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WHO SHOULD GET DONOR ORGANS?: TRANSPLANT SURGEONS, RESEARCHERS GRAPPLE WITH THE TOUGH CHOICES
Fivefold Increase in Organ Donation; Debates on Living Liver Donors, Lung Transplantation; What About Exclusion Criteria?
CHICAGO -- At The American Society of Transplantation Annual Scientific Meeting in Chicago, May 15-19, some of the world's top transplant physicians, surgeons and scientists learned that the public is more willing to consider organ donation. They also discussed whether criteria should be established for excluding people from transplants, and heard the pros and cons on living liver donors and lung transplantation.
Organ donations up fivefold as families are more willing to consider organ donation.
Howard M. Nathan, president, and G. David Fleming, Executive Director of the Coalition on Donation and will lead a discussion of data on public attitudes towards donation. They will examine whether the donor consent rate is affected by publicity and whether organ and tissue donation is moving toward becoming a societal norm. "We find that families are broaching the topic of organ donation on their own, approaching medical staff in hospitals to ask about donation at a higher rate than ever before," says Nathan. They will also report that organ donation increased 5.6% in 1997-98, a five-fold gain from the previous two years.
Transplanting livers from living parents to their children: a debate.
Jean Emond, MD, Chief of the Liver Disease Center at New York Presbyterian Hospital and Christoph Broelsch will debate the merits of transplanting livers from living adults. Among the key issues will be whether the availability of donated livers justifies the risks involved; how successful such procedures have been to date; and whether families considering the procedure are being made fully aware of the procedure's risks and benefits.
Lung transplantation does/does not prolong life
Lung transplantation is a very complex and expensive procedure. But does it prolong life? Adaani E. Frost, M.D., Baylor College of Medicine, and Jeffrey D. Hosenpud, M.D., Medical College of Wisconsin will debate this question, made especially pressing by the limited number of lung donors. One of the key issues will be the use of transplants for emphysema patients, who represent 60% of patients receiving donated lungs. What do the statistics say about their post-transplant survivability? Another key issue will be whether quality of life as well as survival rates should be considered.
Who should NOT get donated organs?
A discussion of exclusion criteria At the AST Annual Scientific Meeting, Gregory Everson, MD, University of Colorado Health Science Center, and Michael Lucey, University of Pennsylvania will lead a free-wheeling discussion of one of transplantation's most difficult questions: With such a limited supply of donor organs, when do we decide a person is not a candidate for an organ transplant? The discussion will cover such potential medical and surgical criteria as level of risk, chance of survival, presence of AIDS, cancer, and hepatitis, as well as other factors. "It's much easier to reach agreement on inclusion criteria than on exclusion criteria," says Everson. "We hope this discussion will be a prelude to a formal consensus conference sometime in the future."
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