Previously, the term “lemon” has been applied primarily to used cars that the buyer only discovers to be of an unsatisfactory quality after the purchase has occure. Well what if you receive a transplanted organ that turns out to be not exactly what you signed up for?
This is exactly what happened to the four people who received 15-year-old Alex Koehne’s pancreas, liver, and two kidneys. Alex’s parents agreed to donate Alex’s organs when they discovered that his death was imminent. It was originally believed that Alex died of bacterial meningitis, but only upon autopsy did Alex’s parents and doctors discover that his actual cause of death was a rare form of lymphoma. Subsequently, the two people who received Alex’s liver and pancreas died of the same lymphoma, and the two people who received his kidneys are being treated for the disease.
Other recent organ transplant mishaps include a man who received a cancerous lung, and people who have received organs infected with West Nile Virus, hepatitis C, and even HIV.
How can this have happened?
The organization that organizes organ donation in the United States, the United Network for Organ Sharing, requires that all organs be screened for cancer, HIV, and other infections prior to donation. In addition, the Center for Disease Control mandates tests for HIV, hepatitis, syphilis, and other bacterial or viral infections on organs from “high-risk” individuals, as well as having a doctor determine from medical records whether the organ donor might have cancer.
Most organ transplants are safe: out of the 230,000 transplants performed between 1994 and 2006 on 64 recipients developed cancer because of receiving a “lemon” organ, as I have termed it.
However, there is always the possibility of some cancer or infection going undetected. I would urge hospitals to increase the strictness of their organ donor standards, as they are free to do. Such a move would benefit everyone because the minor inconvenience of running a few more tests and doing a more thorough background check is far smaller than the hassle of getting entangled in endless lawsuits over whose fault it is that someone received a “lemon” organ.
Sources:
http://blogs.discovermagazine.com/discoblog/2008/04/08/organ-transplants-gone-horribly-awry/
http://discovermagazine.com/2008/apr/16-how-do-transplant-patients-wind-up-with-deadly-diseased-organs
2 comments:
While in theory we should make tests as stringent as possible to weed out every "lemon organ", we have to consider the practicality of it also. 64 out of 230,000 organs only constitutes 0.028% of all transplanted organs. What if it was only one out of 230,000 organs which was a lemon organ? Should we still make the tests more stringent to weed out that last organ? Ideally we would want to, but we also have to consider the costs of these tests (I don't know what the costs are like, but I imagine running them 230,000 times would be a hefty amount, correct me if I'm wrong). In this case wouldn't the money be better spent on vaccinations or combating diseases in third world countries? At what point can we say that the success rate of transplants is good enough?
I agree with Mike's comment, that perhaps although such stories are terrible and, potentially, preventable, these instances are so rare and uncommon that the money would be better spent on other, more common medical problems. In this case, the ethical theory of utilitarianism should, in my opinion, be employed. The money should be spent in a way which would benefit the greatest number of people, which in this case would be possibly a vaccination or cure for a disease such as HIV/AIDS.
Also, I could be interested to see if a similar situation exists for blood transfusions; that is, if a similar number of people are affected by diseases not caught in tests for blood transfusions.
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