Why is there a shortage of minority organs for transplants? What in the match up demands that it be a matching minority? Is the difference between a minority kidney and a non minority or different minority kidney that great?
anonymouse
I don’t think the issue is one of “racial” minorities but of “blood type” minorities. If you share a blood type with only .005% of the general population you are going to be a minority with little chance of getting matched up with a donor organ, no matter what color you are.
I’m not sure your premise is correct. Is there a shortage of “minority” organs?
The only factors I know affecting the usefulness of tranplanted organs are things like blood types and other cellular or molecular level differences. And we’re all pretty much the same on that level.
The very first heart tranplant was from a “mulatto” to a white man – and this was in apartheid South Africa!!
“non sunt multiplicanda entia praeter necessitatem”
- Seems to be a cultural difference,based somewhat on urban legend,racial mistrust,(they screwed me when I was living they’re not going to do it when I’m dead.),religious beliefs(usually misunderstood as the churches keep trying to point out)
- Usually nothing.
- There are some differences based on genetics, "Race’ A has a propensity to have antibody X, the other ‘races’ have a propensity to carry X. Most ‘races’ have antibody Z, ‘race’ A generaly have Z. (why didn’t i use ‘generaly’ in the first place?)
You should know that, D, chapter 17 wasn’t it?
“Something inciteful that some one else once said”- Suhm Wonn (1397-1334)
There’s a lot of mea culpa ( or youa culpa) breast beating going on in San Antonio right now about not enough minorities are signing on to donate organs and therefor minorities with failing organs are dieing at a faster rate that non minorities. Unless they can play basketball and are on really good terms with their brother.
Mamamaroon
“3 great minds acting as one ,there goes the Union.”-M.Howard
Pluto, it is ‘documented’ that in the U.S.,at least, ‘minorities’ in generall tend to donate at a lower rate than the ‘master race.’ Various ‘civic’ groups,political grps, and churches have rallys to inform and solicit the 'minority’group they ‘represent.’
and “you can ‘quote’ me on that.”
“Something inciteful that some one else once said”- Suhm Wonn (1397-1334)
No, it’s a real thing. The blood bank where I donate is in need of African-ancestored bone marrow. I’ll look into it.
Saw this bumper sticker today:
Don’t take your organs to Heaven. Heaven knows we need them here
It’s definitely true that there is a shortage of minority donors of organs, and just as significantly, bone marrow.
Every so often, a black celebrity or a member of his/her family will contract cancer, and need a bone marrow transplant. Now, while it’s not ABSOLUTELY necessary that the marrow a patient receives come from someone of the same race, the closest matches USUALLY do come from someone of the same ethnic background. Meaning that a black cancer patient’s best chance of finding a bone marrow match would come in the black community. The same holds true of other organs.
In recent years, I’ve seen baseball star Rod Carew and football star Charles Haley making numerous media appearances, encouraging black Americans to register as organ and bone marrow donors (both had children suffering from cancer… Carew’s daughter died of it). Both have admitted to journalists that it’s tough to get ANYONE to donate, but FAR tougher in the black community.
Why? Some would call it urban legends, but the bottom line is: huge numbers of black people just don’t trust white institutions, whether it’s the police, hospitals, or schools, or anything else. In fairness, this isn’t JUST paranoia: when you’ve heard stories like the Tuskegee syphillis experiment (in which white doctors used black men as guinea pigs, letting them suffer and die from syphillis, rather than treating them), it becomes easy to believe that hospitals are filled with evil, sinister white doctors, who’d gladly kill black people to harvest their organs.
In any case, black people are VERY wary of white doctors, and don’t trust them with their vital organs.
no no no
I dont wanna know about the politics involved. I want details on these so called
antibodies X or Z or whatever. Details. Ensy weensy tiny details that even a maroon like me can understand.
please?
Mea culpa
Youa culpa
Tu culpa
Mia Sorvino
I haven’t found anything on transpants, specifically, yet. However, at the Sickle Cell Society home page, I found an article on blood groupings that might have some bearing on the issue of transplants:
http://www.sicklecellsociety.org/resnrep.htm#anchor78688
If the link doesn’t work, go to the home page www.sicklecellsociety.org and click on Latest Reports and Research, then select Why is Blood from Afro-Caribbean Donors Special?.
An article in the Seattle Times mentions in passing that Kidney transplants (unlike heart transplants) require the matching of several proteins and antigens that occur with greater frequency among people of the same ethnic backround, although it provides no details: http://www.seattletimes.com/news/health-science/html98/asia_021199.html . I could hypothesize that bone marrow transplants would be similar to kidneys, involving blood the way they do, but that would be pure speculation.
(Hey, Judy! You have to come around more often!)
Tom~
Hi Judy!
Our immune system is supposed to check out every protein in our bodies. Those that it recognizes as self, it ignores. Those that it doesn’t recognize as self (from invading bacteria, viruses, altered proteins on cancerous cells, and from transplanted organs), it considers non-self. These non-self proteins act as antigens, triggering a response from the immune system that gets rid of the “germs”, causes apoptosis, or cell death in small cancers, and rejection of transplanted tissues.
All of the cells in your body have proteins randomly stuck into their cell membranes. Some of these proteins are HLA (human lymphocyte antigen) proteins. These are the key proteins used by the immune system to learn “self”. It is these HLA proteins that must match (to varying degrees, depending on tissue type) in order for the recipient not to reject the organ outright.
It turns out that the importance of HLA-matching varies depending on which tissue is being transplanted. For corneas, it doesn’t matter. For heart & livers it matters somewhat. For kidneys, it matters more. (It could also be that transplant teams prefer to hold out longer for a better kidney match, since dialysis is an option not available for heart or liver transplants) For bone marrow, it matters most of all. This is because, when you transplant a bone marrow you are in effect, transplanting an immune system. In fact, from the narrow perspective of the immune system, it considers that you have transplanted a body onto it.
