Pub Date : 2021-05-15DOI: 10.7591/cornell/9781501755439.003.0012
M. Gershun, J. Lantos
This chapter chronicles the author's narrative following her new hypertension medication routine until her blood pressure met Mayo standards. It details the costs, the hassles, and the barriers to donating a kidney that the author experienced, notably the blood kit shipping glitch, the early arrival of the blood pressure cuff, and having to return the blood pressure apparatus and submit her PAP smear, colonoscopy, and mammogram results. The chapter then shifts to illustrate the results of the committee deliberation after the rigorous process and evaluation the author went through. Finally, the chapter presents the possibility of entering the Kidney Paired Donation program after the author and Deb Porter Gill obtained the results.
{"title":"The Odyssey Continues","authors":"M. Gershun, J. Lantos","doi":"10.7591/cornell/9781501755439.003.0012","DOIUrl":"https://doi.org/10.7591/cornell/9781501755439.003.0012","url":null,"abstract":"This chapter chronicles the author's narrative following her new hypertension medication routine until her blood pressure met Mayo standards. It details the costs, the hassles, and the barriers to donating a kidney that the author experienced, notably the blood kit shipping glitch, the early arrival of the blood pressure cuff, and having to return the blood pressure apparatus and submit her PAP smear, colonoscopy, and mammogram results. The chapter then shifts to illustrate the results of the committee deliberation after the rigorous process and evaluation the author went through. Finally, the chapter presents the possibility of entering the Kidney Paired Donation program after the author and Deb Porter Gill obtained the results.","PeriodicalId":297467,"journal":{"name":"Kidney to Share","volume":"116 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114946665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-15DOI: 10.7591/cornell/9781501755439.003.0005
M. Gershun, J. Lantos
This chapter evaluates the author's narrative after her meeting with Deb Porter Gill. It offers a variety of outcomes if the author had not liked Deb and withdrawn the offer to donate. That could have been for any reason, including political values, lifestyle, religion, or skin color. The chapter argues that living donors are treated by the law and by doctors as the owners of their bodies, and their body parts are considered goods that they can donate or not to whomever they want. The chapter examines the justice-based approach to organ allocation. In contrast with the living donors, cadaveric donors are generally put into national pools and allocated according to nationally agreed-upon criteria. The chapter states that their use is governed not by the autonomy-based preferences of the donor or the donor's family but, instead, by considerations of justice that are built into the administrative rules that dictate how organs should be allocated. Ultimately, the chapter presents the practical reasons for treating cadaveric organs differently than organs from a living donor.
{"title":"Do I Own My Organs?","authors":"M. Gershun, J. Lantos","doi":"10.7591/cornell/9781501755439.003.0005","DOIUrl":"https://doi.org/10.7591/cornell/9781501755439.003.0005","url":null,"abstract":"This chapter evaluates the author's narrative after her meeting with Deb Porter Gill. It offers a variety of outcomes if the author had not liked Deb and withdrawn the offer to donate. That could have been for any reason, including political values, lifestyle, religion, or skin color. The chapter argues that living donors are treated by the law and by doctors as the owners of their bodies, and their body parts are considered goods that they can donate or not to whomever they want. The chapter examines the justice-based approach to organ allocation. In contrast with the living donors, cadaveric donors are generally put into national pools and allocated according to nationally agreed-upon criteria. The chapter states that their use is governed not by the autonomy-based preferences of the donor or the donor's family but, instead, by considerations of justice that are built into the administrative rules that dictate how organs should be allocated. Ultimately, the chapter presents the practical reasons for treating cadaveric organs differently than organs from a living donor.","PeriodicalId":297467,"journal":{"name":"Kidney to Share","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128724602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-15DOI: 10.7591/cornell/9781501755439.003.0002
M. Gershun, J. Lantos
This chapter discusses a system for screening living donors. The chapter begins with a narrative of the author as she was anxiously waiting to hear whether the Transplant Selection Committee at the Mayo Clinic in Rochester, Minnesota, was going to approve her as a kidney donor. It then recounts the author's decision to donate one of her kidneys to a stranger. A few months earlier, she had read an article in the Kansas City Jewish Chronicle about a woman who needed a kidney. The article detailed how Deb Porter Gill had been diagnosed with insulin dependent diabetes and developed unrelated chronic kidney disease. The chapter narrates the reasons why Deb's story tugged at the author. Ultimately, the chapter looks at the importance of the whole series of evaluation and screening in kidney transplantation.
