Human Organs From Pigs — But You’d Have to Kill One to Get One.

What if we could end the organ shortage tomorrow and everyone on the list could get a transplant within a few weeks?  Would you be willing to endorse this new source of organs?  If the source were a pig would you be willing to kill it to save your own life?

Xenotransplantation is the process of transplanting organs from animals into humans and historically that hasn’t worked too well. The human immune system immediately and violently attacks organs from animals and even our most powerful immunosuppressant drugs are ineffective but scientists are working on the problem because if we could use animal organs (ethical questions aside for now) we could end the organ shortage almost immediately.

The answer may lie in raising transgenic animals – animals that carry genes from other species or in the case of humans, animals that have been genetically modified so that their organs are transplantable into human beings.

According to www.actionbioscience.org  Transgenic animals are not a pipe dream either, they are already being produced.  The majority has been mice but scientists have also produced rabbits, pigs, sheep, and cattle. The primary question is not if we can raise pigs to produce organs for humans but when that is likely to happen and it’s possible it could happen relatively soon.  In Korea scientists have already cloned a genetically altered pig with hopes of using its organs in humans but that has, to my knowledge, not yet been done successfully.

There are distinct medical applications to the process of transgenics and providing a ready supply of transplantable organs is one of them.  Presently there is a single protein that can cause rejection but researchers think they can eliminate that problem in the not too distant future by replacing it with a human protein.  It is also possible that animals could be raised to be disease resistant which would benefit both the animal and humans to which some animal diseases can cross.

Pigs are currently thought to be the best candidates for organ donation. The risk of cross-species disease transmission is decreased because of their increased phylogenetic distance from humans. They are readily available, their organs are anatomically comparable in size, and new infectious agents are less likely since they have been in close contact with humans through domestication for many generations.

Aside from growing organs for transplantation, milk producing animals are desirable, too, because they can be used to producenutritional supplements and pharmaceuticals.   Products such as insulin, growth hormone, and blood anti-clotting factors may soon be or have already been obtained from the milk of transgenic cows, sheep, or goats. Research is also underway to manufacture milk through transgenesis for treatment of debilitating diseases such as phenylketonuria (PKU), hereditary emphysema, and cystic fibrosis.

So, yes, there are great possibilities with transgenic animals but there are also ethical concerns that must be addressed.  For example:

• Should there be universal protocols for transgenesis?
• Should such protocols demand that only the most promising research be permitted?
• Is human welfare the only consideration? What about the welfare of other life forms?
• Should scientists focus on in vitro (cultured in a lab) transgenic methods rather than, or before, using live animals to alleviate animal suffering?
• Will transgenic animals radically change the direction of evolution, which may result in drastic consequences for nature and humans alike?
• Should patents be allowed on transgenic animals, which may hamper the free exchange of scientific research?

Animals like pigs offer hope for the thousands of people languishing on the national transplant list.  Unfortunately these things take time and while scientists and then politicians and bureaucrats investigate the possibilities thousands will die waiting for organs.  The altruistic system that we have in place in America just isn’t enough.  We must do more to save the lives of those who need organs.  Hope lies in xenotransplantation, regenerative medicine, therapeutic cloning and artificial organ development.  We must keep that hope alive by support these efforts.

Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 2,500 member Organ Transplant Initiative and the author of most of these donation/transplantation blogs.

You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

Please view our video “Thank You From the Bottom of my Donor’s heart” on http://www.organti.org This video was produced to promote organ donation so it is free and no permission is needed for its use.

If you want to spread the word personally about organ donation, we have another PowerPoint slide show for your use free and without permission. Just go to http://www.organti.org and click on “Life Pass It On” on the left side of the screen and then just follow the directions. This is NOT a stand-alone show; it needs a presenter but is professionally produced and factually sound. If you decide to use the show I will send you a free copy of my e-book, “How to Get a Standing “O” that will help you with presentation skills. Just write to bob@baronson.org and usually you will get a copy the same day.

