Patient dies weeks after kidney transplant from genetically modified pig
nytimes.com
nytimes.com
> The hospital said it had “no indication that it was the result of his recent transplant.”
A major issue, at least in Canada, is that the system will let you get too sick to recover before helping you. There are times when a healthy person enters the queue, and doesn't get fast-tracked / called upon until their health begins to fail severely.
The problem is poor healthcare...
Yes.
But most healthcare is terrific and supplied by dedicated professionals working in systems and institutions of variable quality.
But the bad outcomes are what we notice.
If it bleeds it leads
Happens every day.
Yeah, I'm in the burbs and My neighbor's wife died like this. They gave her something obviously wrong, (some thick orange drink iirc?) and when they questioned it the tech insisted it was necessary for a diagnostic of some sort. According to my neighbor, she went very south about 2-3 minutes after consuming it and was dead in a couple hours. He is unable to get any documentation from the hospital about what the substance was, who ordered it, etc.
This was 2ish years ago.
He was very brave. A decision like this is immense.
Additionally, the transplant happened in March, which is “weeks ago” but not 2 weeks ago, which is the timeframe I initially assumed from the headline.
I was born more than 2000 weeks ago.
That bit of the headline is just pointless.
Mathematically true isn't sufficient (and possibly sometimes not even relevant), "weeks ago" bears more meaning in common language than "there exists N such that N > 2 and N weeks passed".
So you were born that many weeks ago, but not really weeks ago.
What matters is how things are understood and it's not usually the interpretation of a formal version of the text (or it is, but a complex one that depends on the mood, the culture and the knowledge of the recipient, their understanding of the author, possibly on other factors as well, that most likely doesn't quite match a naive formal translation)
Very editorialized title.
“Patient given modified pig kidney dies two months later, cause not confirmed to be kidney” or something along those lines would be the best headline.
Sadly, the article's headline does just that.
Dr. Jarvik is quite the character.
I think the transplant team likely did have tons of evidence showing the kidney was fine - monitoring things heavily is just normal procedure after any transplant, even more so after this kind of transplant. He would have had daily or weekly labs showing Creatinine/eGFR, ultrasounds, blood tests, urine tests, regular appointments talking about symptoms and lots more.
Its possible that the pig kidney caused the death in some way that isn't clearly understood yet though. Maybe some proteins in the kidney went into the bloodstream and affected another organ, maybe they exacerbate congested blood vessels somehow etc. Maybe an autopsy will reveal more.
But yeah if you read the history of transplants or any risky new medical procedure, they are very fragile and can be set back decades or stopped when they go bad or mistakes are made. There are incentives for people to cover up the reason's things failed and history of hospitals lying out of their teeth to cover their asses (see Charles Cullen in The Good Nurse).
I guess I'm saying there is plenty of evidence on both sides of the answer to the question of "why did he die".. either way he did something heroic.
"donor" seems a little rich.
I dislike what precedent this sets in human's "use" of animals.
As a potentially dead human, I’m ok with them using animals bred to be donors for this.
I’m a Stage IV Kidney Disease patient.
This pig would have lived a very short and probably isolated life (to isolate from pathogens). No matter how well it was treated in life it was still forcibly operated on and/or killed at the end.
I don't think it should be used in this context either, it should be called something like "organ provider" which gets "harvested".
The term was previously used when describing human donors. They just kept using it because it's as good a euphemism as any.
I don't think animals can opt-in to such a system, as such I'd consider it an incorrect usage of the term.
The point is not the animal's comprehension of the term but the implication that the animal gave consent to have their organs harvested by saying "donor". If you argue that the pig cannot understand English so can't be offended the same applies that they can't understand English so cannot give affirmative consent.
This is a normal usage of language and not some attempt to wiggle around meaning. If this somehow makes you uncomfortable, you should remember that, if you eat meat, or otherwise consume any sort of animal product, or if you have ever done so, then aforementioned animal was straight up killed, humanely or sometimes inhumanely, to make that product.
We domesticate animals to make our lives easier through the usage of their byproducts and this is just one of those usages. Yes, an animal died, but it wasn't killed without reason or justification.
We don't live in a Star Trek world where one can wave some sort of device and the person is magically healed. People are working to get there and maybe someday they will succeed, but until then, imperfect means are all we have.
It's either that or dead humans. Which do you prefer?
I do, technically, have an issue with our modern meat production, which ia a straight up horror show - for the animals and for the people growing them, but that's entirely unrelated to this case here.
As far as my knowledge of the word "donation" goes, it means that someone voluntarily gave something to another, and the person giving is the donor.
I'm not an authority for the English language, so maybe donation can also apply to a scenario in which something is taken with no active consent. In that case the term would also apply to theft though, that makes me kinda doubt that...?
But I guess we can go with that.
As far as I know, the term donor is defined to mean that the entity voluntarily gave something. Using it in a context without the entity being willing still seems to be invalid to me, but as I said: I'm by no means an authority on the English language
Do you not think that most people who have stopped using animal products have not already come to the conclusion that what they did was (direct or indirect) killing and they deemed it as immoral? Using this argument in an animal ethics debate is ineffective at best.
I'd also contend pet breeding is a wildly misguided practice too. Attempting to maintain breed "purity" is at the very least detrimental to their health, but even a pug mutt is clearly not an animal that should exist.
Sorry, the burden of proof goes backwards. When you are doing something this novel and the patient dies so soon afterwards, the null hypothesis is that it had something to do with the transplant and you have to show evidence that it was not due to the transplant.
Having said that, I do think you're right, the cause of death should absolutely be shared, otherwise it looks quite dodgy. If he was indeed discharged with "one of the cleanest bills of health I’ve had in a long time", then how could he die so shortly after, and why would there not be more discussion around the specifics?
It’s very possible for him to have the cleanest bill of health he’s had in 6 months or a couple of years, while still dying.
I suspect that unwinding whether his death is related to the transplant or not is non-trivial. He had a few issues that would likely kill him soon. Figuring out which one did, and whether it was caused by the transplant, may be difficult.
For example, here’s what Wikipedia says this of the first receiver of a heart transplant (https://en.wikipedia.org/wiki/Louis_Washkansky):
“As a result of heart attacks in 1965, approximately only one third of his heart was still functioning. In late October, he went into a diabetic coma, but regained consciousness. Once, when he was swollen with fluid and in considerable pain, his wife Ann asked him in a whisper how he was doing. He managed a smile and whispered, "I'm on top of the world." He was also suffering from kidney and liver failure.”
And that’s a case where no good alternative treatment existed, at a time when ethics committees weren’t as stringent as they are today, if they existed at all.
This is similar to AIDS. AIDS almost never kills directly. Some other disease like cancer or pneumonia does the actual killing.