本章讨论筛选活体捐献者的制度。这一章从作者的叙述开始，她焦急地等待着明尼苏达州罗切斯特市梅奥诊所(Mayo Clinic)的移植选择委员会(transplantation Selection Committee)是否会批准她作为肾脏捐赠者。然后叙述了作者决定将她的一个肾脏捐给一个陌生人。几个月前，她在《堪萨斯城犹太纪事报》(Kansas City Jewish Chronicle)上读到一篇文章，说一位妇女需要一个肾脏。这篇文章详细描述了Deb Porter Gill是如何被诊断为胰岛素依赖型糖尿病并发展成无关的慢性肾脏疾病的。这一章叙述了黛布的故事吸引作者的原因。最后，本章着眼于整个系列的评估和筛选肾移植的重要性。
{"title":"Why Not Me?","authors":"M. Gershun, J. Lantos","doi":"10.7591/cornell/9781501755439.003.0002","DOIUrl":"https://doi.org/10.7591/cornell/9781501755439.003.0002","url":null,"abstract":"This chapter discusses a system for screening living donors. The chapter begins with a narrative of the author as she was anxiously waiting to hear whether the Transplant Selection Committee at the Mayo Clinic in Rochester, Minnesota, was going to approve her as a kidney donor. It then recounts the author's decision to donate one of her kidneys to a stranger. A few months earlier, she had read an article in the Kansas City Jewish Chronicle about a woman who needed a kidney. The article detailed how Deb Porter Gill had been diagnosed with insulin dependent diabetes and developed unrelated chronic kidney disease. The chapter narrates the reasons why Deb's story tugged at the author. Ultimately, the chapter looks at the importance of the whole series of evaluation and screening in kidney transplantation.","PeriodicalId":297467,"journal":{"name":"Kidney to Share","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116143832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-15DOI: 10.7591/cornell/9781501755439.003.0021
M. Gershun, J. Lantos
This chapter talks about the key lessons following the author's story. It argues that kidney donors are not patients in the traditional sense of that word, and should perhaps think of them as philanthropists who donate a body part instead of donating money. The chapter investigates the attitudes, procedures and practices, and ethos of transplant centers with regard to living donors. It examines the sorts of barriers that the author described, and studies how the process or the cost may put off good candidates to donate. The chapter then turns to discuss the significance of increasing the number of kidney transplants in society. It illustrates how research into the motivations of donors led to the development and widespread adoption of a set of guidelines for evaluating stranger donors. Ultimately, the chapter discusses transplant centers and advocacy organizations' use of conventional and social media, and personal networks to encourage, train, and help patients to “recruit” unrelated donors.
{"title":"Lessons Learned","authors":"M. Gershun, J. Lantos","doi":"10.7591/cornell/9781501755439.003.0021","DOIUrl":"https://doi.org/10.7591/cornell/9781501755439.003.0021","url":null,"abstract":"This chapter talks about the key lessons following the author's story. It argues that kidney donors are not patients in the traditional sense of that word, and should perhaps think of them as philanthropists who donate a body part instead of donating money. The chapter investigates the attitudes, procedures and practices, and ethos of transplant centers with regard to living donors. It examines the sorts of barriers that the author described, and studies how the process or the cost may put off good candidates to donate. The chapter then turns to discuss the significance of increasing the number of kidney transplants in society. It illustrates how research into the motivations of donors led to the development and widespread adoption of a set of guidelines for evaluating stranger donors. Ultimately, the chapter discusses transplant centers and advocacy organizations' use of conventional and social media, and personal networks to encourage, train, and help patients to “recruit” unrelated donors.","PeriodicalId":297467,"journal":{"name":"Kidney to Share","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131586330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-15DOI: 10.7591/cornell/9781501755439.003.0014
M. Gershun, J. Lantos
This chapter looks at how the author and Deb Porter Gill decided to go public on social media about their match. The chapter narrates the people's reactions upon hearing their story, most either thought the author was a living saint or a misguided fool. It also inspired some of their acquaintances to share their own family stories about kidney disease, organ donation, and other medical miracles. Some talked about the health problems that regrettably meant they could never donate. The chapter also mentions the Kansas City Jewish Chronicle's update to Deb's story, which launched quite a bit of quiet speculation in the Kansas City Jewish community about who had been identified as Deb's match.
