Re: New UNOS Rules

[Guest guest]

This has probably been asked before, but if a person is a poor candidate for

tx but were to get it anyway and then die, can't we just pass the liver on

to someone else again? (Assuming we aren't talking about cancer or

something.)

----- Original Message -----

.. Creatanine varies with the amount of muscle mass an

> individual has as well as their kidney function. Usually women have

> lower creatanine values because they aren't as muscular as men and are

> usually smaller in body size overall, as well. As you get older or less

> fit, your creatanine goes down. Sometimes to values below the normal

> range. In my elderly patients most have creatanine levels below normal.

> We should probably have a different normal range for elderly patients

> but this research has not been done.

> People with severe liver disease and kidney involvment are very sick and

> have a very poor prognosis and short life expectancy. That is the reason

> for moving them up the list, if they are being considered for tx.

> Every doctor dreads having to make the decision not to offer a treatment

> such as tx or cardiac bypass, etc. Because medicine is both an art and a

> science, there are few hard and fast rules. We know that with certain

> numbers (test values) and certain clinical signs and symptoms, some

> patients are very poor candidates for these procedures. When the supply

> of organs is vastly out numbered the patients needing them, it makes the

> decisions to tx a very sick patient ever more difficult. Most of us

> would like to have some guidence that we can go by, point to, to aide

> our decision and make it so that we are not passing the final vote to

> say yeah or neh. I'm sure that is what was on those doctors minds when

> that discussion came up.

>

> Aubrey