Now she has developed brain damage (or damange, according to the article title)
http://story.news.yahoo.com/news?tmpl=story&ncid=68&e=2&cid=68&u=/nyt/20030221/ts_nyt/girl_in_transplant_mix_up_develops_brain_damange
Her prognosis is not good, but even if the first transplant was not botched, it would not have been good.
While I agree with the above sentiment (not knowing the veracity of it, or how widespread such feelings are), if that were my child the logic would be ignored.
Excellent points Broomstick. I’m not saying what they did was wrong per se, or that a person should only get one transplant, I’m just uncomfortable with putting a second set in to a person who is in such bad shape already. If someone’s second liver starts to go bad then certainly they should get on the list again. Imagine if someone on the list was in a bad car accident, and was in critical condition from their injuries and unlikely to recover, and the next day their number came up on the list. Assuming that they could make it through the surgery (which is stretching this hypo, I know, but bear with me…) should they get the organs?
Obviously these protocols have been developed by people who have put a lot more time, expertise and thought into it than I. Just something to ponder I suppose.
Slightly off the current topic, sorry…
AB plasma can be given to anybody regardless of blood type. As noted above the red cells are no longer present in significant amounts in plasma so the red cell antigens are of no major concern. But you have to consider the blood group antibodies as well. A type O person will have both anti-A and anti-B in their plasma, thus it would only be safe to give to another type O. A type AB person on the other hand has neither anti-A or anti-B in their plasma so it is safe to give to any blood type- A, B, AB or O.
Just wanted to make it clear that blood type does matter with plasma transfusions as well as red cells.
Cool for your Mom Irishgirl. I’m glad you prefaced that with “many”.
But you are very much mistaken to say that it is not a life saving procedure or that rejection cannot be staved off indefinitely– in the vast majority of the cases it certainly can.
I too am very involved with Transplants at the moment. United Network for Organ Sharing (UNOS) keeps statistics on the different types of transplantation in the U.S.
http://www.unos.org/data/about/viewDataReports.asp
Some examples:
Heart Transplants 78.3 of Males and 76.3 of females are alive after 3 years (the longest surving Heart lung double tx is 19 years now*)
Lung Transplants 57 & 58 percent are alive after 3 years
Liver Transplants about 80% of the recipients are still alive after 5 years (longest surving is 30 years now*)
Kidney Transplants about 91% of both sexes survive 3 years (longest surviving 37 years*)
Virtually all of these people would have died within weeks/months not years. I have read that it is possible that there may be a 1% failure rate after 5 years no one is really sure, but that is the current best guesstimate* – if so for the majority of say, heart tx, to fail it will take 31 (!!) years (22% the first 3 years, 28% over the next 28 years). Of course many of these people are either elderly or late 40/50’s/60’s (& Life expectancy is still early 70’s) so we can expect the death rate to be higher – but not this will not be due to transplant.
In short, I feel you painted a too grim picture of TX recipients. For most people it will be a long term life saving operation. Transweb.org has transplant games every year for this vast majority you should check them out.
*A lot of the uncertainty and guessing is because the new classes of inmmunosurpessant drugs only came into existence in the mid/late 80’s and completely changed the rules. They made TX much more survivable – the long term survivor recipients are from the old drugs – things are only going to get better long term. Any TX physician will tell you they are still trying to find the best levels and uses of these drugs. Thru trail and error is this being refined as we speak.
I believe she and her family are illegal aliens, and they entered the US specifically so she could get a transplant. I’m ok with that, as I would’ve done the same thing. But what about the megabucks this is going to cost, who’s going to pay for this and what about all the US citizens who can’t get transplants and in many cases can’t even afford healthcare? I don’t know what the answer is, but something doesn’t seem right here. Do I have my facts correct? I hope not.
Ring
Some background on Jessica and who is paying for it. Yours is the first mention I have seen of her being an illegal alien, I do not believe that to be the case.
Thanks, I’m very glad I was wrong. This is the kind moral dilemma I can easily do without. The stupid local rag said that the family was from Guadalajara, Mexico and had illegally entered the US specifically to get the transplant.
A little warning about a practice that could cost you your life. From the Oct 2002 issue of Playboy (Yes, I read the articles sometimes.) “By some definitions, the leading cause of death among organ donors is the organ-donation procedure itself.”
There are cases where the donor would have survived if it weren’t for the harvesting of the organs. There is a case in one hospital whereby victims of traumatic head wounds were given drugs which thin the blood. Which does two things, it makes the head wounds more serious and it “masks signs of life by muting the carotid pulse.” The protocol also told doctors to search for the heartbeat by hand rather than hooking them up to a monitor.
Reading this article you can quickly come to the conclusion that some doctors don’t care if someone is dead before they take their organs. And this is such a shame because organ donation is such a great thing you can do for someone. It’s as great a gift as childbirth. Perhaps even moreso because it is at the expense of your own life.
I’d also like to point out that the bodies of most “organ donors” aren’t used to save someone’s life. They are used for research or for teaching medical students. Still, it’s a worthy cause, especially if you have a blood type that is valuable.
I’m curious about this too.