{"title":"Going Public, Moving Forward","authors":"M. Gershun, J. Lantos","doi":"10.7591/cornell/9781501755439.003.0014","DOIUrl":"https://doi.org/10.7591/cornell/9781501755439.003.0014","url":null,"abstract":"This chapter looks at how the author and Deb Porter Gill decided to go public on social media about their match. The chapter narrates the people's reactions upon hearing their story, most either thought the author was a living saint or a misguided fool. It also inspired some of their acquaintances to share their own family stories about kidney disease, organ donation, and other medical miracles. Some talked about the health problems that regrettably meant they could never donate. The chapter also mentions the Kansas City Jewish Chronicle's update to Deb's story, which launched quite a bit of quiet speculation in the Kansas City Jewish community about who had been identified as Deb's match.","PeriodicalId":297467,"journal":{"name":"Kidney to Share","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122020458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-15DOI: 10.7591/cornell/9781501755439.003.0015
M. Gershun, J. Lantos
This chapter begins with Deb Porter Gill and the author's discussion about directed donation after their chain in the paired exchange called off. The chapter then displays Deb's frustrations with the Mayo Clinic's lack of communication and attention to detail in the process of her impending surgery and other necessary tests. It then turns to highlight the author's biggest obstacle: the dry ice saga. The author received an email from Mayo, with template language saying they were required to recheck blood for HIV and hepatitis within twenty-eight days of all organ donation surgeries. The chapter describes how the author struggled to find a dry ice source and shipment to ship the HIV-hepatitis lab kit back to Mayo on time.
{"title":"The Countdown Begins","authors":"M. Gershun, J. Lantos","doi":"10.7591/cornell/9781501755439.003.0015","DOIUrl":"https://doi.org/10.7591/cornell/9781501755439.003.0015","url":null,"abstract":"This chapter begins with Deb Porter Gill and the author's discussion about directed donation after their chain in the paired exchange called off. The chapter then displays Deb's frustrations with the Mayo Clinic's lack of communication and attention to detail in the process of her impending surgery and other necessary tests. It then turns to highlight the author's biggest obstacle: the dry ice saga. The author received an email from Mayo, with template language saying they were required to recheck blood for HIV and hepatitis within twenty-eight days of all organ donation surgeries. The chapter describes how the author struggled to find a dry ice source and shipment to ship the HIV-hepatitis lab kit back to Mayo on time.","PeriodicalId":297467,"journal":{"name":"Kidney to Share","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130707702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-15DOI: 10.7591/cornell/9781501755439.003.0022
M. Gershun, J. Lantos
This chapter looks at Deb Porter Gill's and the author's lives nearly two years since transplant operation. Both women continue to enjoy good health, with no significant complications from the procedure. It describes Deb's vigilant regimen of medications, as her prescriptions put transplant recipients at particular risk for COVID-19. The chapter also highlights Deb's periodic checkups and the author's sixth-month follow-up and last visit to the clinic. One year after the donation surgery, the author's tests showed that she continued to do well with one kidney. Ultimately, the chapter discusses the friendship they created following the surgery, and the author's partnership to write a book.
{"title":"Epilogue","authors":"M. Gershun, J. Lantos","doi":"10.7591/cornell/9781501755439.003.0022","DOIUrl":"https://doi.org/10.7591/cornell/9781501755439.003.0022","url":null,"abstract":"This chapter looks at Deb Porter Gill's and the author's lives nearly two years since transplant operation. Both women continue to enjoy good health, with no significant complications from the procedure. It describes Deb's vigilant regimen of medications, as her prescriptions put transplant recipients at particular risk for COVID-19. The chapter also highlights Deb's periodic checkups and the author's sixth-month follow-up and last visit to the clinic. One year after the donation surgery, the author's tests showed that she continued to do well with one kidney. Ultimately, the chapter discusses the friendship they created following the surgery, and the author's partnership to write a book.","PeriodicalId":297467,"journal":{"name":"Kidney to Share","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128379684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-15DOI: 10.7591/cornell/9781501755439.003.0003
M. Gershun, J. Lantos
This chapter focuses on the careful medical and psychosocial screening that is required for living donors. It analyzes the motivations of family donors, voluntariness, and the possibility of intrafamilial coercion. In the early days of transplantation, nobody was considering living donors who were unrelated to the recipient. That was partly for legal reasons, partly for emotional reasons, but mostly for medical reasons. The chapter then shifts to discuss the first kidney transplant that took place in 1950, and traces the discoveries and developments in early medical science. The key breakthrough in improving outcomes for liver, kidney, and heart transplants was the fortuitous discovery of a remarkable new immunosuppressive medication, cyclosporine, and better tissue typing. The chapter then investigates how these developments in immunosuppression and tissue matching improved the outcomes of transplantation from both related and unrelated donors.
