I want you to have my organs, but you can't have 'em

[Asher]

I think a lot of you missed this, by the way:

Transplant programs have been screening potential donors, but in some cases use organs from people in high-risk groups if they've tested negative for diseases. The new legislation means that practice must stop.

They already do screen and test the organs for diseases. This means that people waiting for the new organs -- even organs screened and tested -- have a smaller pool to get organs from. Given that a huge percentage of them will die before receiving an organ, I don't see how anyone at all can make a reasonable discussion against screening and testing "high-risk" organs but still permitting the patient to use them if they so choose.

[Perfection]

Ben, you have to admit Asher has a point. Certainly there are instances where a gay man has about the same risk as a heterosexual and this can be determined relatively easily. Also, we should note that there probably will be instances where a gay dude's organ would be the only option for a patient, and in that case transplantation might be worth the risks.

As such I think it's evident a straight ban should not be done.

[Reiko]

These policies are based on statistics. The US FDA has compiled some.

Why doesn't FDA allow men who have had sex with men to donate blood?

A history of male-to-male sex is associated with an increased risk for the presence of and transmission of certain infectious diseases, including HIV, the virus that causes AIDS. FDA's policy is intended to protect all people who receive blood transfusions from an increased risk of exposure to potentially infected blood and blood products.

The deferral for men who have had sex with men is based on the following considerations regarding risk of HIV:

* Men who have had sex with men since 1977 have an HIV prevalence (the total number of cases of a disease that are present in a population at a specific point in time) 60 times higher than the general population, 800 times higher than first time blood donors and 8000 times higher than repeat blood donors (American Red Cross). Even taking into account that 75% of HIV infected men who have sex with men already know they are HIV positive and would be unlikely to donate blood, the HIV prevalence in potential donors with history of male sex with males is 200 times higher than first time blood donors and 2000 times higher than repeat blood donors.
* Men who have had sex with men account for the largest single group of blood donors who are found HIV positive by blood donor testing.
* Blood donor testing using current advanced technologies has greatly reduced the risk of HIV transmission but cannot yet detect all infected donors or prevent all transmission by transfusions. While today's highly sensitive tests fail to detect less than one in a million HIV infected donors, it is important to remember that in the US there are over 20 million transfusions of blood, red cell concentrates, plasma or platelets every year. Therefore, even a failure rate of 1 in a million can be significant if there is an increased risk of undetected HIV in the blood donor population.
* Detection of HIV infection is particularly challenging when very low levels of virus are present in the blood for example during the so-called "window period". The "window period" is the time between being infected with HIV and the ability of an HIV test to detect HIV in an infected person.
* FDA's MSM policy reduces the likelihood that a person would unknowingly donate blood during the "window period" of infection. This is important because the rate of new infections in MSM is higher than in the general population and current blood donors.
* Collection of blood from persons with an increased risk of HIV infection also presents an added risk if blood were to be accidentally given to a patient in error either before testing is completed or following a positive test. Such medical errors occur very rarely, but given that there are over 20 million transfusions every year, in the USA, they can occur. That is one more reason why FDA and other regulatory authorities work to assure that there are multiple safeguards, not just testing.
* Several scientific models show there would be a small but definite increased risk to people who receive blood transfusions if FDA's MSM policy were changed and that preventable transfusion transmission of HIV could occur as a result.
* No alternate set of donor eligibility criteria (even including practice of safe sex or a low number of lifetime partners) has yet been found to reliably identify MSM who are not at increased risk for HIV or certain other transfusion transmissible infections.
* Today, the risk of getting HIV from a transfusion or a blood product has been nearly eliminated in the United States. Improved procedures, donor screening for risk of infection and laboratory testing for evidence of HIV infection have made the United States blood supply safer than ever. While appreciative and supportive of the desire of potential blood donors to contribute to the health of others, FDA's first obligation is to assure the safety of the blood supply and protect the health of blood recipients.
* Men who have sex with men also have an increased risk of having other infections that can be transmitted to others by blood transfusion. For example, infection with the Hepatitis B virus is about 5-6 times more common and Hepatitis C virus infections are about 2 times more common in men who have sex with other men than in the general population. Additionally, men who have sex with men have an increased incidence and prevalence of Human Herpes Virus-8 (HHV-8). HHV-8 causes a cancer called Kaposi's sarcoma in immunocompromised individuals.

http://www.fda.gov/cber/faq/msmdonor.htm

And that is just for blood donations. If you can be infected with blood then you can with organs.