Also…there is more information on this blog site about other donation/transplantation issues. Additionally we would love to have you join our Facebook group, Organ Transplant Initiative The more members we get the greater our clout with decision makers.

UNOS CEO: Study Could Redefine “Medically Suitable” Donors

On August 11, I sent a letter to Walter Graham, CEO of the United Network for Organ Sharing (UNOS) asking what UNOS was doing or was going to do to increase the supply of organs. My letter noted that the number of transplants performed each year has plateaued at about 28,000 while the number of people on the list continues to grow.  Today there are 114,899 people waiting and so far this year there have been 11,469 transplants from 5,677 donors.   As you can see, the gap continues to widen.  With only four months left this year we may fall far short of the 28,000 number.

Below you will first find my letter to Mr. Graham, followed by his response.  You can decide if he responded to my concerns and most importantly, your concerns about how our national donation/transplantation system is managed.

August 11,2012

Walter Graham

Chief Executive Officer

United Network For Organ Sharing

Richmond, Virginia

Dear Mr. Graham:

You might remember me as a Minneapolis, Minnesota based communications consultant that worked with UNOS in the 90’s.  During that period I was diagnosed with dilated cardiomyopathy and subsequently had a heart transplant at the Mayo clinic in Jacksonville, Florida in August of 2007.

I am writing not as a former consultant but rather as a very grateful heart transplant recipient, founder of Facebook’s nearly 2500 member Organ Transplant Initiative (OTI), author of over 120 blogs on donation/transplantation issues (www.bobsnewheart.wordpress.com)  where we have 100,000 readers and writer/producer of three videos on organ donation. I am a very active advocate for organ donation and have been for many years.

I’ll get right to the point.  I have a growing concern about the Inability of the altruistic system to meet the demands for organ transplants and UNOS’ reluctance to make or even recommend significant changes to the system.

I am quite aware of all the ethical and other arguments forwarded by UNOS for rejecting changes that would include presumed consent and donor incentives/compensation among others.  I am puzzled as to how UNOS can find these suggestions unethical or unworkable but has made no statement about the ethics of allowing people to die due to the failure of the altruistic system to generate enough transplantable organs.  How can it be ethical to allow an inadequate system to prevail?

Having been on that list I have first-hand experience with the depression that accompanies it, knowing that the government contractor that is funded with my tax dollars is doing little beyond promoting altruism to significantly increase the number of available organs.  It is discouraging and depressing for those on the list to continually hear that every option other than altruism is either unethical or unworkable.

I am hoping that you can offer some hope that I can pass on to members and other interested parties that the gap not only is closing but will close and soon.  Please offer some explanation other than renewed efforts at increasing altruism of just what UNOS is doing and will do to help those who are languishing on an ever growing list of people who need transplants.  Please prove me wrong.  I would be most grateful to see clear, compelling evidence that the altruistic system can work and is working.

It is almost 30 years since the National Organ Transplant Act (NOTA) was implemented..  I think that is plenty of time to determine if a system works.  Unless you can prove otherwise, It seems clear that with 114,000 people listed and only about 28,000 transplants done every year despite intense and noble efforts at increasing donation rates, altruism alone cannot meet the demand – ever.  .

Please respond as soon as possible.  I plan to publish my letter to you and your response side by side.

Thank you for your consideration and time

Bob Aronson

Return letter from Walter Graham

Received on August 22, 2012

Dear Bob:

Thank you for your letter, and yes, we remember your valuable contributions to us as a consultant in the 1990s.  We are glad you continue to do well with your transplant and engage the public in this vital cause.

Your concern regarding the shortage between available donors and the needs of waiting candidates is widely shared.  Our ultimate goal and fondest hope is to be able to provide transplants for all candidates in need, to prevent deaths and needless suffering while waiting.

As you may recall from your work with us, the primary mandate of UNOS as operator of the national Organ Procurement and Transplantation Network (OPTN) is to allocate organs from deceased donors equitably among transplant candidates.  Other significant roles, as specified in federal law and regulation, including maintaining a clinical database on all donors, candidates and recipients; monitoring compliance with OPTN policies; and investigating donation- or transplant-related issues that may pose a risk to the health and safety of transplant patients, living donors or the public.

