If you have PBC, the idea that someday you might need a liver transplant isn’t easy to think about. I know I didn’t want to consider it, when I was diagnosed in 1992.
But I wish I’d been more prepared for the challenges that arose in 2005, when I learned that I needed a new liver. I hope that sharing my story, today, will help you if and when a transplant becomes necessary.
Source: Living Donor Liver Transplant Provides New Lease on Life – American Liver Foundation
Some Kentucky surgeons worry that a new way of allocating livers to U.S transplant patients could be detrimental, or even deadly, to people in the bluegrass state.
“The fear in Kentucky and many southern states, and many states that have transplant centers that represent rural patients, is … we’re going to become organ farms for large cities,” said Dr. Malay Shah, surgical director of liver transplant for UK HealthCare in Lexington.
The board that handles the issue on a national level passed a new policy earlier this month that will give patients who live in distant locales, such as Chicago, access to livers donated in Kentucky. The policy affects the handling of livers from most deceased adult donors across the country.
Source: Will new U.S. policy make it too hard for Kentuckians to get liver transplants? – Insider Louisville
A bill to expand organ donor registration in Kentucky has successfully made it through the state House of Representatives and now awaits Gov. Matt Bevin’s signature. It is expected to take effect next year.
The legislation, backed by Kentucky Organ Donor Affiliates and Kentucky Circuit Court Clerks’ Trust for Life, was approved by the House on Tuesday after being passed by the Senate earlier this month.
Senate Bill 77 will make it possible to register for organ donation through the Kentucky Online Gateway, a single sign-on system for accessing various government programs. The public also can continue to use old methods, such as signing up when getting a driver’s license or by going online to donatelifeky.org.
Source: Organ donation bill passes in Frankfort, heads to governor’s desk – Insider Louisville
We have a liver selection meeting every Wednesday to consider which patients will get transplants. Each patient is listed by name, age, weight, diagnosis and MELD score – a number, based entirely on lab values, that predicts how bad their liver is and correlates with how likely they are to die waiting for a transplant. A score of 15 is where we start to consider transplantation, and 40 means a 90 percent chance of dying within three months.
Scanning the list, I noticed with discomfort that the patients at the top, with a MELD of 35 or more, had mostly the same diagnoses: alcoholic liver disease; nonalcoholic steatohepatitis, or NASH, a consequence of obesity leading to fatty liver; and an occasional hepatitis C, a virus that was once the most common indication for liver transplant but now is being cured. This was not surprising. These diagnoses make up greater than 60 percent of the national waitlist, and that number continues to grow.
Source: One number determines who gets an organ transplant, and it’s horribly unfair – Chicago Tribune
Physicians, nurses, and other clinicians readily acknowledge being troubled by encounters with patients who trigger moral judgments. For decades social scientists have noted that moral judgment of patients is pervasive, occurring not only in egregious and criminal cases but also in everyday situations in which appraisals of patients’ social worth and culpability are routine. There is scant literature, however, on the actual prevalence and dynamics of moral judgment in healthcare. The indirect evidence available suggests that moral appraisals function via a complex calculus that reflects variation in patient characteristics, clinician characteristics, task, and organizational factors. The full impact of moral judgment on healthcare relationships, patient outcomes, and clinicians’ own well-being is yet unknown. The paucity of attention to moral judgment, despite its significance for patient-centered care, communication, empathy, professionalism, healthcare education, stereotyping, and outcome disparities, represents a blind spot that merits explanation and repair. New methodologies in social psychology and neuroscience have yielded models for how moral judgment operates in healthcare and how research in this area should proceed. Clinicians, educators, and researchers would do well to recognize both the legitimate and illegitimate moral appraisals that are apt to occur in healthcare settings.
Source: How clinicians make (or avoid) moral judgments of patients: implications of the evidence for relationships and research
I had a three tube blood draw and a urine sample today (02/22/2019) for my internal medicine doctor. I am working with the doctor for help controlling the diabetes type 2 that I have.