I won’t rehash the information in Tom’s posts, except to summarize that the chance of finding an HLA match is highest in relatives (~100% in identical twins, ~25% in siblings) or in groups of people who tend not to marry outside their group, so that the whole group share a relatively small number of HLA types, or in people from the same ethnic background. Here in the US, we also have the additional “problem” of mixing HLA types. Let’s say John has a mother of Irish descent, and a father of Italian descent. John gets one copy of chromosome 6, where HLA types are carried, from his mom (6m) & one from his dad(6d). The HLA type on 6m is likely to be common in the Irish-American community, while the HLA type on 6d is likely to be common in the Italian-American community. But the combination of 6m + 6d is likely to be relatively uncommon in both communities. In the Irish-Italian-American group, you have more HLA types distributed among a much smaller number of people, so you have a lower chance of any one combination coming up twice.
Even so, if the proportion of people from different ethnic groups who needed trasplants were equal, and the proportion of people donating their organs were equal, all Americans would have an equal shot at getting a transplant. African-Americans, however, are much more likely to develop kidney failure as a consequence of high blood pressure, or diabetes, than other groups. Because of cultural differences, and some distrust of the mostly white medical profession (there are still too many people who believe that checking yes to organ donation on your driver’s license means that no one really tries to save you), African-Americans are less likely to agree to organ donation.
Fortunately, we don’t have to wait for a perfect match. There are medications out there that suppress the immune system enough to allow partially matched organs not to be rejected in most cases. Unfortunately, they also make recipients more susceptible to infections.
Sue from El Paso
members.aol.com/majormd/index.html
But,Darrin,you asked WHY a shortage ofminority organs. the reasons ARE political,socialogical,and religious in nature. so,Tu culpO.(don’t you make me have to email you again.I’ll repeat publicly that I liked yuoa culpa,Ey! Paisan! Youa culpa!")
Astorian, i aint blamin any body for being suspicious,just look at what the white man has done to the white man, somebody a little different is really gonna get it. Ok, Durwood, I don’t know exactly which anti-bodies or such are more prevalent or peculuar in which genetic heritage group .(that makes more sense here than minority) Looks like majormd is on that like a leech on a hog right now.Hey! maj how you knew that? about my heritage? cept my daddy is of german and french extraction,italian about the only European thing i don’t got.
Mia culpa
Mia Farrow
Sophia Lorenzo (whoo hoo)
“Pardon me while I have a strange interlude.”-Marx
spaghetti carbonara
Kevin Bacon
your humble TubaDiva
This thread seems to imply a disturbing procedural lack among tissue banks.
Let us suppose (as the information available certainly shows is the case), that my ethnic group has only a 1% occurence of antigen X (and is therefore likely, in the case of a transplant, to develop antibodies against antigen X, leading to rejection, etc.), which is a much lower occurence than in the general population. Whilst this does not guarantee that some organ from the p-a-l will be unusable by me, the probability is that I am likely to get a better match from within my ethnic group.
However, if, turning matters around, I donate some organ, will tissue bank personnel just toss it in the freezer without running antigen spectrum tests on it?
It might be contended that tissue bank (other than blood bank) technology is so primitive than organs must be kept “on the hoof”, and that matching can only be done at the time of excision. Is this, in fact, the case?
“Kings die, and leave their crowns to their sons. Shmuel HaKatan took all the treasures in the world, and went away.”
Organ banks work as follows:
Patients 1-25 need kidneys. They get HLA-typed & entered into a database listing the exact match type, good match types, and marginal match types.
They start dialysis while waiting for a kidney & wait for the call.
Person A takes a bullet to the head. His heart & lungs & kidney are fine, but his EEG is flatline & 2 neurologists/neurosurgeons certify brain death. His main doctor talks to family about several issues - withdrawing life support and organ donation.
(UNPAID ADVERTISEMENT: No organs are accepted without next-of-kin approval. If you intend that your organs be donated, tell people! It helps make a difficult decision with confidence at a time when time matters. Back to our regular programming)
Immediately blood is drawn & lymphocytes are tested for HLA type. That is in called to the nearest transplant coordinator while organs are being collected. The information is entered into the computer & any perfect matches in patients 1-25 come up. Then any good matches, then any marginal matches. If more than 2 in any group come up, for kidneys, it goes by date entered into the system (I think); for other organs, it goes by medical urgency. A recent change is that matching the organs to recipients in that area is given less importance; matching to the people in most need, even if further away, is given more importance.
Kidneys are also different in that healthy people can live with just one, so that siblings are a potential source of an exact match (25% chance) or marginal-good match (probably another 5-10% chance) and they can choose to donate a kidney to you.
The whole organ transplant system is political. THere are many ethical dilemmas, particularly in the arena of liver transplants since alcohol-related cirrhosis is the single biggest cause of liver failure. Many cried out that “innocent” people died who could have benefitted from one of the livers allocated to Mickey Mantle. But if thousands of baseball fans thought about organ donation as a result of the publicity, & decided to become organ donors, and just 3 of them have since died & donated organs, more lives were saved. Tough decisions in many cases…
Sue from El Paso
members.aol.com/majormd/index.html
What are you trying to imply, Akat? my brain transplant went like clock work.But as to your"turning matters around" if the… wait a minute. Are you saying that donating means giving ?
major, make that ‘geo-political’ did they get that worked out yet? Some states were passing laws that ‘their’ organs couldn’t go to out of staters.Well, for Kansas and Alabama, I agree. And Arkansaw probably uses all they got in state, with the incredibly close almost exact genetic matches there.
“Pardon me while I have a strange interlude.”-Marx