Promoting organ donation is interwoven among all of our responsibilities, and transplantation depends entirely on the public’s willingness to donate.  That said, managing the organ donation system is not a fundamental mandate that federal law or regulation has assigned to us.  Our essential responsibility is to make sure that available organs are used in the most responsible and effective way possible.

State and federal law governs the process of donation in the United States.  Any change to the current voluntary nature of donation, whether that would involve preferred consent, financial incentives, preferred status or other means, would involve a public initiative to amend the law.  UNOS, as a corporation, has declared its support of careful study of potential incentives, financial or non-financial, that would encourage donation while respecting individuals’ freedom of choice.  Such study may involve legislative efforts to suspend the law to allow examination of the results.  As a federal contractor for the OPTN, UNOS cannot develop policies not supported by the law or expend limited resources lobbying for legislative changes beyond the OPTN’s mandate.

One of the fundamental questions UNOS is seeking to answer has to do with the potential number of persons who could qualify for deceased organ recovery.  Our Center for Transplant System Excellence is conducting a Deceased Donor Potential Study. This study will identify the total number of medical cases in which persons could be deceased organ donors regardless of issues of consent. The results of this study will provide a better understanding of what is possible. The merits of whether a system based on altruism is the best approach could then be understood in the context of what is possible. It may well be that the number of medically suitable cases as currently defined is not adequate in any circumstance.

Many people are convinced that the delicate nature of donation may be adversely affected by negative connotations or perceptions generated by controversy over debates about changes to the underlying legal system such as presumed consent. That being the case, it is prudent to pursue the DDP Study to learn what the potential might be before considering whether to advocate for a fundamental change.

Among key strategic goals for the OPTN are increasing the number of transplants performed and optimizing post-transplant survival.  Even with the current supply of donated organs, we can increase utilization of organs and enhance survival by better matching available organs with candidates who are the best long-term match.  In promoting organ donation, we actively support efforts such as those of Donate Life America, which has recently announced more than 100 million Americans have formally registered their wish to donate organs and tissues and has set an ambitious goal of 20 million new donor commitments this year.

We all agree a higher rate of donation is essential to save lives and relieve suffering of men, women and children anxiously awaiting an organ transplant.  UNOS and the OPTN are dedicated to helping save and enhance lives through organ allocation.  Whether society may be ready to adopt a new model for the process of organ donation is an important discussion that would involve society as a whole and active support of state and national lawmakers.

Walter Graham

CEO

Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 2,500 member Organ Transplant Initiative and the author of most of these donation/transplantation blogs.

You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

Please view our video “Thank You From the Bottom of my Donor’s heart” on http://www.organti.org This video was produced to promote organ donation so it is free and no permission is needed for its use.

If you want to spread the word personally about organ donation, we have another PowerPoint slide show for your use free and without permission. Just go to http://www.organti.org and click on “Life Pass It On” on the left side of the screen and then just follow the directions. This is NOT a stand-alone show, it needs a presenter but is professionally produced and factually sound. If you decide to use the show I will send you a free copy of my e-book, “How to Get a Standing “O” that will help you with presentation skills. Just write to bob@baronson.org and usually you will get a copy the same day.

Also…there is more information on this blog site about other donation/transplantation issues. Additionally we would love to have you join our Facebook group, Organ Transplant Initiative The more members we get the greater our clout with decision makers.

Addiction — A Journey Into Hell

If you are suffering from organ failure and you are an addict you can be eligible for an organ transplant but you have to be clean and sober first and  most transplant centers require at least six months of sobriety before they will consider you.

Yesterday I posted a blog “My Last Drunk..” about the time 30 years ago I checked myself into treatment for alcoholism.  It was not a particularly outrageous story but it was significant  to me because it was my very last drunk.

