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My Transplanted Heart and I Will Die Soon

4 points by dmitrygr 4y ago

gus_massa 4y ago
A sad story, but it looks like the "Why they didn't cure cancer?" comments each time we had the sad news of another person that died to cancer. For cancer the best explanation I found is https://phdcomics.com/comics.php?f=1162 https://phdcomics.com/comics.php?f=1162 There is a tradeoff, how to kill the cancer without killing the person, and it's hard. My guess is that for transplants it's possible to make a similar sad comic. There are just too many small problems to solve, and solving each one gives only an improvement of 1%. One tradeoff is to select an organ that is as compatible as possible with the recipient, but you can wait forever until there is a perfect match. Another tradeoff is how much immunosuppressant to give, too few and the organ is rejected, too much and other illness kill the recipient. There are probably a few more... > And for the patients who have called me or written from their post-transplant deathbeds, dismayed, “I did my best, I took every pill, every day. …” I blame medic miscommunication here. Even if you follow each step 100% you still don't get a 100% success long term. Sometimes medic like to give the optimistic happy path, and don't explain the hard parts. My recommendation is to ask random questions about bad outcomes, they sometimes try to explain that it's not so bad and the explanation has some info about the unhappy path. > Indeed, the prevailing metric for success as codified by the Health Resources and Services Administration is only one year of post-transplant survival, which relieves pressure for improvement. I doubt everyone is happy with the 1 year survival rate statistic. For example I found this: "Recent advances in heart transplantation" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039932/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039932/ > Perhaps this is why life expectancy after heart transplantation is little changed compared to when I received a heart in 1988. Is this correct? Here I found some current numbers https://www.medicinenet.com/how_long_can_you_live_after_a_heart_transplant/article.htm https://www.medicinenet.com/how_long_can_you_live_after_a_he... Is it possible to find the numbers from 1988? There is a similar problem with cancer, because life expectancy has increased, but the change is not visible enough.

4 points by dmitrygr 4y ago

A sad story, but it looks like the "Why they didn't cure cancer?" comments each time we had the sad news of another person that died to cancer. For cancer the best explanation I found is https://phdcomics.com/comics.php?f=1162 https://phdcomics.com/comics.php?f=1162 There is a tradeoff, how to kill the cancer without killing the person, and it's hard. My guess is that for transplants it's possible to make a similar sad comic. There are just too many small problems to solve, and solving each one gives only an improvement of 1%. One tradeoff is to select an organ that is as compatible as possible with the recipient, but you can wait forever until there is a perfect match. Another tradeoff is how much immunosuppressant to give, too few and the organ is rejected, too much and other illness kill the recipient. There are probably a few more... > And for the patients who have called me or written from their post-transplant deathbeds, dismayed, “I did my best, I took every pill, every day. …” I blame medic miscommunication here. Even if you follow each step 100% you still don't get a 100% success long term. Sometimes medic like to give the optimistic happy path, and don't explain the hard parts. My recommendation is to ask random questions about bad outcomes, they sometimes try to explain that it's not so bad and the explanation has some info about the unhappy path. > Indeed, the prevailing metric for success as codified by the Health Resources and Services Administration is only one year of post-transplant survival, which relieves pressure for improvement. I doubt everyone is happy with the 1 year survival rate statistic. For example I found this: "Recent advances in heart transplantation" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039932/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039932/ > Perhaps this is why life expectancy after heart transplantation is little changed compared to when I received a heart in 1988. Is this correct? Here I found some current numbers https://www.medicinenet.com/how_long_can_you_live_after_a_heart_transplant/article.htm https://www.medicinenet.com/how_long_can_you_live_after_a_he... Is it possible to find the numbers from 1988? There is a similar problem with cancer, because life expectancy has increased, but the change is not visible enough.