From KXAN, Local NBC affiliate, Austin, TX, By Phil Prazan
With the new Ebola infection of a Dallas nurse, we wanted to know more about what the Centers for Disease Control call the two “high risk procedures” for spreading the disease. Any time a healthcare provider works around bodily fluids of someone with Ebola, the risk for contamination is there.
“Any orifice, your mouth, your nose, your eyes. Wherever blood can come out,” said Catherine Troisi with the University of Texas School of Public Health.
The CDC says the two high risk procedures are respiratory intubation and kidney dialysis. Respiratory intubation is the insertion and extraction of a breathing tube. Kidney Dialysis usually involves connecting the patient to a machine via IVs and tubing to clean the blood.
“I think it is showing us where we are and where we are not prepared for an outbreak,” said Troisi.
She says this outbreak has a 70 percent mortality rate with most cases centered in West Africa. The virus survives a few hours as the bodily fluid dries. But if it stays in liquid form, it can stay active for days.
Most diseases do not require protective gear. Fewer than half of Ebola patients hemorrhage bodily fluid, but wearing the gear is crucial. Troisis describes it as the number one step.
“Because your safety equipment may be contaminated on the outside. It’s when you get out of it that you have to be particularly careful,” said Troisi.
If it’s done right, she says it should take about 15 minutes to put on and take off the protective clothing. With a second healthcare worker infected, it emphasizes every precaution is necessary.
Kidney Transplant Debate
From Slate.com, by Eric Posner
A Moral Market
“Any orifice, your mouth, your nose, your eyes. Wherever blood can come out,” said Catherine Troisi with the University of Texas School of Public Health.
The CDC says the two high risk procedures are respiratory intubation and kidney dialysis. Respiratory intubation is the insertion and extraction of a breathing tube. Kidney Dialysis usually involves connecting the patient to a machine via IVs and tubing to clean the blood.
“I think it is showing us where we are and where we are not prepared for an outbreak,” said Troisi.
She says this outbreak has a 70 percent mortality rate with most cases centered in West Africa. The virus survives a few hours as the bodily fluid dries. But if it stays in liquid form, it can stay active for days.
Most diseases do not require protective gear. Fewer than half of Ebola patients hemorrhage bodily fluid, but wearing the gear is crucial. Troisis describes it as the number one step.
“Because your safety equipment may be contaminated on the outside. It’s when you get out of it that you have to be particularly careful,” said Troisi.
If it’s done right, she says it should take about 15 minutes to put on and take off the protective clothing. With a second healthcare worker infected, it emphasizes every precaution is necessary.
Kidney Transplant Debate
From Slate.com, by Eric Posner
A Moral Market
Altruism exchanges could ease the desperate shortage of kidneys for transplant.
Sunday is the 30th anniversary of the National Organ Transplant Act, but no one wants to celebrate. U.S. policy on organ transplants—especially as applied to kidneys—is a mess. More than 100,000 people languish on the waitlist for kidneys, thousands of them dying before they receive a transplant. In 2012, almost 35,000 people joined the waitlist, while only 17,000 received transplants. Every year the waitlist lengthens.
NOTA virtually guaranteed this shortage by shutting down an incipient market in kidneys. Some economists have argued that the best way to encourage people to donate kidneys is to allow people to sell them. Since almost everyone has one unneeded kidney, and most people could use some money, a market would form. The estimated price—perhaps in the range of $100,000 per kidney—would be less than the cost of dialysis (more than $70,000 per patient per year), even taking into account transplant surgery, and so the donor fee would be paid by insurers, including Medicare and Medicaid.
The law reflected a popular, inchoate repugnance at the idea of kidney-selling. Ethicists have tried to supply a philosophical argument. They argue that, if a market for kidneys existed, poor people would be taken advantage of; moreover, we should not treat body parts as “commodities.” Neither of these arguments is persuasive. A regulated market that required informed consent would eliminate the worst forms of exploitation and could ensure (as under current law) that kidneys were equally available to rich and poor. If poor people really can’t be trusted to make good decisions on their own behalf, then a simple solution is to ban poor people from selling their kidneys while allowing everyone else to do so. Nor is it clear why it’s more objectionable to sell a kidney than, say, one’s hair, blood plasma, egg cells, or sperm (sale of which is legal in most places within the United States).
But political opposition to selling kidneys will not go away, and so the question is how to increase the supply of kidneys without creating a market. Most proposals, including a recent open letter by transplant experts and bioethicists to top government officials, try to thread the needle by giving donors implicit or in-kind compensation, such as travel expenses to the hospital, a tax credit, or priority on the waitlist if they ever need a kidney themselves. The proposals amount to attempts to evade moral objections by allowing limited, implicit compensation rather than a price in dollars.
But it is possible to be more imaginative. It may help to sort out the source of moral objections to a market in kidneys. One possible view is that people should notexchange their body parts for other things of value. Another is that people shouldn’tprofit on the sale of their body parts. These ideas are different.
To see why, imagine that Martha wants to donate her kidney to her daughter (this is legal, of course), but the daughter’s body would reject her mother’s kidney because the mother’s and daughter’s antigens are not matched, or similar enough. Meanwhile, an unrelated person named Frank wants to donate his kidney to his son, but also cannot do so because of immunological incompatibility. But it happens that Martha matches with Frank’s son and Frank matches with Martha’s daughter. Could Martha donate her kidney to Frank’s son in exchange for Frank donating his kidney to Martha’s daughter?