To Prisoner,
I suggest you start looking only at the pictures (for learning anatomy of course) rather than take an article in Playboy for medical information. Palpating a heartbeat rather than doing an EKG is inane. The only donors suitable are those that have undergone brain death but have fully functioning circulatory systems. If there is one thing they want to be sure of is that the heartbeat is excellent.
Anti-coagulants would never be given to a head trauma patient that was not already brain dead except immediately prior to harvesting. I am unfamiliar with their use pre organ harvesting at all, but I guess that is possible. However, if someone were brain dead, given an anti-coagulant, and suffered a severe intracranial bleed, that would be a reasonable way to get the heart to stop, once again rendering donation untenable.
It is true that the rare organ donor is used for research purposes. In order for the body to be used as a cadaver in anatomy class in school it would have to either be unclaimed or given by the family for that purpose. To suggest there is any other way for saying yes on your drivers license will allow you to end up being dissected is absurd.
Corbomite: No, organs are only tried once. It is way too traumatic for them to be transplanted. The chance of retransplanting them has a minimal chance of success and is not tried.
IMHO Duke screwed up big time in re-transplanting that girl. She was already known to be severely brain damaged due to extended time on a heart lung machine and it was a total waste of some good organs in order for the hospital there to seem more caring and to help ameliorate their initial massive error.
However, it pains me to see the mother on TV saying she wants to see the doctors in jail. Somewhere along the line a horrible mistake was made, but it was totally inadvertant and without any criminal intent. No punishment for whoever made the error is either warrented or valuable. I don’t know much about how transplantation works in the OR but I imagine the surgeons themselves are a tad busy and rely on some designated person to be sure the correct organs have been delivered.
No jail time, no, but I feel Duke U. should pay out the ASS for this one.
I hate the concept of lawsuits, and the fact that our society has become so litigous is just irritating. However, maybe if Duke gets hit in the only place it hurts, they’ll fix the hole that allowed this travesty to happen.
I’d like to add to dauerbach’s excellent answer to prisoner the most important reason the scenerio that Playboy lays out almost certainly (I’d say in +95% of the cases) cannot possibly happen in the U.S.:
The “doctor’s” providing critical care have nothing to do with Organ donation. The organ procurement organization (OPO) is not notified until all lifesaving efforts have failed and death has been determined. The OPO does not notify the transplant team until your family has consented to donation.
Remeber most hospitals will over irde your donation card descion if your family balks – so make sure your nexty of kin are aware of your choice.
Also, the critical care Doctor cannot designate where the organs go, so there is no reason for him to give up on you - his patient - for a stranger when can easily be sued…
Italics from this U.S. government site. prisonor’s (helpfully) put forward a common and dangerous myth that almost certainly has cost lives. there are other such misunderstandings asked and answered on this site as well.
amarone, Malkin is about as slanted as an Olympic Ski Jump on this issue. Her book, Invasion has the following authors’ books “Closely related” by Amazon:
Ann Coulter
Bill Gertz
Sean Hannity
Michael Savage
Pat Buchanan
G. Gordon Liddy
Hardly an unbiased group, who would DREAM of printing something not quite so backed up in fact. FAR right wingers.
Although I do not like any of those people myself, I don’t see why someone with strong right wing views would be any more likely to make something up than someone with strong left or libertarian or a host of other views. Are we perhaps seeing some of your own bias here?
Here’s another site reporting that she was smuggled into the country: BBC news. The BBC can hardly be described as right wing.
I find it appalling that there is even a shred of a chance that this surgeon might somehow be permitted to keep his License.
Sorry. This is SO basic, that it is way beyond irresponsible, and way into the realm of criminally negligent. When she dies, and she likely will in the next few days, he should be charged with criminally negligent homicide.
I doubt he will be. Surgeons are God. Pity, that… I know how to read. You know how to read. Doesn’t this putz know how to read the label BEFORE he gores into a human being and starts cutting and pasting?
:mad:
Cartooniverse
CNN is now reporting that she has died. 
Well I got my question answered just not in the way that I wanted. I thought that maybe there would have been a chance of survival if they got the bad organs out and new ones in. But apparently the damage was already done and that was not possible. RIP Jesica.
Well this is certainly only my opinion, but my mother spent a great deal of time at Duke the last two years of her life. Duke is a totally outstanding hospital with some of the best doctors in the world. This is a horrible incident. But to destroy this hospital over this and take away the medical care that many people need, and to further increase medical costs because of that would be a terrible blow to a lot of very sick people. I would not lay the blame for this on one doctor. He is taking the blame openly because he was head of the surgical team. There were a lot more people involved in this. Ever heard the saying that the louder the protest the more guilt involved?
Would I let this surgeon operate on me if I needed a transplant to save my life? You betcha I would.
Cartooniverse,
I don’t see how you can say that the doctor is responsible, either criminally or otherwise. Do you even know if it was his responsibility to check on the blood type? Sure, he was “captain of the ship” and ultimately responsible for anything that happens during the surgery. That is a fine legal point. The real question is was he culpable. This is not like taking out the wrong kidney. Surely the surgeon needs to know which is diseased and to discern right from left. This is a case where an awful lot is happening very quickly. Certain responsibilities are by neccessity delegated, and my best guess is making sure the right organs were sent and about to be inserted is one of those that are delegated. As I said before, the surgeon had plenty of other things on his mind.