I write a lot about addiction because it is one of the primary killers of human organs and because this group is dedicated to ending the organ shortage I’m hoping that stories about addiction and recovery will  help those suffering from the disease find their way into a recovery program.  If we can do that the demand for organs will decrease and those who remain on the list will have a better chance of getting a transplant.

I realize that there are many who refuse to believe that addiction is a disease and many who think addicts even if they are in recovery should not be eligible for transplants because of what they did to themselves.  And I will be the first to admit that addicts do the damage to themselves but it’s not on purpose, it is not because they choose to destroy their organs, their families and their careers.  Who would be crazy enough to do that?  The life of an addict is pure hell and readers will just have to believe me when I say, “No one would choose to live like that, no one!”

When you are an addict you are totally out of control and you don’t set out to harm anyone including yourself but the power of the disease is so great it is irresistible.  When the demand for your drug of choice invades your body you must respond to it no matter who gets hurt along the way. You will lie, cheat, steal and in some cases even physically harm anyone who gets between you and, in my case, my bottle.

Being an addict also means you spend inordinate amounts of time trying to figure out how to feed your habit.  With alcohol money is not as much a problem as with illegal or prescription drugs.  Alcohol is easy to get and relatively cheap but you still must plan.  In most places you can’t buy a bottle of booze on a Sunday so you have to make sure that you have enough booze on Saturday to take you through Monday.  Then in many cases, especially if you have a family you don’t want to know about your addiction, you have to have a place to hide your drug of choice.  I had a secret panel in the wall of our finished basement, a cubby hole In the garage, a special place in a sand pit near my home where I could hide and then dig up my bottle, inside an old tire in the garage and the bottom of the waste basket under used paper towels in the men’s room at my place of employment.

If illegal drugs are your problem then money becomes a huge issue and you will either steal it or con your best friends or family out of it by manipulating them in any one of a number of ways.  No lie is too outrageous for the addict and in many cases no action is too outrageous.  That’s how powerful the addiction is.  You will literally sell your soul to get what you need and the worst part of it is that you can’t even really get high anymore, you use to try to feel normal but all you really get is sicker and sicker both mentally and physically until either you are hospitalized, treated or die.

Addiction will overwhelm your sense of ethics, pride, morals, self-worth and will to live.  I remember having a conversation with myself once in which I said, “Bob you have to stop drinking, you are killing yourself!”  My response without thinking and without pause was, “I don’t care.”  That’s the power of the drug.

When I drank I sometimes consumed up to two quarts of vodka a day.  I was a big man 6’4” and 250 lbs.  I could hold a lot and miraculously I functioned.  I got up every day, put on a suit threw a quart of vodka in my oversized briefcase and went to work.  I drank my way through four years as a Governor’s press secretary and appeared to many if not most to be sober, I almost never was.

In the four years I anchored Morning Edition on the Minnesota Public Radio Network I rarely drew a sober breath yet I interviewed people, had impeccable timing, read news and performed all the other duties an on-air person can do. Sometimes I struggled mightily to keep from slurring words and to walk straight but I was able to fool most  of the people, most of the time.

But it all catches  up with you and at some point you find yourself in places and with people you would not normally associate with.  It is as though the rest of the world can’t see you.  All the while you know it is wrong but you just keep sinking deeper and deeper into the bottomless pit of despair and the more you realize how you have degenerated the more you use your drug of choice to help you forget what you have become.

Addiction is a horrible disease and as I mentioned in yesterday’s blog it cannot be overcome with will power it takes help, a lot of help from a lot of people and then it takes superhuman effort and the help of those same people and even more to stay sober.

One of the toughest parts of recovery is following the Alcoholics Anonymous step that dictates that you make amends to those you have harmed.  It means you must apologize and it also means your apology may not be accepted and you have to learn to live with that.  It’s part of the soul and conscience cleansing process and it is difficult but necessary.

Recovery from addiction is on-going.  You are never recovered because one drink, just one, will send you right back into that deadly spiral into the depths of living hell.  As the expression goes, “One drink is too many and a thousand is not enough.”

