I thought all donors had to be living with a beating heart, are deceased non-heartbeat donors viable for some subset of organ transplants? How does this work exactly?
They collect the organs from people who have just died, such as in car crashes. In the paperwork for getting a California driver license, you check a box saying whether you are willing to be an organ donor. If you check yes and you are later killed in a crash, they immediately bring your remains to a hospital that is always awaiting such deliveries, and a transplant operation gets going right away.
Motorcycles are sometimes called "donorcycles" because of the high likelihood that any given crash will be fatal, and that the rider is young and healthy and thus a highly desirable source of transplant material.
It's important to understand that there are some very strong selection biases here in the U.S.
While fatalities per passenger-mile may be 24x cars (as below), you have to realize that the population riding motorcycles in the U.S. is not a random sampling. These people aren't trying to get around, they're acting out an image. For that behavior I don't blame them, but it is what it is.
Anecdotally, a little less than half of U.S. motorcyclists are fat, bald, drunk dudes riding Harleys or Harley look-alikes with the legal minimum protective gear (which in some states is none at all), while another little less than half are young, shirtless dudes on sportbikes. To their credit, they are wearing full-face helmets (because you can't go 200mph without one). Also, something like half of motorcycle fatalities involve alcohol[0]. Yikes.
<10% of motorcyclists are riding reasonable, well-maintained bikes with a modicum of skill and all of the proper protective gear.
So while motorcycling qua motorcycling may be more dangerous than driving a car per vehicle-mile, the difference is probably a lot smaller when controlling for differences in the behavior of people doing it. To put it in perspective, in the U.S., if motorcycling is ~30x deaths per vehicle mile compared to cars, bicycling is ~20x (though you do get exercise, which extends your life). And miles per motorcycle (or bicycle) are << miles per car per year in the U.S. People don't realize, but moving to the suburbs and driving everywhere vs. living in the city is taking the same sort of risk one might by motorcycling. </rant>
A friend studying prosthetics told me half the recipients are motorcyclists.
Riding a motorbike is amazing fun, but if you ride long enough, something terrible will happen. Every rider has a story of an accident. Although you are more manoeuvrable than a car, can get out ahead of traffic, are smaller, can see more, and are more keenly alert... a little tap you'd hardly notice in a car can kill you.
A doctor friend of mine would joke about it being good organ transplant weather when it was raining, because they’d get dead motorcyclists turning up in the rain so frequently.
It's rather astonishing that all the safety regulations for cars manage to exist in the same legal system that allows motorcycles on public roads at all. Last I read the death risk ratio was about 24x.
More likely it's just because cycles existed before the safety regulations and there would be too much backlash to banning them. Plenty of other things that only harm yourself, like drugs or unpasteurized milk are also illegal.
I’m still amazed by this one. My first thought on riding a 250 was “how is this possibly legal?” And then the jump to a big bore (non-cruiser) is completely insane.
Fun social engineering fact: countries that make organ donation (on death) opt-out instead of opt-in have much shorter waiting lists for organs. The USA could save thousands of lives by switching to opt-out.
Funnier social engineering fact: If it's legal for people sell their kidneys, wait lists for kidneys goes to zero[1]. Too bad only one country in the world does that.
Another fun fact. The US government spends more on dialysis than the budget for NASA.
From news sources I found, it looks like the system in Iran works exactly as one would expect: the poor and desperate end up with one less kidney while not significantly benefitting from the trade.
Which is precisely the reason such sales are outlawed worldwide.
Poor people need kidneys far more often than rich people.
Diabetes and uncontrolled high blood pressure are the top cause of kidney failure. These two conditions are far more common in the poor, and far more likely to be poorly managed.
Also if the price of a kidney relative to median income in the U.S. was similar to Iran, then a kidney would cost $15,000. This is expensive but still far cheaper than dialysis. And there is no reason an ACA plan or Medicaid wouldn't pay for it.
If the ACA or Medicaid will pay for kidneys for those who can't afford, what stops the price of kidneys from becoming equivalent to the price of dialysis should the kidney not be bought?
