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Saturday, September 23rd 2006

Improvements In Lung Transplantation?

I raise my eyebrow at some of the ‘points’ made in this New York Times story, but interesting enough. New “rules” improve lung transplants.

Starting in May 2005, new rules nationwide put patients who needed transplants most at the top of the list — people who would soon die without a transplant, but who had a good chance of surviving after one.

Previously, lungs went to whoever had been waiting longest, even if another patient needed them more. The waiting time was often two years or more, so there was little hope for people with lung diseases that came on suddenly or progressed rapidly.

Another major change is that more lungs from cadavers have become available, for two reasons: more people are becoming organ donors, and doctors have figured out ways to salvage lungs that previously would have been considered unusable. The new methods use drugs, respirator settings and other techniques to prevent damage to the lungs and keep their tiny air sacs open in brain-dead patients.

In the past, lungs could be retrieved from only about 15 percent of organ donors, but at some centers the rates have risen to 40 percent. Dr. Herrington said that in Minnesota, the number of lungs retrieved went to 97 from 25 in a single year.

Distribution of resources based on need is a dangerous move. Utilitarianism philosophically has no end…you can’t use it to justify it in one aspect of medicine and then turn around and say it doesn’t apply in another.

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