Vezna Hang and her son. Hang was so sick with COVID-19 before he was vaccinated that he needed a double lung transplant. Now he encourages others to get injections.
Vezna Hang
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Vezna Hang
Vezna Hang and her son. Hang was so sick with COVID-19 before he was vaccinated that he needed a double lung transplant. Now he encourages others to get injections.
Vezna Hang
According to figures from the American Organ Sharing Network, about 1 in 10 lung transplants in the United States are performed for COVID-19 patients.
This trend is raising questions about the ethics of allocating scarce resources to those who have chosen not to get vaccinated against the coronavirus.
“They’re accumulating steadily. So it’s very much a reality,” said David Klassen, UNOS’s medical director.
“If there were more lungs to transplant, I believe the number would be greater than them,” he said.
According to the latest UNOS figures from October this year, 238 people across the country have received lung transplants due to COVID-19 since the first surgery was followed up in August 2020.
According to UNOS data, the number of lung transplants for COVID patients has increased tenfold from the first year of the pandemic to 2021, according to UNOS data, the number of transplants for other top lung diseases, such as emphysema, cystic fibrosis and pulmonary fibrosis, all decreased compared to previous years.
“It’s happening in the US. It’s happening in Canada, too. New Haven Health Transplant Center,” said David Mulligan, president of Yale.
More than 2,000 common lung transplants are performed each year in the US, costing about $1.2 million for a double lung transplant.
The rise in COVID-related transplants is forcing doctors to grapple with how to best manage those who receive them, especially now that vaccines are widely available.
“When someone has COVID so severe that they need a lung transplant, and they refuse to get vaccinated, it’s an ethical dilemma,” says Mulligan. “How can they jump in and take a lung from someone who is sick, but is doing the best they can to take care of themselves and avoid getting COVID?”
The Ethic of Non-judgment
Transplant centers consider a variety of factors when listing people who need organs. But social and behavioral factors – such as how people get sick – are often not included.
Smokers may be eligible for a lung transplant, just as excessive drinkers can also be listed for a new liver if they haven’t smoked or been sober for six months.
Not judging people’s past behavior is pretty standard in medicine. But future behavior, when it comes to implants, is fair game, according to Olivia Kates, an assistant professor of medicine at Johns Hopkins.
“I think [COVID-19 patients] Kates says they must be vaccinated or be able to demonstrate immunity to COVID-19 in the future, so that their next set of lungs are not at risk,” said Kates.
Some transplant centers said patients would lose their place on the list if they weren’t vaccinated against the coronavirus.
But some say that excluding anyone who has not been vaccinated against COVID to even be considered for an agency might be unfair because it could exclude racial, religious or ethnic groups that have lower vaccination rates.
The current system of people on the transplant waiting list strives for fairness and favors “those who can’t wait any longer for their organs, but if they get an organ, they have a chance.” society benefits and retains that agency,” said Govind Persad, who teaches bioethics and health law at the University of Denver.
When a transplant is the only option
Candidates for lung transplants after COVID-19 are often young and healthy, like 41-year-old Vezna Hang. He got COVID in March of this year, not long after moving to Tampa from New York. His symptoms were barely noticeable, just a loss of taste and smell at first.
Vezna Hang and her son visit outside the hospital in the spring of 2021.
Vezna Hang
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Vezna Hang
“One day, I just looked in the mirror and saw that my lips and fingertips were blue,” he said.
Constants have no base conditions. But COVID-19 caused inflammation in his lungs, leading to permanent scars. A transplant is his only option.
“For the first time in my life, I was scared. And from day to day, there were times when I really didn’t think I was going to make it. And leaving my son, you know, that caused it. a lot of trouble for me.” my mind.”
The father of 5-year-old Hang was not vaccinated when he was sick. Florida didn’t open up access to vaccines to his age group, 40 and older, until late March, after he fell ill.
But Hang understands people who are unsure about injections. He said he was one of them before he got sick.
“This terrible virus hits everyone differently. It’s unpredictable,” Hang said.
“From what I’ve been through, being inside the hospital and seeing all the unvaccinated people being hospitalized, it really motivates me, my family and my friends to get vaccinated. room,” he added.
The caregiver’s dilemma
There is no overarching national policy on how to handle transplant rejection. American Society of Transplantation Surgeons Vaccination is recommended for anyone awaiting a transplant. Doctors say that’s because the immune response is stronger if a patient is vaccinated before, rather than after, a transplant.
Deborah Adey, a kidney transplant specialist at the University of California San Francisco, says it’s not usually patients who are difficult to convince.
Adey, who has seen transplant patients years ago fall ill with COVID after living with unvaccinated family members, said: “Where we got into trouble was because caregivers.
“There are always anti-vaxxers around. That’s not entirely new. But this level of resistance to doing something for the public good? I’ve never seen anything like this,” said Adey. added.
Kiran Dhanireddy, executive director of the transplant institute at Tampa General Hospital, said community exposure poses serious risks, especially with a highly contagious variant like delta.
“Especially during this last surge, we had a number of transplant patients die from COVID,” he said. “And these are patients who have been largely vaccinated, but because their immune systems are suppressed, they don’t have a normal immune response to the vaccine, and therefore don’t have the same level of protection.” a normal person. “
People living with donated organs must take immunosuppressive drugs for life to prevent their bodies from attacking and rejecting new organs, making them more vulnerable to COVID-19 while it’s around. .
