Quote:
Originally Posted by jot9011
You obviously have NO idea what you are talking about
EVERY patient waiting for an organ transplant in the United States is registered in the UNOS (United Network of Organ Sharing) computerized data network. This is a national network that matches organs with recipients based on genetic suitability and severity of illness. No ONE hospital gets preference over another, regardless if they have 20 livers sitting in the O.R. and only one liver transplant candidate. All candidates have equal access to donated organs, theoretically.
However if you are in the position of making a sizeable donation to the UNOS system (cough...Mickey Mantle...cough...cough Steve Jobs)....well lets just say, money talks. No one will admit to that, but it still is a fact of life that the privileged are....well......privileged
and BTW Steve Jobs DID have pancreatic cancer, not the most aggressive kind, but any kind of pancreatic cancer is bad b/c there is usually an abscence of symptoms until late in the course of the disease. Most likely this IS metastatic liver cancer. And THAT IS a relative contraindication to liver transplant. Especially withe the shortage of organs. There have been around 100 transplants for this type of pancreatic tumor. (neuroendocrine islet cell tumor) , usually done for symptomatic relief. The long-term survival is not great however.
So please stop berating people, when you don't have the correct information.
|
Facts, and the truth, will set you free. Luckily, anybody with just a little bit of common sense and knowledge can tell who's right. So, if you will, let's go one by one.
1.- True that anybody awaiting an organ for transplantation in this country is listed in UNOS. But matching organs according to "genetic suitability"??!! (
Ouch!!). That's a nice one! It is not true, however, that all the organs get allocated according to the severity of illness, although for livers, in the current (MELD) system, the severity of illness does play an important role.
2.- A hospital can get preference, if it is the only one within an OPO (organ procurement organization) coverage area in which the allocation is first by OPO, then by State, then by UNOS Region, and then finally National. As an example, if you live to the west of the Hudson river, in NJ, you can get a liver with a much, much lower MELD (thus healthier) than if you live just across the bridge, in NY. Granted that you can get listed in both places, but many insurance companies will not pay for your care if you chose to go out-of-state, or out-of-region, making it really impossible for you to get to those organs (unless you pay out of pocket).
3.- When Mickey Mantle got his liver transplant, the organ allocation system was completely different to the one we have today, and was geared basically by waiting time, not severity of disease. And even though a lot of progress has been made since, his case helped to create a largely negative cloud of perception regarding the fairness of access to liver transplantation, that perdures to this date (e.g.: just judging from what has been written in this forum so far). And, by the way, I don't consider poor Mickey Mantle a privileged.
4.- This is NOT metastatic liver cancer, but metastatic neuroendocrine tumor (mNET) to the liver;
Big difference!. This is not the same as the commonly known pancreatic cancer, which refers to any variant of pancreatic adenocarcinoma. This last one is, indeed, an
ABSOLUTE (not "relative")
contraindication for liver transplantation. To this date, mNET is, in fact, an approved medical indication to treat well selected (and that is
medically selected, not economically selected) cases.
5.- Only 100 cases done??!! Now that's free talking! Just a French series published a year ago in the American Journal of Transplantation quoted 85 cases of liver transplantation for mNET. If you add that to the previously reported series, you add over 350 cases (an those are just the published ones). And the results are, contrary to what you say,
BETTER than for other indications. Again, not free talking, but facts: the current 1-year patient survival in the USA for liver transplantation (all comers) is 88 %, which compares poorly with the last series published from Milan in July of 2007, in which out of 24 patients transplanted for mNET, the 5-year survival was 90%. Now, how is that not great result?
6.- Finally, THESE ARE LIVER TRANSPLANTS, not aspirins!!! You don't transplant a liver for "symptomatic relief" (or maybe you do, which explains all that non-sense in your message.)
So please, read through, and read again, and when you think you know the right answers, come back and even you can take the test again.
06-21-2009, 09:24 PM
Google: steve+jobs+liver+transplant
Linear Mode
