Thursday, February 15, 2007

From the womb of my mother . . .
.
From Deathdealer’s blog

http://blogg.sol.no/deathdealer


Født til Donor!
27 January kl. 14:10

Donorsøsken tillatt! Endelig, vil alle vi som er eldst i søskeflokken kanskje si. Det var sannelig på tide. Skjønt, vi har jo alltid behandlet våre yngre brødre og søstere som en slags reserver - som skal trå til, når vi trenger det. Enten det gjelder å ta støyten for ugagn vi selv har bedrevet eller ile unnsettende til, når vi sitter som verst i klisteret. Hva annet har man småsøsken for? Med den nye loven om donorsøsken åpnes imidlertid nye muligheter. I kraft av deres nye status som mine potensielle organdonorer, må jeg i fullt alvor vurdere om mine småsøsken umiddelbart skal forbys å røyke og drikke, påbys å trene regelmessig, spise sunt og holde sine tanker moralsk plettfrie. Skjønt - det vil vel kanskje lovmakerne ta seg av. Det er jo ingen vits med donorsøsken, hvis de får løpe fritt og pådra seg både det ene og det andre - eller hva?

Free translation below.


Born to be a donor.

Donor-siblings are finally accepted !!
“Finally,” can all of us who are the older one among the siblings maybe say.
Although . . . we have always treated our younger siblings as a kind of “spare-thing” who shows up when we need them. Either it is the one to blame when we have done anything wrong or the one to come to our rescue if we have gone in “the pitfall.”
For what else do you have siblings?
With the new law, new options reveals.
In the virtue of the new law and the potential of future organ donor, I seriously have to look forward to that my siblings don’t start to smoke nor drink alcohol, I have to demand them to go to regular training, eat healthy and keep a high morale standard.
On the other hand . . . That’s maybe the authority’s job.
I mean . . . It doesn’t make sence with donor siblings, if they can run free and do whatever they want, incur the one illness after the other and so on . . . or what’s your opinion??

11 comments:

Hammer said...

I don't have any siblings, guess I'm out of luck lol.

Anonymous said...

In some European countries, blood, kidney, or bone marrow donations among siblings (and other relatives) have been common for decades. I cannot see something wrong in it as long as the donor is old enough to form his opinion and can decide on his own, without any pressure.

One of my own siblings refused to get tested as a donor. I have never had a problem to accept the decision and never brought up the topic again. Donations are gifts, and gifts can neither be expected nor exacted.

(Yes, I have heard about people who made a baby because they hoped the new child could save the life of an elder sibling who was in need of a bone marrow donation. I have to admit that I do have a problem with that way of thinking. But I do not walk in the boots of a desperate parent.)

Anonymous said...

p/s: Please excuse my posting anonymously again.

BBC said...

Hum, I don't know how it is over there. But some of it kind of makes sense.

It really doesn't matter in the long run though. Scientists parts of God will make it all better in the future.

And the present doesn't concern me as my DNA has been here since my conception millions of years ago.

BBC said...

Hammer, in a way you do. We are one. Your basic DNA is the same as mine or anyone else's.

Kirsten N. Namskau said...

Anonymus: Thank you for your comment. It is highly appreciated.
It's OK to be anonymus, don't worry about that.

What I think is the hidden question here, is the morality of the action. Can we have trust in that the donor agree in the act, if they start to use babies??? As they already have started to do.
How did the baby agree in the act of being a donor?

Kirsten N. Namskau said...

I can see that you already, in a way, have answered/given your opinion about that fact.

The other question I put is: Can we really trust that the donor, any donor, have given the aproval of being a donor.
Officially it is strict, yes....But the TRUTH of what they do...is that the same??

Also OFFICALLY, they have very strikt rules when they give blood-transfusion ... But how many per year get AIDS-infected blood-transfusion?
If they had followed the rules, it should have been impossible to use "rotten" blod.
And not only AIDS-infected ... What about all other kind of genetical problems following the blood they use?
I have heard about one who became alcoholic after a blood-transfusion. It showed up that the blood was taken from a heavy alcoholic and the blood had a high level of alcohol under the transfusion.
Can I mention problems as diabetic, liver-defects, medication that the giver has been taken is stored in the blood etc etc ...
They don't talk about it, because what the authorities don't talk about it not to worry about. The problems showing up afterwards is YOUR problems.
THEY DON'T CARE ...

Hammer said...

Yeah the mothers that give birth again so the sick child can have a bone marrow transplant, very weird and scary. So many ethical questions and so many sick people as a result of sloppy and ignorant medical practices.

Anonymous said...

