Lung transplants for the unvaccinated in Montreal.
As it should be.
Treadmill run in a gym (very high risk of exposing others) or uncrowded outdoor run (very low risk)?
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He would rather die than get the jab. Would he also refuse to take the anti-rejection drugs for the rest of his life?
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Actually, it was three patients who needed double lung transplants. She was highlighted because she was a mother of 5.
Per the article, non of them were anti-vaxxers, but just didnāt have time to get the vaccine or some other excuse.
Given a choice of a vaccine or needing a lung transplant, would most people choose needing the lung transplant?
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Yes. Iām guessing most people in that situation would choose the vaccine. I would. But thatās not the point. Iām not about denying healthcare to anyone based on being forced to make this choice. 
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Of course, that connects to the fact that in the US, health care is rationed by money. The patient faces a lifetime of increased medical bills (immunosuppressant drugs to stop rejection, plus increased risk of serious infectious diseases and cancers), even beyond any costs to the patient for the immediate treatment.
Maybe the distinction between transplant recipients is that one is refusing to get a vaccine now and the others have agreed to be vaccinated going forward. There is also the matter of these happening in different countries where presumably there are different criteria for receiving an organ.
I had a family member who received an organ transplant. A top priority is that the recipient does everything possible to keep their organ and to follow directions. The ability to take the medication, the ability to not smoke, not drink to excess. The ability to have a support system. This is not a fair or equitable system. When there are not enough of something to go around (in this case, organs) then they have to make judgements that donāt seem fair.
I so wish that there were enough donated organs that everyone who wants one could. My relative almost didnāt. You have to be so sick that you need a transplant but not sick enough that you wouldnāt survive. Itās an extremely fine line.
My opinion is that to those who donāt have intimate knowledge of a person receiving an organ, it seems unfair. But once youāve been through the hoops, it seems in line with what you experienced.
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People are denied transplants for a ton of lifestyle choices/reasons. There is a major organ shortage and the teams making transplant list decisions need to prioritize people who have the best shot of surviving and being good stewards of those organs.
My Dad was a 20 year heart transplant survivor. He had to make a lot of changes to his lifestyle before they would put him on the list. He also spent the next 20 years taking 20+ medications, multiple times/day, having to have follow ups every 6 months, inclusive of invasive tests, and a host of other things. He was also required to get flu shots every year along with other preventive measures.
If someone is refusing to get something as simple as a vaccine, I can totally understand how a transplant team would be worried about compliance with everything else.
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Is this not true of all transplant patients?
There are long waitlists for transplants. Unfortunately, there are rejections, and people have to go back on the list. The suffering and anxiety these poor patients and their families have to endure is unimaginable. When they get the transplant, there are the subsequent major comorbidities of subsequent rejection, graft versus host disease, infection, post-transplant lymphoproliferative disorders, etc.
If someone doesnāt want the vaccine, thatās a red flag that they already are not taking the steps to protect themselves and the transplanted organ they may receive. If they are not willing to do that, then maybe the transplant should be given to someone who does. Someone else gave their life so that another may live. Show some respect for that organ/person or let someone else have it.
ETA the transplanted patient is now the steward of that organ
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Agree with everything youāve said.
Adding that part of the calculus and placement on the transplant list is the patientās prognosis post-transplant.
Someone not vaccinated against covid would be extremely high risk of dying from covid post-transplant if they are exposed, and well, they will be. Even if they choose at that point to get vaccinated, transplant patients arenāt having good antibody responses because of all the immunosuppressants they are taking. No transplant team wants to give a patient such a scarce resource, only to die relatively soon thereafter. Transplant teams are facile at making those calculations/trade-offs.
So, while I donāt support denying medical care to anyone based on vaccination status, I do support putting an unvaccinated person relatively lower on the list, similar to how alcoholics needing a new liver typically are (and they can only be on the list if they have stopped drinking for a certain period of time).
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Totally agree.
And I donāt support withholding medical care to unvaccinated either. But you can look at it a different way - by giving a transplant to an unvaccinated person, you are actually withholding care to the vaccinated person who needs the transplant also. So there is no withholding of care when it comes to transplants. Someone will get that organ. And thatās where the putting unvaccinated lower on the list as you say comes into play.
(Just wanted to stress that there is no withholding of care if someone else wants to start that argument.)
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Treadmill. Sheās committed, but not an Antarctic marathoner. Also likely a good idea to give the immune system a fighting chance. I wonāt soon forget my bout with H1N1, which came on as I was trying to power through a 10K race. I was beaten by an 80-year-old doc, went home and was sick for a month. Still get burning in my quads whenever Iām getting sick.
Have you seen the movie, āThe God Committee?ā It stars Kelsey Grammer as a doctor on a hospital board that decides who gets the next heart transplant. Itās one of the most serious movies Iāve ever seen - I donāt think anybody smiles in it at all. Itās quite sobering to see these people make life and death decisions for others.
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Your whole post is excellent, and this sums it up perfectly.
Coupled with this. There are so many on the list that thereās no reason at all to put someone so unwilling to do something for their health above someone who is equally as needy and very willing to do whatever it takes.
Itās not about the vaccine itself. Itās about whoās most likely to make choices to survive with that precious organ.
My guy dealt with a patient who was a heavy drinker and refused to give up alcohol for a liver transplant. He didnāt get the liver (and later died). It was really sad for his mother because his dad died of cirrhosis too and he was her only son (might have been only child). But thatās not a sad enough story to put someone on top of the list who is just going to destroy another liver when someone else equally needy is willing to do what it takes.
There arenāt enough organs out there for everyone needing one.
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Will the potential transplant recipient refuse to take the anti-rejection drugs because they only make profits for BigPharma? Will they refuse to follow other post-transplant protocols because someone posted on Facebook that their personal research showed that they were not necessary? People with that mindset are not good candidates for a transplant.
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No I havenāt. I will see if it is on Netflix. I remember hearing about it when it came out.
I also remember the controversy of Mickey Mantle when he received his liver transplant. I was upset that someone with his lifestyle was able to get a transplant so quickly and then died anyway 2 months later. That was such a waste of an organ that could have gone to someone else.
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