UCHealth, a Colorado-based nonprofit health care system, recently denied a patient a kidney transplant because she had not been vaccinated against the coronavirus. This woman is temporarily removed from the transplant waiting list and has 30 days to start her vaccination; Otherwise, it will be permanently removed from the list. The event infuriated Colorado State representative Tim Geithner, who called the work “disgusting” and “discriminatory”.
« Physicians should consider the short- and long-term health risks of patients when deciding whether or not to recommend them for transplantation. “Can we read this morning on Twitter account UCHealthWhich justified her decision after the wave of indignation caused by this story. The organization also noted that patients, like living donors, should already be vaccinated against hepatitis B and against measles, mumps and rubella, among others; Vaccination against COVID-19 It was added to the list several weeks ago, due to the risks the coronavirus poses to people who have had transplants.
UCHealth reports that several studies show that between 20 and 30% of non-immunized transplant recipients who have contracted COVID-19 have died. according to Washington PostThe patient concerned, Leilani Lutali, who suffers from end-stage kidney disease, was reported to have told 9 news She is now “forced to make the decision to make her uncomfortable” in order to continue living.
New Crisis Standards of Care
On Tuesday, UCHealth confirmed that nearly all recipients and organ donors should be vaccinated against the coronavirus in addition to other vaccines already required. Other transplant centers in the United States have implemented similar policies or are in the process of adopting them, according to Dan Weaver, a spokesperson for the care organization. ” The University of Washington Medicine has long required that patients awaiting a solid organ transplant be up to date with all important vaccinations before the procedure. We stress the University of Washington medical centers that also mandate the COVID-19 vaccination.
To date, 65.5% of the US population has received at least one dose of the vaccine (56.5% have been fully vaccinated). It turns out that the large number of unvaccinated people has prompted hospitals in several states to adopt new Specific “standards of care” In other words, when resources are limited (dialysis machines, resuscitation beds, etc.), they allow themselves to prioritize patients with the greatest likelihood of survival – a condition not to mention the lack of ventilators at the start of the pandemic, which led to In some countries to choose which patients should be saved. ” The goal of the Standards for Crisis Care is to provide care to as many patients as possible and save as many lives as possible ‘, summarizes the Idaho Department of Health and Welfare In a press release.
It is the question of prioritizing vaccinated people because of scarce health resources – on which individuals’ survival depends – that is clearly controversial. However, we must admit that in the case of transplants, this has always been the case: the number of available organs does not allow to meet all needs, doctors are forced to give priority to those who have more than one opportunity. Survival after transplant. Went, Studies have shown The mortality rate for hospital transplant recipients due to COVID-19 has exceeded 20% – far more than the 1.6% mortality rate typically seen in the United States.
In the United States, as elsewhere, organ shortages are a long-standing problem. across the Atlantic, More than 106000 people They are in the transplant queue, to which a person is added every nine minutes. It is estimated that 17 people die every day while waiting for an organ.
Device offers are often rejected
According to government statistics, less than a quarter of American patients awaiting a kidney transplant receive a transplant. But you should know that in the United States, the organ rejection rate available is beyond comprehension: Study published in August 2019 employment open gamma network It reveals that a large number of kidney offers from deceased donors were received by the applicants but were rejected on their behalf. ” Most of the kidneys (84%) were rejected on behalf of at least one candidate before being accepted for transplant ‘,” the study authors say.
During the study period, ten patients on the waiting list died each day despite receiving a kidney. These rejections are based on quality standards, which are often considered too weak. However, many patients accept a lower quality kidney simply so that they do not have to undergo further dialysis, Dr. Sumit Mohan points out to AFP.
For a patient who is temporarily removed from the list of people waiting for a transplant, the problem does not appear (at least, not yet). She said she was concerned about the health consequences of vaccination; Moreover, she and her benefactor said 9 news They opposed the vaccine on religious grounds – citing the use of embryonic cell strains in vaccine development and testing. With no hospital in Colorado willing to perform the transplant, both are looking at other options out of state.
L ‘United Network for Member SharingThe body that coordinates organ donation at the national level has indicated that it does not impose conditions on the registration or withdrawal of a person as a candidate for transplant, so that transplant centers such as UCHealth can ” Make such decisions on the basis of [leur] individual medical judgment ‘ said the official spokesperson. in France, Press release from the Biomedical Agency dated March 2021 clearly states that “ Failure to vaccinate potential recipients against COVID-19 does not constitute a barrier to their access to organ and tissue transplants “However, donors and recipients should have a tPCR test prior to the operation, which will be postponed in case of a positive result.
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