Government to ban private organ transplants...

[Horsebox]

...in an attempt to thwart wealthy foreigners jumping the queue for a new liver.

Is this right?

Should the donated organs go to the most needy, regardless of status or depth of pockets or should the transplant system follow the rules of capitalism and let money do the talking?

bbc article

[Ms T]

When news of these transplants were exposed at King's College Hospital, I was visiting a relative in the Liver Unit and I can assure you that the patients were not very impressed. (td)

[Marmora Man]

To answer Horsebox - the majority of UK's hospitals are managed and funded by the NHS - therefore NHS patients should have priority. That's the easy answer.

As with all transplants - donor / receiver compatibility is a major factor in deciding who gets what. Thus if there are, say, 70 potential liver transplant patients on the critical list and a donor organ arrives but it, doesn't unfortunately, match any of the potential recipients - what to do? Some of the factors in the decision making process will be:

a. The need to not waste the organ

b. The need to keep the surgical team in practice - it used to be that any team had to carry out a minimum no. of these specialist procedures a year to maintain and develop expertise.

c. The opportunity to "exchange" the organ with another hospital (abroad since the donor system in UK is very sophisticated and can match a donated organ to all / any on the list awaiting transplant)

d. The opportunity to earn revenue for the hospital - to be used for the hospital (not paid to the surgical team).

I've no doubt annaj can add a lot more background.

If all healthcare were privatised then the patient's insurer would normally stump up - because of the need to match the organ for compatibility money cannot, by itself, take anyone to the top of a waiting list for a transplant.

[bignumber5]

Hypothetically, private care involvement should have no bearing on allocation of organs from non-heart beating donors (Heart beating donors are a bit more complicated), as the Transplant team (who make the allocation decisions) are an independent NHS multicentre team with no personal involvement in the care of anyone awaiting an organ until they are allocated one. Hypothetically, private healthcare would only serve to get you a nicer bed to recover in, and transfer a wedge of your bank balance to a surgeon. Hypothetically.

So where can private healthcare upset the system?

I have no idea: My involvement with transplant services has been mostly at the non-heart beating donor end, a little around heart and lung recipients, and all NHS.

As for the overseas issue, I understand that if we don't have anyone waiting who is a tissue match but someone overseas is then it makes a lot of sense. And there are good chances that there will be an overseas tissue match when there isn't a UK one, because simple statistics are that there are a number of conditions, such as hepatitis, which result in the need for an organ transplant, which are more prevalent in other countries than here. If you have 100 times the number of people awaiting transplant, logic states a significantly increased chance that an organ will match someone from that group.

Money at any stage will not make you a viable tissue match to an organ that you are not, nor will it stop you from being the only match currently on the waiting list if you are potless.

I've not fully evaluated the evidence regarding this particular "scandal", and what evidence there is doesn't seem to be particularly extensive or objective. An independent enquiry seems useful.

[antijen]

So why did George Best become top priority.

[bignumber5]

i haven't seen his medical notes so i don't know

[buggie]

As BN5 has already mentioned, tissue type has a big part to play - could well be that no one else (as poorly as him - remember he'd gone dry for 6 mths+ beforehand) matched the donor liver... should the donor liver have gone to waste??

The proportion of organs donated is low mainly because of the poor number of people making it clear before the time comes that they'd like to donate, but also because it's limited situations that organs can be taken (due to medical history/how the donor has died etc).

This is why the work done at Kings regarding living liver donations (the liver can regenerate itself) is so exciting and a very positive step forward.

[dulwichmum]

antijen Wrote:

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> So why did George Best become top priority.

I think that this is a really interesting point. I have no doubt that George Best's tissue type, alcohol dependance etc were issues determining his suitability for transplant. But just because George Best opted for private healthcare, should that disclude him from his rights to NHS care or place on the waiting list for organ donation? He was a tax payer in this country. If he decided to pay for private healthcare, surely he would remain as eligable as any other citizen of this country for donor organs.