I’ll close with this. If you are an addict, there is hope and there is help. It isn’t easy and it isn’t quick but it can work and you can live a normal life again but you cannot do it alone.  You need help.  You can start by calling your local chapter of Alcoholics Anonymous or Narcotics Anonymous or any accredited treatment center. In most cases insurance will cover treatment.  If you are uninsured there is still help available through AA and NA.  It is only a phone call away. You just have to take it one day at a time, sometimes, it is one moment at a time but it is always moving forward, sober!

f you are an addict, think you might be or know someone who needs help here are some resources. 

http://nationalsubstanceabuseindex.org/

http://www.addictionresourceguide.com/resources.html

http://www.drugabuse.gov/publications/principles-drug-addiction-treatment/resources

Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 2,500 member Organ Transplant Initiative and the author of most of these donation/transplantation blogs.

You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

Please view our video “Thank You From the Bottom of my Donor’s heart” on http://www.organti.org This video was produced to promote organ donation so it is free and no permission is needed for its use.

If you want to spread the word personally about organ donation, we have another PowerPoint slide show for your use free and without permission. Just go to http://www.organti.org and click on “Life Pass It On” on the left side of the screen and then just follow the directions. This is NOT a stand-alone show, it needs a presenter but is professionally produced and factually sound. If you decide to use the show I will send you a free copy of my e-book, “How to Get a Standing “O” that will help you with presentation skills. Just write to bob@baronson.org and usually you will get a copy the same day.

Also…there is more information on this blog site about other donation/transplantation issues. Additionally we would love to have you join our Facebook group, Organ Transplant Initiative The more members we get the greater our clout with decision makers.

Cheney Got a New Heart — Ethicists Need One

I am an average American male, human being.  I’m not a genius not gifted just a man of normal intelligence who likes to think and read and research and write about about what I’ve found.  Some things really stump me, though.   I’m terrible at math, I love physics but don’t have a clue about how any of it works, and even after spending a good many years as a professional broadcaster I still don’t completely understand how the sound and picture got from me to your radio or TV.  What mystifies me most, though, is the thought process of people who call themselves ethicists.  The word is even hard to say, you kind of feel as though you have developed a lisp.

Just so we are all on the same page here, it is important to define our terms.  First the Dictionary.com definition of ethics  http://dictionary.reference.com/browse/ethics

eth·ics

   [eth-iks] Show IPA

plural noun

1. ( used with a singular or plural verb ) a system of moral principles: the ethics of a culture.

2. (the rules of conduct recognized in respect to a particular class of human actions or a particular group, culture, etc.: medical ethics; Christian ethics.

3. moral principles, as of an individual: His ethics forbade betrayal of a confidence.

4.( usually used with a singular verb ) that branch of philosophy dealing with values relating to human conduct, with respect to the rightness and wrongness of certain actions and to the goodness and badness of the motives and ends of such actions.

Art Caplan of the University of Pennsylvania, the man who questioned whether the Vice President was too old to get a transplant, is a “Bioethicist.” The same Dictionary gives this definition.

bi·o·eth·ics

   [bahy-oh-eth-iks] Show IPA

noun ( used with a singular verb )

a field of study concerned with the ethics  and philosophical implications of certain biological and medical procedures, technologies, and treatments, as organ transplants, genetic engineering, and care of the terminally ill.

Having established who and what we are talking about let us return to the continuing saga of the Cheney heart transplant.  The ethicists are rallying behind their colleague Art Caplan.  One said, “The ethical issues are not that he (VP Cheney) got a transplant, but who didn’t?”

What an absurd argument!  That could be said about anyone who got a transplant.  if a 40 year old got a new liver, do we ask, “Who didn’t get the liver he just received?” I may not know much about ethics but I do have a clue about logic and somehow logic has been lost in the arguments forwarded by these learned people.  I wonder how well any of them would do on “Are you smarter than a 5th grader.”  Probably not real well being as that takes knowledge not philosophizing.

