor and protect this gift.” On the other hand, those who are listed as transplant recipients who have not been vaccine-free have strong opinions regarding those who don’t desire to receive the vaccine. Dana J. Ufkes, aged 61, a seasoned Seattle realtor has been listed on the list of recipients of kidney transplants (this second time from 2003 ), in the hopes of getting the third transplant of her kidney). prospective recipients should be removed in the event that they refuse the COVID vaccine. Ufkes responded in a direct manner: “Absolutely.”

At the age of 17 Ufkes suffered a serious kidney infection that was not diagnosed and untreated. Her kidney condition worsened and she needed an organ transplant. First, she had a transplant in the year 1986 followed by another in 1992.

“They have a longer lifespan than they did in the past,” she says. However, they’re not permanent. (According according to an article published in The American Kidney Fund, transplants from living donors typically last from 15 to 20 years while those from deceased donors can last from 10 up to fifteen years.) The decision to get vaccine-free or not is obviously an individual choice. Ufkes states. But, “if they don’t want to get vaccinated but desire to be included on the list I’d say this is a mistake.”

In announcing the absence of organs “it’s nothing like giving them away in the same way as jelly beans” the doctor says.

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