Yet I'm sure somebody will claim these statistics are all fabrications.

[Ben Kenobi]

Ben, you have to admit Asher has a point. Certainly there are instances where a gay man has about the same risk as a heterosexual and this can be determined relatively easily.

How so?

What's to stop gay people from saying they are 'clean' so to speak? What this would do is force every donor to undergo testing for HIV, and that has problems with patient confidentiality and disclosure.

Honestly, screening is the better option.

Also, we should note that there probably will be instances where a gay dude's organ would be the only option for a patient, and in that case transplantation might be worth the risks.

And if someone dies from HIV contracted from an organ donation where the organisation knew there was a risk of such occurring? They would be sued to bankruptcy. It's not worth the risk, of killing a patient by cutting corners.

Secondly, even if we did what Asher said, we would have an increase in unsuccessful donations, where the success rate would go down and a very small increase in the number of total donations. Is that increase worth the lower success rate? It won't solve the organ problem, and it will lower people's confidence in organ transplantation. If even one in ten organ donors change their minds, then that will have an overall negative effect.

[Ben Kenobi]

What kind of diseases do you think monogamous homosexual couples get, Ben? What has your church told you?

I'm sure a perforated rectum is high and an associated infection would be high on the list of things that I would want to have. Maybe I should post some pictures too.

The difference is: intravenous drug use is inherently risky.

Monogamous gay sex is not.

They both have inherent health risks.

It's not an insult so much as a pertinent observation.

You should call a spade a spade. An insult is an insult, I'm sure you would consider it a 'pertinent observation' if I called you brainless.

I think the point is clear, if we allow gay men to donate then we ought to lift the same ban on intravenous drug users. After all the security of the blood supply is less important then assuaging hurt feelings.

[Perfection]

Originally posted by Ben Kenobi
What's to stop gay people from saying they are 'clean' so to speak? What this would do is force every donor to undergo testing for HIV, and that has problems with patient confidentiality and disclosure.

Shouldn't all donors be tested anyways?

Originally posted by Ben Kenobi
And if someone dies from HIV contracted from an organ donation where the organisation knew there was a risk of such occurring? They would be sued to bankruptcy. It's not worth the risk, of killing a patient by cutting corners.

Well, they'd definitely would need to provide informed consent of the risks here. With that could include liabiltiy waivers.

Originally posted by Ben Kenobi
Secondly, even if we did what Asher said, we would have an increase in unsuccessful donations, where the success rate would go down and a very small increase in the number of total donations. Is that increase worth the lower success rate? It won't solve the organ problem, and it will lower people's confidence in organ transplantation. If even one in ten organ donors change their minds, then that will have an overall negative effect.

This seems more like a data presentation problem then an actual problem. We could for instance take data for both high risk operations and low risk operations.

[Perfection]

Originally posted by Ben Kenobi
I'm sure a perforated rectum is high and an associated infection would be high on the list of things that I would want to have. Maybe I should post some pictures too.

That sounds excruciatingly painful, which would mean it probably wouldn't go undetected for long and lead to a considerable risk with transplantation.

[Dinner]

Every blood donation is screened prior to use so I figure every organ is as well.

[DrSpike]

If you accept an organ transplant from a homosexual does that turn you into teh gay?

[Proteus_MST]

Originally posted by Ben Kenobi

So why should we accept donations that are harmful just to make the donor feel better?

They aren´t harmful.
We´re talking about organs that are perfectly O.K. but whose donors are disallowed to donate them just because oif their sexual preference.