Under NOTA, the answer was (or was believed to be) no: An exchange of any kind was illegal. In a subsequent law, called the Charlie W. Norwood Living Organ Donation Act, Congress clarified that this type of exchange, called a “paired donation,” is lawful. But only a few hundred transplants per year are arranged through paired donations because it is hard to find and arrange matches between strangers. [Read more]
Gift of Life
From KCBS, San Francisco, CA, by Ann Notarangelo
Walnut Creek Woman Set For Life-Saving Kidney Donation From Longtime Friend, Co-Worker
A Walnut Creek woman who learned she had the same kidney disease that killed her grandfather, mother and uncle is getting a live-saving transplant from someone near to her, literally and figuratively.
Jody Miranda will be getting a kidney from her friend and longtime co-worker at John Muir Medical Center in Walnut Creek, Teri Lineker.
For the past nine years, Lineker and Miranda have been a team in the Emergency Department.
We’re like sisters,” said Lineker. “We mess with each other during the day.”
Miranda was suffering from renal failure after years of polycystic kidney disease.
“Maybe two years ago things really started to hit and my kidney’s started failing really bad,” said Miranda.
When she started getting sick, that’s when I started getting worried because I know she’s got kids,” said Lineker. “She’s a single parent.”
Jody started dialysis but knew she would eventually need a kidney transplant.
I figured I’d never know the donor,” said Miranda. “They said there was an eight-and-a-half year waiting list for my blood type.
But just as their personalities clicked, so did their blood types – and Lineker surprised her friend with the offer to donate a kidney.
“I’m like are you serious? She was, ‘why, you don’t want me to?’” laughed Miranda. “I said, ‘No! Of course I do!’ It’s just, wow.”
“She needs to be around for her kids and if I can give her something to help her live then that’s the important thing,” said Lineker.
Surgery is scheduled for Friday and the two have inspired coworkers who’ve chipped in with a Gofundme page, personal days and more … to help the friends recuperate.
“It’s going to change my life forever,” said Miranda. But some things won’t change.
“Oh, I’ll still pick on her,” laughed Lineker.
These two have helped others when life itself seemed to be in question. Lineker said this is an extension of who she is and there is no uncertainty.
“Life’s short,” Lineker said. “And if you can help someone extend their life … I wish more people would do it.”
Lineker will likely be off of work for six weeks. Miranda will have a longer recovery and be off for at least two-and-a-half months.
From Vandalia Leader, Vandalia, MO
Vandalia resident gives kidney to friend
Her friend, Chris Mattox, of Springfield, has the genetic condition polycystic kidney disease (PKD), which has no cure.
According to the National Kidney Foundation, PKD causes numerous cysts to grow in the kidneys. These cysts are filled with fluid. If too many cysts grow or if they get too big, the kidneys can become damaged. PKD cysts can slowly replace much of the kidneys, reducing kidney function and leading to kidney failure.
Needless to say, Mattox needed a kidney transplant and Goeppner wanted to see how she could help.
“Chris is one of these type people like me, who would do anything he can to help everyone else but won’t ask for help,” Goeppner said. “I knew the situation was getting dire when he was starting dialysis.”
She contacted the University of Kansas Hospital (KU Hospital), whom Mattox was working with, in April to see if she was a suitable donor.
She already knew the two had the same blood type.
A test was taken in mid-June and she proved to be a suitable donor.
Surgeons Dr. Sean Kumer and Dr. Timothy Schmitt scheduled an August 5 surgery.
During the surgery, Goeppner’s kidney was surgically placed inside Mattox’s body. The area was stapled and the kidney was functioning immediately.
Meanwhile, Goeppner said she was worn out from the surgery.
“They told me when you go in that the donor would feel a lot worse than the recipient,” she noted. “It would be like a truck ran over you.”
Goeppner was released after two days.
Mattox remained in the hospital and went home three days later. He went back due to some fluid retention, but once it was resolved, he was reportedly doing well and returned to work on October 1.
“Like I’ve told him all along, the world is a much better place with him in it,” Goeppner said. “I did it for him and I did it for his daughter (who is in college.) I just wanted them to have a long, happy life together.”
Goeppner said she was thankful she could help out her friend.
“I’d do it all again in a heartbeat, knowing it went so well and it helped him so much,” she said.
Goeppner, who works at WERDCC in Vandalia, said she does notice from time to time that her energy levels now go up and down.
Goeppner and Mattox became good friends when the two of them worked at the Ozark Correctional Center.
Mattox served in a reserve unit and was deployed in late 2006. He served overseas for 10 months.
His service inspired Goeppner to join the National Guard in early 2007, though she officially was sworn in during mid-August of that year.
Three weeks later, she received orders to report for active service.
She had previously had an opportunity to enlist but passed it up. Mattox’s service was the inspiration she needed.
Goeppner received a medical discharge in May 2013.
Goeppner is the mother of two sons, ages 18 and 25.
According to the National Kidney Foundation, there are currently 101,170 people in the U.S. awaiting kidney transplants.
There were only 16,896 transplants in 2013, with 11,163 coming from deceased donors and 5,733 coming from living donors.
Goeppner noted that she’s an advocate for donating blood and platelets regularly.
“If you can’t give an organ, give blood if you can,” she said. “It’s a big help.”
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