{"title":"The Arcane Process of Screening Living Donors","authors":"M. Gershun, J. Lantos","doi":"10.7591/cornell/9781501755439.003.0003","DOIUrl":"https://doi.org/10.7591/cornell/9781501755439.003.0003","url":null,"abstract":"This chapter focuses on the careful medical and psychosocial screening that is required for living donors. It analyzes the motivations of family donors, voluntariness, and the possibility of intrafamilial coercion. In the early days of transplantation, nobody was considering living donors who were unrelated to the recipient. That was partly for legal reasons, partly for emotional reasons, but mostly for medical reasons. The chapter then shifts to discuss the first kidney transplant that took place in 1950, and traces the discoveries and developments in early medical science. The key breakthrough in improving outcomes for liver, kidney, and heart transplants was the fortuitous discovery of a remarkable new immunosuppressive medication, cyclosporine, and better tissue typing. The chapter then investigates how these developments in immunosuppression and tissue matching improved the outcomes of transplantation from both related and unrelated donors.","PeriodicalId":297467,"journal":{"name":"Kidney to Share","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126210179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-15DOI: 10.7591/cornell/9781501755439.003.0013
M. Gershun, J. Lantos
This chapter investigates why the various matching and swapping arrangements are hard to implement, arguing it is difficult to schedule even one transplant in ways that are convenient for the donor and meet the needs of the recipient. The chapter analyses the difficulties of this complicated exchange, especially if there are two or more transplants. With such awareness, the chapter reviews the innovative program that was recently initiated at the University of California, Los Angeles Medical Center, which allows people to donate a kidney today in exchange for a voucher that a designated recipient can redeem for a kidney in the future if and when a kidney is needed. Even though the new and more complex elaboration of paired exchanges or vouchers increased the pool of people who can donate and increased the chances for people on transplant waiting lists to get an organ, the chapter explores how they begin to look more and more like markets. And, in most countries, markets in organs are illegal.
{"title":"Complexities of Increasing Organ Supply","authors":"M. Gershun, J. Lantos","doi":"10.7591/cornell/9781501755439.003.0013","DOIUrl":"https://doi.org/10.7591/cornell/9781501755439.003.0013","url":null,"abstract":"This chapter investigates why the various matching and swapping arrangements are hard to implement, arguing it is difficult to schedule even one transplant in ways that are convenient for the donor and meet the needs of the recipient. The chapter analyses the difficulties of this complicated exchange, especially if there are two or more transplants. With such awareness, the chapter reviews the innovative program that was recently initiated at the University of California, Los Angeles Medical Center, which allows people to donate a kidney today in exchange for a voucher that a designated recipient can redeem for a kidney in the future if and when a kidney is needed. Even though the new and more complex elaboration of paired exchanges or vouchers increased the pool of people who can donate and increased the chances for people on transplant waiting lists to get an organ, the chapter explores how they begin to look more and more like markets. And, in most countries, markets in organs are illegal.","PeriodicalId":297467,"journal":{"name":"Kidney to Share","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129913409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-15DOI: 10.7591/cornell/9781501755439.003.0010
M. Gershun, J. Lantos
This chapter begins with detailing the author's final results following her three-day grueling tests for glucose tolerance, psychological screening, kidney function, EKG, and a chest X-ray. The author found out that there was an issue with her blood pressure. It then outlines the four available choices she could take: to end the process, to lose some weight and reduce salt intake and retest in a few months, to start on a very low dose of antihypertensive medication and retest in two weeks, and finally, to take her current results to the Transplant Selection Committee and hope for the best. Ultimately, the chapter presents an alternative plan, to become part of the Kidney Paired Donation program, if the new blood tests ruled the author unable to donate directly to the intended recipient.
{"title":"The Endgame","authors":"M. Gershun, J. Lantos","doi":"10.7591/cornell/9781501755439.003.0010","DOIUrl":"https://doi.org/10.7591/cornell/9781501755439.003.0010","url":null,"abstract":"This chapter begins with detailing the author's final results following her three-day grueling tests for glucose tolerance, psychological screening, kidney function, EKG, and a chest X-ray. The author found out that there was an issue with her blood pressure. It then outlines the four available choices she could take: to end the process, to lose some weight and reduce salt intake and retest in a few months, to start on a very low dose of antihypertensive medication and retest in two weeks, and finally, to take her current results to the Transplant Selection Committee and hope for the best. Ultimately, the chapter presents an alternative plan, to become part of the Kidney Paired Donation program, if the new blood tests ruled the author unable to donate directly to the intended recipient.","PeriodicalId":297467,"journal":{"name":"Kidney to Share","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133684791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：