At the risk of sounding like a reactionary I have to say that some of these ethicists are the ones who got us in this donation shortage in the first place.  For years the ethicists have been telling us that the only ethical way to obtain organs is through the “Altruistic” system which is what we have now — people voluntarily becoming donors.   This method has been in effect since 1984.  The problem is that it doesn’t provide anywhere near enough donors to satisfy the need, therefore from 6000 to 7000 people die each year while waiting for organs.

The ethicists have met many times to consider alternatives to altruistic donation and each time after a great deal of philosophizing, consternation and speculation have found that the alternatives are, you’ve got it, “unethical.”

Now I’m no rocket scientist and don’t have a PHD or a fancy title like “Bioethicist” but I do have common sense.  It seems to me that if you are really concerned about ethics you would have to expand your thinking to a bigger picture.  These ethicists appear to have quit thinking about the problem when they reached their myopic conclusion.  They conveniently ignore the fact that people are still dying and will continue to die because they refuse to allow change.  Doesn’t that deserve some of their “ethical” brainpower, philosophizing and speculation, too?   It is amazing to me how strangely silent these “holier than thou” ethicists are about not questioning the ethics of allowing people to die.

There may be an explanation for their actions though and that explanation was found way back in 1931,long before transplants were considered possible.  You see, even then the medical community was having problems with ethicists who considered themselves to be “Experts.”  http://tinyurl.com/7c8fnho

Harold J. Laski writing in the London’s Fabian Society, manuscript in February of 1931, presented a challenge to the expertise of an “expert” in decision-making with the following:
:
“But it is one thing to urge the need for expert consultation at every stage in making policy; it is another thing, and a very different thing, to insist that the expert’s judgment must be final. For special knowledge and the highly trained mind produce their own limitations which, in the realm of statesmanship, are of decisive importance.

Expertise, it may be argued, sacrifices the insight of common sense to intensity of experience. It breeds an inability to accept new views from the very depth of its preoccupation with its own conclusions. It too often fails to see round its subject. It sees its results out of perspective by making them the centre of relevance to which all other results must be related. Too often, also, it lacks humility; and these breeds in its possessors a failure in proportion which makes them fail to see the obvious which is before their very noses.

It has, also, a certain caste-spirit about it, so that experts tend to neglect all evidence which does not come from those who belong to their own ranks. Above all, perhaps, and this most urgently where human problems are concerned, the expert fails to see that every judgment he makes, not purely factual to nature, brings with it a scheme of values which has no special validity about it. He tends to confuse the importance of his facts with the importance of what he proposes to do about them.”

I have no idea who Mr. or Dr. Laski was but his profound insight into the psyche of ethicists is a perfect reflection of my thoughts only articulated far more effectively.

I suppose there’s a role for ethicists to play in our society but at this point in my life (73 years worth) I don’t need a so-called ethicist to explain the difference between right and wrong to me.  I’ve not studied the great philosophers to the extent they have but living as long as I have and having had a heart transplant has pretty much instilled in me a set of values that I think are pretty solid.  That’s probably true about most people. We don’t need much help in making moral decisions.  Do we want information?  Sure.  Will we accept advice?  Sometimes.  Do we need to have ethicists make decisions for us?  Never!  Unfortunately they do and It has cost thousands of lives.

Bob Aronson, a 2007 heart transplant recipient is the founder of Facebook’s 1700 member Organ Transplant Initiative and the writer of 110 blogs on donation/transplantation issues on Bob’s Newheart on WordPress. 

You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

 Please view our video “Thank You From the Bottom of my Donor’s heart” on http://www.organti.org This video was produced to promote organ donation so it is free and no permission is needed for its use.

If you want to spread the word personally about organ donation, we have a PowerPoint slide show for your use free and for use without permission.  Just go to http://www.organti.org and click on “Life Pass It On” on the left side of the screen and then just follow the directions.  This is NOT a stand-alone show, it needs a presenter but is professionally produced and factually sound.

 Also…there is more information on this blog site about other donation/transplantation issues. Additionally we would love to have you join our Facebook group, Organ Transplant Initiative The more members we get the greater our clout with decision makers.