Imagine you are sick, really sick. You need a liver transplant. Here are your choices:
- Hang on as long as you can hoping a healthy liver shows up before it’s too late; or,
- If you just can’t wait, you might be able to get one from Keith Richards (slightly used, if you know what I mean).
Well, apparently if you live in the United Kingdom, this is exactly the kind of thing you might hear as you sit by the door waiting for an organ transplant. Because of a nationwide shortage of “healthy” transplantable organs, the UK has begun using what they themselves have termed “marginal organs.” Public relations alert: hasn’t anyone told these people that they need a better moniker? Marginal organs? That’s like calling sushi “raw dead fish.” Come on people: marketing!
But I digress….
According to the BBC News:
…marginal organs are deemed to be of higher risk, but still considered safe, and their use is controlled by national guidelines set out by the NHS Blood and Transplant Service. Ten years ago, 13% of all transplants used marginal organs; now that figure has increased to more than 25%. Now, the University Hospital of South Manchester (UHSM) has admitted that Wythenshawe Hospital has extended its criteria to ‘increase the number of viable lungs available for donation.
This excerpt was from an article about whether it was prudent to let patient know when they were being offered a so-called marginal organ instead of a healthier one. The issue is, apparently, that a large number of patients die waiting for suitable organs, but if they just open up the definition of “suitable,” more people could receive transplants. Unfortunately, the only way to expand the definition of “suitable” is to include organs from people who may be alcoholics, diabetics, very old, or who have engaged in some sort of lifestyle activity that might make their organs, well, marginal. The National Health Service is concerned that if they start telling patients that doctors believe a particular liver is good, even if it did come from Charlie Sheen, patients might decline transplants “for the wrong reasons” and end up dead anyway.
Well this is an interesting ethical dilemma and a product quality issue that doesn’t show up in Consumer Reports. Every transplant organ is certified pre-owned, if you know what I mean; there is nowhere to go buy one fresh off the shelf. When you’re talking Levis or BMWs, “factory seconds” are not a problem. Might just mean that one of the buttons is tarnished or that it has a few extra miles on the odometer. When you’re talking transplantable organs, “marginal” is not exactly the description you’re looking to hear. “Well, Ms Suennen, we don’t have any of the premium hearts, but we do have some factory seconds with a couple of minor flaws. Don’t worry, they have most of their valves. Half price and with two you get a free checking account!”
Reading this article made me flash back to that scene in Young Frankenstein when Igor (Marty Feldman) goes to secure a brain for the Creature and, instead of getting one from a super scientist as planned, he grabs one labeled “Do Not Use: Abnormal” (he thinks it’s from a patient named Abby Normal). Chaos ensues. No doubt Mel Brooks would love this organ transplant story.
But in real life, they have had a few instances when the transplanted marginal organs had some pretty serious flaws, like lungs from a smoker that gave the new recipient a fatal lung cancer soon after a transplant.
Professor James Neuberger, the associate medical director at NHS Blood and Transplant Service, said in that same BBC article that while recipients need to fully understand the implications of transplantation before they consent, he said there were often difficult decisions for both doctor and patient. “Often it is just not possible to give all the information to the recipient because all the information won’t necessarily always be available until the time that the surgeons have had the opportunity to look at the organ. You have to balance the risk of the transplant…. against the risk of not getting a transplant which, for most people is, unfortunately, death.”
So that’s a tough call. Premature death or a second rate organ, which might lead to your premature death if you roll a 7 on the craps table of life. This looks like the world’s best argument for taking care of yourself so you can minimize the need for someone else’s organs. One can only hope that our next generation of organ donors takes heed.