Kirsten, I can follow your scepticism and indignation quite well. I cannot know about concealed incidents; but I remember reports of transmitted infections. Before consistent screening of blood donations, dozens of people in my country were infected with HIV by transfusions, which is a shame, as knowledge and tests would have been available already. However, their share in HIV infections per year never hit the one percent mark.

Twenty years later, donor selection and screening in Western Europe have reduced the number of HIV transmissions by blood transfusion next to zero. In England, screening blood donations for HIV antibodies began in 1985. After that, it took 11 years till the first HIV infection transmitted by blood transfusion was detected. For a short overview, see http://www.eurosurveillance.org/ew/1997/970501.asp#1
The abstract also cites a paper on the estimated risk of HIV transmission by screened blood donations in the United States: between 1 in 450.000 and 1 in 660.000 (units transfused, if I remember correctly).

(Concerning percentages and risk calculations: The studies and models do have their limitations, and national data characteristics do not facilitate comparisons between different countries. But the authors are usually aware of the limitations and try to make them transparent.)

For Spain and the period from 1997 to 1999, the residual risk of HIV infection by screened blood transfusions was 1.95 per million, or about 1: 512.820 donations, see
http://www.eurosurveillance.org/em/v10n02/1002-226.asp

NAT tests which are used to detect viral RNA can even lower the risk if used consistantly, see
http://www.eurosurveillance.org/em/v10n02/1002-227.asp

However, even by the help of the most elaborated, consistant, and careful screening, the residual risk can only be reduced, not eliminated. (That is why people should not misuse donation as free HIV tests.) Modern NAT tests still have a diagnostic gap of 10 to 15 days. Which means: Infections within the two weeks prior to donation go undetected. According to the model used in the study mentioned above, the risk of an undetected infection despite NAT testing is 1: 5.540.000.

(NAT means Nucleic Acid Amplification Test Technology. It allows to detect genetic material (nucleic acid), the viral RNA, for instance. PCR and TMA are NAT methods; usually, PCR is used to test pooled samples, TMA in single samples.
Older test technologies detect antibodies. ELISA and Western blot are two of those methods. They do have their advantages, but one has to wait till the infected organism has built enough antibodies. That is why the diagnostic gap for ELISA is at least 3 months.)

That is the situation in Western Europe. In the developing countries however, the risk is so high that it boosts the worldwide share of HIV infections by blood transmission to estimated 5 to 10%. There are many contributing factors, i.e.:

- high prevalence of infections, associated with ignorance of transmission risks and misconceptions on transmission
- lousy infrastructure (medical equipment, laboratories, cooling, transportation, etc.)
- absence of consistent screening, donor training, and donor selection
- not properly trained medical personnel
- inappropriate donation policy (i.e. payment of donors)
- inappropriate use of donations

In many developing countries, even the reuse of hypodermic needles, syringes and transfusion devices is still common, although infections of all kinds are very spread among the population.

So for those countries, we have:

- high prevalence of infections
- plenty of people who are in desperate need of every cent they can get
- the fact that due to their situation, poor people are more likely to suffer from infections
- a system where donors get paid or rewarded
- inappropriate handling of hypodermics

combined with the lack of donor selection and consistent screening.

I would think twice before accepting a blood transfusion in one of those countries, on moral grounds as well as for my own safety.

Some links:

PubMed abstracts (full text can be ordered)
- Safety of blood transfusion at the international level (full text in french only):
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17005427&query_hl=11&itool=pubmed_DocSum
- Blood safety in developping countries (1994):
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=7701809
- WHO on lack of governments' support for safe blood supply
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=12295854
- WHO on blood safety:
http://www.who.int/inf-pr-2000/en/pr2000-25.html

WHO on HIV and prevention:
http://www.euro.who.int/aids/prevention/20021127_2
http://www.euro.who.int/aids/prevention/20031114_1/
http://www.who.int/topics/hiv_infections/en/

Kirsten N. Namskau said...

Thank you for the information. You are so right in what you are telling us.
Here in Egypt ... (I don't think I have to say more than to name the country...)

Anonymous said...

Kirsten, I heard that Egypt finally changed the former policy on HIV and Hepatitis C, and that prevention campaigns as well as blood donation screening started three or four years ago –is that bogus? Or is it for the wealthy only? Both would be a very sad thing.

How about the standard of knowledge in general population: do ordinary people in Egypt know about HIV and prevention? Is therapy available?

I do not know how life in Egypt really is nowadays. But many years ago, I spent some time in Egypt and was simply charmed. Not by politics, of course, but by the culture as well as by the friendliness, the politeness and the decency of people. (And by the cuisine, I admit it.) Sadly, health care was a mess then and for ordinary people almost inexistent. I hope that is better now.