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PostPosted: Tue Oct 13, 2009 11:12 am 
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heard this on the radio this morning and all I could think was WTF..

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LONDON, England (CNN) -- A leading UK hospital has defended its practice of using organs donated by smokers after the death of a soldier who received the cancerous lungs of a heavy smoker.

Corporal Matthew Millington, 31, died at his home in 2008, less than a year after receiving a transplant that was supposed to save his life at Papworth Hospital -- the UK's largest specialist cardiothoracic hospital, in Cambridgeshire, east England.

Papworth Hospital released a statement saying using donor lungs from smokers was not "unusual."

The statement added that the hospital had no option but to use lungs from smokers as "the number of lung transplants carried out would have been significantly lower," if they didn't.

An inquest held last week heard that Millington, who served in the Queen's Royal Lancers, was serving in Iraq in 2005 when he was diagnosed with an incurable condition that left him unable to breathe.

He was told he required a transplant and in April 2007 received a double lung transplant at Papworth Hospital.

Less than a year later, doctors discovered a tumor in the new lungs. Despite radiotherapy, Millington died on February 8, 2008, at his family home near Stoke-on-Trent, in Staffordshire.

The inquest found a radiologist failed to highlight the growth of a cancerous tumor on the donor lungs.

Tests found that he had received the lungs of a donor who smoked up to 50 cigarettes a day, the inquest at North Staffordshire coroner's court heard.

The hospital said in the statement: "This is an extremely rare case. Papworth Hospital has a very strong track record of high quality outcomes and this is an extremely rare case.

"Patients who are accepted on to the transplant waiting list have no other option open to them, however, we must stress that all donor organs are screened rigorously prior to transplantation.

"Using lungs from donors who have smoked in the past is not unusual. During 2008/09 146 lung transplants were carried out in the UK.

"During the same period 84 people died on the waiting list. If we had a policy that said we did not use the lungs of those who had smoked, then the number of lung transplants carried out would have been significantly lower."

The tumor's growth was accelerated by the immuno-suppressive drugs Millington was taking to prevent his body rejecting the transplanted lungs, the inquest heard.

North Staffordshire coroner Ian Smith recorded that Millington, had died of "complications of transplant surgery and immuno-suppressive drug treatment."


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PostPosted: Tue Oct 13, 2009 11:31 am 
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I second the WTF. Sad.


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PostPosted: Tue Oct 13, 2009 12:10 pm 
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Indeed. Sad.

However, at least he got an extra year of life...

Silver lining and all that jazz.

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PostPosted: Tue Oct 13, 2009 12:43 pm 
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Yeah, while sad, this does come under the category of "Having some time is better than none", to me.

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PostPosted: Tue Oct 13, 2009 12:48 pm 
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A year longer going through several months of recovery from the surgery, then chemo and finally death by cancer?

I suppose he and his family might be thankful for any time, no matter the conditions, but to me, its the policy that doesn't make any sense.

Would you support eye transplants with cataracts? liver transplants from Hepitis patients?


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PostPosted: Tue Oct 13, 2009 12:54 pm 
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Well, obviously they shouldn't do it if they know the lungs have cancer. But they didn't know, and just because a person smokes 50 cigarettes a day doesn't mean they have cancer. Not allowing the donation of lungs of smokers would result in more deaths.


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PostPosted: Tue Oct 13, 2009 12:55 pm 
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Ladas wrote:
Would you support eye transplants with cataracts? liver transplants from Hepitis patients?


Of course not. I don't support the actual transplanting cancer into someone... that verges on Mengele territory.

But, as a snark... Hooray for British Healthcare! The GOLD Standard in Socialized Medicine!

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PostPosted: Tue Oct 13, 2009 12:58 pm 
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50 cigarettes a day is a lot. That is like two and a half packs a day. I don't see how they could rationalize that at all.

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PostPosted: Tue Oct 13, 2009 1:43 pm 
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LK:

You don't see how who could rationalize that?

The smoker? I'm guessing you aren't referring to him.

If you mean the transplant hospital, I'd venture to guess that they rationalized it by screening the lungs for cancer, and finding none, deciding that transplanting the lungs was better than letting him die on the waiting list.

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PostPosted: Tue Oct 13, 2009 2:22 pm 
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Hahaha, no not the smoker.
It would seem to me that a set of lungs from a 2.5 pack a day smoker would automatically be rejected. It seems like common sense to me? You can screen for cancer, but in its earliest stages it could still go undetected especially in a situation like organ transplant/donation where time is of the essence and testing is liable to be hurried.

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PostPosted: Tue Oct 13, 2009 2:27 pm 
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Being very generous, lets say there is a 20% chance that lungs donated by a 2.5 pack a day smoker have undetectable cancer. If you had a 99.9% chance of dying if you got no lung transplant, wouldn't you want to take the 80% chance that the smokers lungs didn't have cancer?


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PostPosted: Tue Oct 13, 2009 2:31 pm 
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LadyKate wrote:
You can screen for cancer, but in its earliest stages it could still go undetected especially in a situation like organ transplant/donation where time is of the essence and testing is liable to be hurried.


In theory, the supply of donor tissue/organs should never be hurried, as it is a relatively steady and stable process.

The recipient's testing might be hurried, leading to a mismatch; but that would have nothing to do with receiving tissue/organs susceptible to cancer.


Basically it comes down to what the standard of practice is, and whether regulators/society deems is an appropriate standard of practice. Apparently in England, smokers' lungs are acceptable provided no evidence of cancer is found. I'm not sure about the standard here.

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PostPosted: Tue Oct 13, 2009 2:35 pm 
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Aegnor wrote:
Being very generous, lets say there is a 20% chance that lungs donated by a 2.5 pack a day smoker have undetectable cancer. If you had a 99.9% chance of dying if you got no lung transplant, wouldn't you want to take the 80% chance that the smokers lungs didn't have cancer?


Yeah. More than likely.

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PostPosted: Tue Oct 13, 2009 2:48 pm 
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And that is the conclusion that they've come to. Restricting these types of lungs would likely needlessly result in deaths. That, rarely, someone might contract cancer from the lungs and die, is a small price to pay, considering they would have likely died earlier anyway, if they didn't recieve the lung transplant.

It definately sucks for this guy, but I don't think they should make any policy changes, except maybe making sure that they are properly screening the donated lungs for cancer, given the time constraints.


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PostPosted: Tue Oct 13, 2009 2:52 pm 
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You're right. It just seems really crappy...I feel bad for the guy.
I guess those things do happen and its a risk he was probably willing to take.

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