According to CNN, "it is unlikely that someone like Steve Jobs can 'cut the line' of the transplant waiting list. The reason that some people might be able to get transplants more quickly is that they're standing in more lines. Nothing prevents someone from being evaluated and listed at multiple transplant centers. As long as a patient has the wherewithal to fly around the country -- and be available at the drop of a hat if a liver becomes available (this is where the private jet comes in handy) -- a patient can, in theory, be evaluated by all the transplant centers in the country."
If you legalize selling organs, less rich people will be able to afford them. I don't like the idea of merchandizing humans. It is worse than prostitution. Maybe worse than slavery, as humans become disposable.
It is problematic yes, however so is most of medical care, poor don't get access to it as much as the rich do , whether it is countries or people.
Sadly, economics dictate a lot of people's health is going to be like. Living/Work conditions lifestyle, diet are all influenced by wealth.
Poor people work most of the dirty and unhealthy jobs that significantly cut short life spans. Wealth and lifespans are known to be strongly correlated.
As countries we are perfectly comfortable reserving vaccines blocking poor countries with patents, polluting a lot more or exploiting their labor in terrible conditions we wouldn't tolerate. Compared to what we are willing to accept already this doesn't seem worse.
If a commercial system could save more lives(probably more likely rich) it is not that much worse for poor than it already is.
Yep. I have type 1 diabetes for 27 years, and so far, no complications.
I recently contracted a shiga toxin producing E. coli strain which was cultured from my bowels. I also cultured entericocci (ETEC) but that’s not relevant to the discussion. I am lucky Shiga toxin E. coli (remember this famous Jack In The Box Breakout, FTW https://en.m.wikipedia.org/wiki/1993_Jack_in_the_Box_E._coli... ) did not affect my kidneys.
I am a dual US|European Union (Croatian) national. Croatia has one of the highest (ethical) transplant rates in the world. Let it be known that I would get it in Croatia over the USA.
I learned today that one can be a living heart donor. There is a special type of donation where a person who needs lungs gets a lungs+heart donation from a deceased donor, while the living person's healthy heart is transplanted to another person whose heart needs to be replaced. It seems this has advantages both for the lung recipient and the heart-only recipient and allows for compatibility in cases where the lungs and heart of the deceased person will not work separately for the two recipients.
Sure, but "dead" is a Humpty Dumpty word. Some organs need the donor to be legally but not colloquially dead. In other words, you are dead and your heart is still beating.
can you share a link, I'd like to learn more about this "organ shelf life". Very fascinating. Maybe I was mistakenly applying the sudden death of the brain without blood perfusion to hold likewise for every other organ. Like a heart attack when blood ceases to flow into it turns the myocardium to scar tissue. But that must not be an instant process, probably takes some time. I know temperature can keep tissues viable longer too, so that's another variable to consider.
For the brain it's pretty damn quick (minutes before significant damage). heart transplants rely on being able to run an artificial heart and lung machine to oxygenate and pump the blood while the heart is stopped, removed, and replaced.
Where I am being on an organ donor list also makes you eligible to be used as a cadaver. I’m not comfortable being prodded by med students but would give an organ.
Considering that some people have been revived without side effects after multiple hours of being brain-dead (e.g. famous example of women who drowned in icy water), how 'dead' is 'dead', in the context of being an organ donor?
I've heard it said that "you're not dead until you're warm and dead", but 6-12 hours doesn't seem like a lot of time, to make sure you're not coming back.
e.g., I drown in an icy pond, and I'm found after 5 hours. I might be revived, I might not...but the heart only has an hour before it's toast.
Clinical Death != brain dead, Clinical death has a very well defined and nearly irreversible process [1].
The longest human is known to be revived is only in the range 10-15 minutes. Brain damage is quite likely at this point. The longest for an animal is for cat - 1 Hour.
Only clinically dead people are eligible for organ transplantation
That's what I'm concerned about. Clinical death is apparently survivable.
> Reduced body temperature, or therapeutic hypothermia, during clinical death slows the rate of injury accumulation, and extends the time period during which clinical death can be survived. The decrease in the rate of injury can be approximated by the Q10 rule, which states that the rate of biochemical reactions decreases by a factor of two for every 10 °C reduction in temperature. As a result, humans can sometimes survive periods of clinical death exceeding one hour at temperatures below 20 °C.[20] The prognosis is improved if clinical death is caused by hypothermia rather than occurring prior to it; in 1999, 29-year-old Swedish woman Anna Bågenholm spent 80 minutes trapped in ice and survived with a near full recovery from a 13.7 °C core body temperature. It is said in emergency medicine that "nobody is dead until they are warm and dead."[21] In animal studies, up to three hours of clinical death can be survived at temperatures near 0 °C.[22][23]
I'd rather not be harvested too quickly, when I could have been revived without issue.