I haven´t seen a study to date that puts gay persons at such a high risk that the risk involved in getting organs from gay persons cancels out the usefulness of the organs given by them.

And whose "feelings" are more hurt?
That of the gay man dying and not being able to donate his perfectly healthy organs, or that of the possible receiver who finally dies, because the only suitable heart he could gave gotten was in the body of a gay person?

Well, even if the risk for gay persons might be slightly higher, you could just screen the organs of gay men more thorougly before transplantation. Every life counts, even the life of those whose life might only be saved by accepting organ donations from gay persons.

[Asher]

Originally posted by Ben Kenobi
How so?

What's to stop gay people from saying they are 'clean' so to speak?

What's to stop straight drug users from saying they are 'clean' so to speak?
What's to stop a HepC or HIV-infected straight person from saying they are 'clean'?

Honestly, screening is the better option.

All organs need to be screened and tested by law anyway.

And if someone dies from HIV contracted from an organ donation where the organisation knew there was a risk of such occurring? They would be sued to bankruptcy. It's not worth the risk, of killing a patient by cutting corners.

So why is it okay to kill the patient by withholding healthy organs?

Secondly, even if we did what Asher said, we would have an increase in unsuccessful donations, where the success rate would go down and a very small increase in the number of total donations.

Proof? This sounds like BS to me.

Please provide evidence that someone in Canada was given an HIV-infected organ that was screened for HIV.

Is that increase worth the lower success rate?

Do you think everyone is ridiculously stupid?

You're making absurd assumptions that don't make any sense at all, except to somebody who thinks all gays are diseased, then making that the pillar of your argument.

[Asher]

Originally posted by Ben Kenobi
I'm sure a perforated rectum is high and an associated infection would be high on the list of things that I would want to have. Maybe I should post some pictures too.

How does an infection in a perforated rectum affect, say, the heart? And how often do you think this happens? I know a LOT of gay people, but none have ever experienced this. What's the rate of this, since apparently you think it's quite high?

They both have inherent health risks.

No, they don't. A monogamous gay relationship is no more a health risk than a monogamous heterosexual relationship.

You should call a spade a spade. An insult is an insult, I'm sure you would consider it a 'pertinent observation' if I called you brainless.

Since I have demonstrated the capacity for original thought not shoved down my throat by church doctrine, it would not be a pertinent observation.

I think the point is clear, if we allow gay men to donate then we ought to lift the same ban on intravenous drug users.

Your point is clear, but it's nonsense. There is nothing inherently dangerous to the organs of a person by having monogamous sex, whether it's hetero or homo. Despite the fact that you think gays have cooties, that's not relevant here.

After all the security of the blood supply is less important then assuaging hurt feelings.

As has been repeatedly said -- it's not about hurt feelings (and this isn't about blood supply, please focus), it's about the fact that a huge portion of people waiting organ transplants die waiting. And this blanket rule will needlessly throw out perfectly healthy organs that the doctors (and most patients) themselves would prefer to use.

[Asher]

Originally posted by Perfection
Shouldn't all donors be tested anyways?

ALL blood and organs donated ARE tested. Ben is ignorant on the subject.

[Patroklos]

I'm not sure if you're aware of this, but Health Canada is a beurocratic nightmare of an entity full of politicians and people with degrees from 3rd world countries.

Socialized health care

In any case, is not the instance of HIV dramatically higher in the gay community in the US and Canada?

And prescreening organs only goes so far. There is nothing to stop you from doing all sorts of risky behavior between that screening and your horrific car accident.

In any case, the simple fact is people have crunched the numbers and that is that. The risk outweighs the benefits, and until someone crunches the numbers different (and the doctors in the article didn't) that is the way it is.

You can not screen for HIV for things like heart and lung transplants, the operation goes down within 48 hours (maybe less) of organ availability.

[Patroklos]

ALL blood and organs donated ARE tested.

For what, and how accurately? What are the time periods required for some of these tests? Are they longer than the timeline needed for a lung transplant?