标题: Kidney Transplantation [打印本页] 作者: choi 时间: 4-17-2019 14:36 标题: Kidney Transplantation There is no need to read the rest in any of the following.
(1) Economist, Apr 13, 2019
(a) Opioids and transplants | Life after death; A tragedy has a silver lining. https://www.economist.com/united ... icas-opioid-tragedy
("It [opioid addiction in US] kills around 50,000 people annually, far more than the number who die in traffic accidents or from gun violence" ]niy donation rate differ in the three categories])
Note: In print is a chart (heading: "Shooting up
United States, deceased organ donors
By cause of death, '000")
The x-axis is year (from 2000 to 2018).
Arranged in decreasing order of causes of death in 2018 (who donated) -- not 2000, say.
Brain haemorrage/stroke > Blunt injury [which presumably included accidents and homicide with, say, a club]Cardiovascular ? Drug intoxication > Gunshot wound > Other
"In America many people who need a [kidney] transplant never join the [waiting] list because they cannot pay for the drugs they need to take afterwards.
"the main reason [for kidney transplantation] is diabetes. This is caused predominantly by obesity, which is rampant in more and more countries. So kidney waiting lists will become even longer.
"a kidney transplant, which lasts for 10 to 13 years on average * * *
"Roughly two-thirds of kidney trans[;ants in rich countries are from the deceased donors (see chart on next page). The rest are from living donors who part a kidney to help someone. One kidney can perfectly well manage the job of two that most people are born with.
"Cultural differences plays a role, too. Most Japanese, for example, feel uneasy about the idea of taking organs out of a dead body.
"By and large more people say they want to donate than actually volunteer to add their names to a donor registry. This has encouraged more countries to follow Spain, which has the world's highest organ-donor rate [chart: Spain 70 kidney transplants 'per million people, 2017' of which 63 from 'deceased,' compared with 2nd in chart which is US (63 and 46, respectively] and in 1979 became the first country to introduce a law making organ donation upon death the presumed choice of anyone who has not registered to opt out.
"In the past, older people were rarely considered as potential donors [dead or alive]. But it is clear that this is misguided [from science point of view]
"A kidney donor typically needs two days in hospital and about a month to recover. About 20% suffer some, mostly minor, complications. In many countries some would-be donors are deterred by the cost of travel and other expenses. In the Netherlands, which has the highest rate of living organ-donors in the rich world [chart: 57 kidney transplants per million, 2017 of which 24 from the deceased -- making it 33 from the living], kidney donors get three months of paid leave to recover, as well as payment for related costs -- even such needs as dog-sitting. In America, by contrast, donors get only some expenses paid for, and only if they are poor.
"Almost half of would be kidney donors are not biological matches for the persons for the person they want to help [eg, a parent wants to donate a kidney to child, but can not due to mismatch in major histocompatibility complex (MHC), increasing likelihood of immunological rejection of the transplant]. The parent can participate in a swap] ) . So kidney-exchange schemes have evolved. * * *
"The only country where that [purchase organs in open market] is legal is Iran. Buyers and and sellers are mediated by patient foundations. The price of a kidney is set at roughly the average annual income of a family ion the poverty line. The vast majority of sellers are poor * * * 作者: choi 时间: 4-17-2019 14:37
(2) Leah Hager Cohen. I Secretly Gave away Part of Myself to s Stranger; Without consulting my beloved, I decided to donate of of my kidneys. New York Times, Apr 14, 2019
(in the Modern Love column of SundayStyles section).
Quote:
"The idea never crossed my mind until the afternoon I stood folding laundry and heard a woman on the radio telling the story of donating a kidney to someone she didn't know. I had turned 50 * * * I'd net my beloved three years earlier.
"When I heard th
e radio of becoming an altruistic donor, it seemed an answer. I folded the last pair of socks, went to the computer and looked up kidney donation. I was uncomfortable with the phrase 'altruistic donor' * * * I came across an alternative phrase: nondirected donor [ie, recipient not designated].
"The process began with scans and labs, a psychiatric evaluation, meetings with medical specialists, literature to review and a day urinating exclusively into a big plastic jug. * * * Five months elapsed before the tests were completed and I received word that I had been approved. I just had to sign papers to get entered with national registry, a kind of matchmaker service for organs.
"The kidney was removed from my body and sent on its journey, destination unknown. All we learned was that the transplant was successful.
"The surgery left me with four laparoscopic scars that are barely visible and one big scar that remains vivid.
Of note, the noun and verb are of he same spelling, but the accents differ.
(b) 24-Hour Urine Collection. Johns Hopkins Medicine Health Library, undated https://www.hopkinsmedicine.org/ ... ur-urine-collection
("is used to check kidney function")
by volume and concentration (hence the amount when volume is known) of wastes. This test is also done for a potential kidney donor, to see if his kidney function is normal. If not, he will be rejected as a donor.
(c) a vivid scar