No doctor/hospital is going to harvest organs unless the person is warm and dead and all reasonable means of revival have been already tried.
Also even if revied would you even want to ? While anna as an exception didn't suffer from brain damage , it is likely, and even she had long term issues with nerve function paralysis etc.
Anna and other similar cases are a extreme rarity. policy shouldn't be made basis a one in a million chance, that's why we have vaccines enforced for example.
You can always opt-out or not opt-in depending in on jurisdiction I am sure.
There are plenty of people who opt for cryogenic storage after they die in the hope technology will evolve to revive them. That's natural step to this argument in a way , what if I could be revived some day even if not today ?
Ultimately handling life and death are intensely personal choices.
> No doctor/hospital is going to harvest organs unless the person is warm and dead
Well, that's the thing. "warm and dead" is above and beyond the criteria you referenced earlier, "clinical death". I'd hope you're right, but I'm not convinced you are. It doesn't seem like it from what I've seen.
And, the cooling factor in brain damage prevention is becoming more widely known these days. Anna wasn't just a fluke.
So on the basis of a Wikipedia article and with no further research, you’re now concerned people are harvesting organs when a person could potentially survive?
[0] is the Australian College of Intensive Care guidelines on organ harvesting. There are strict criteria around when a person is considered dead and for organ donation that means brain death.
I’m not sure what you’re worried about, this was easily discoverable - clinical death is not the criteria that is used for the determination of organ donation eligibility
> So on the basis of a Wikipedia article and with no further research, you’re now concerned people are harvesting organs when a person could potentially survive?
No, I'm asking a question and having a discussion, and you decided to jump in with your hostile skepticism that's completely unwarranted. Chill out.
If you re read your comments, there is a tone of ‘they’re up to something and it can’t be good’. It’s as far from ‘I’m interested in this topic and would like to have a discussion to learn more’ as a QAnon follower is from a PhD student.
I’m not the only one who picked up on it as you can see by the other commenter.
> there is a tone of ‘they’re up to something and it can’t be good’
No, there's a tone of 'exactly how dead is dead'. If you look at the other commenter, sometimes doctors jump the gun.
> far from ‘I’m interested in this topic and would like to have a discussion to learn more’ as a QAnon follower is from a PhD student
Congrats, you've managed to drag in completely unrelated politics.
You're assuming the worst of me. You're comparing me to a Qanon follower, apparently. You're giving (unfounded) credit to a commenter who called me a 'covid vaccine denier'. Seems like you're implying that I'm not acting in good faith.
It's like you're looking for people that fit your preconceptions, and shoehorning me into it. That's prejudice, plain and simple. Chill out.
> No, there's a tone of 'exactly how dead is dead'. If you look at the other commenter, sometimes doctors jump the gun.
No, they don't - you made a misunderstanding which perpetuated a line of questioning which isn't a practical concern. Brain Death + other criteria depending on jurisdiction is a pre-requisite for cadaveric organ donation
As to the rest, you have approached this from the perspective of 'prove to me that X doesn't happen' which is perilously close to that of the antivax/antiscience brigades.
I apologise for thinking the worst of you but I wasn't the only one which perhaps reflects on the approach you have taken in your line of questioning in these highly polarised times
I went back and looked up brain death, and yeah, I made a misunderstanding. Fair enough.
> you have approached this from the perspective of 'prove to me that X doesn't happen'
There's absolutely nothing wrong with that. If I'm thinking of buying a power tool, then 'prove to me that <rapid unplanned disassembly> doesn't happen' is an appropriate tone, and exactly the kind of skeptical questioning that should take place: it's my problem if the problem happens.
I don't care what kind of political climate we're in; you don't get to tell me what kinds of questions I'm not supposed to ask.
I'm assuming it's that you can get a kidney transplant from a family member who is lying in the OR next to you. Deceased donors are transported from wherever they died.
