Transplant patients given lungs of smokers due to shortage of organ donors
Desperate transplant patients are being given the lungs of chain smokers because the NHS is so short of organ donations. Surgeons are also being forced to use diseased body parts from cancer sufferers, drug addicts and the very elderly.
Experts say that the waiting list for transplants has now grown so long that hospitals are increasingly resorting to implanting so-called ‘high risk’ organs.
There are around 8,000 people needing an organ donation at any one time and every day three patients die because they do not get one in time. As a result, doctors say that most patients would probably accept a ‘high risk’ or ‘marginal’ organ as without it they may not survive the year.
They are also using tissue from those more at risk of carrying HIV and Hepatitis C such as gay men and drug users. These groups are not allowed to give blood but they can donate organs simply because there is such a shortage.
Professor James Neuberger, associate medical director of the NHS Blood and Transplant, the Government agency responsible for organ donations said: ‘In an ideal world you would rather have lungs from 20-year-old healthy people who have never smoked, but that isn’t a luxury we have. ‘You have to say do you get a lung with more risk or do you get no lung? ‘That sounds crude and brutal but it is the reality.
‘If I were to put it to you or a member of your family that there was a 50 per cent chance of transmitting a virus or a 100 per cent of dying, it will come down to the balance of risk.’
Last week doctors warned that the quality of organs was decreasing because growing numbers of donors are either obese or very elderly. Up to a quarter of dead donors are very overweight compared to just a seventh ten years ago, according to figures from NHS Blood and Transplant. The number of donors over 70 has also quadrupled in the last decade.
Those who are obese are more likely to have coronary heart disease, so their hearts are damaged, as well as fatty livers and pancreases which will not function as well. All organs decline with age so they will less useful for the donor.
Although some patients are specifically asked whether they are happy to take a ‘high risk’ or ‘marginal’ organ, the decision is often left to the doctor. The NHSBT is now drawing up new guidelines which are expected to require hospital staff to check with patients whether they will accept potentially damaged organs.
Dr Alexander Gimson, a liver specialist at Addenbrooke’s hospital, Cambridge, who is advising on the guidance said: ‘We say to people: look, all organs have a risk, some high risk, some low risk, please trust us, we will give you the one that is best for you but we will not necessarily ring you at 2am and say do you want this particular one? ‘We will say here is your organ.
‘I would use an organ from a 100-year-old patient. There is no limit to the age you can use a liver and now we can say what the risks associated with it are. ‘We have certainly, and so have other units, transplanted organs from 70-year-olds.’
‘But last year a young woman died just five months after being given the lungs of a 30-a-day smoker.’ Lyndsey Scott, 28, a cystic fibrosis sufferer, developed severe pneumonia shortly after the transplant.
She was never told the organs would be coming from a smoker and her family claimed that she would never had gone ahead with the operation if she had known.
The mawkishness that shows Britain no longer knows what its heroes are dying for
They were words one hardly expected to hear from one of our most distinguished military figures — especially in the week of Remembrance Sunday. However, that only makes the comments at the weekend of Lieutenant-General Sir Robert Fry, former commander of British forces in Iraq, all the more disturbing.
He said the British people had developed a dangerously ‘mawkish’ attitude towards the Armed Forces. ‘I think that the British people hold the Armed Forces in a state of excessive reverence at the present time. It is a greater infatuation than at any other stage of recent military history that I can recall,’ he said.
With these comments, he has put his finger on a subtle, but crucial and potentially catastrophic shift in our national psyche.
So what’s wrong with ‘reverence’, you may ask. Well, General Fry is making a brutal and, indeed, shocking observation – that the British hold dead soldiers in deep esteem while despising the causes for which they are currently laying down their lives.
This is because fundamental assumptions about this nation and the wars fought on its behalf have been shattered. For most of the past two centuries, he observed, there had been an unspoken agreement that any war fought by Britain would be based on acknowledged rules; this country would most likely win that war; and the outcome would be largely beneficial. That consensus, however, was broken with the war in Iraq — and may never be repaired.
The result has been that the public now mourn excessively the soldiers who have fallen in battle — who are seen increasingly as the victims, not of the enemies of this country but of its government that commits Britain to fight wars its people no longer support.
That is an utterly devastating observation. Devastating because it is true — and because of its implications. For Britain is a fighting nation. It is a land of historic and classic warrior heroes. Military power is part of its DNA.
For centuries, it has successfully used that power to advance its national interests abroad and defend them at home. From the Armada to Trafalgar to the Battle of Britain, military prowess has been synonymous with British greatness and is etched deep into the nation’s cultural memory.
Understanding the fact that wars to defend the nation inescapably entail sacrifice, the British once bore such losses stoically. Until now — when public displays of emotion over fallen soldiers have reached such a pitch that Michael Clarke, director of the Royal United Services Institute, has described them as ‘recreational grief’ in memory of soldiers sent by useless governments to fight pointless wars.
Such erosion of the consensus about military power arguably started long before Iraq. The widespread use of British soldiers in ‘peace-keeping forces’ stretched the patience of the public, who often found it hard to understand why it was necessary to police the world in this way, let alone see what good it did.
It is rooted further back still, in the last century’s two world wars which, although Britain won them, exacted a terrible toll of casualties and provoked as a result a near-terminal revulsion against war itself.
There is surely a more profound reason still. The acceptance that soldiers fight and die for the good of the nation is based on belief in something beyond the self. But with the erosion of religious faith and the corresponding conviction that there is nothing beyond this world, the idea of dying for any cause becomes less and less persuasive.
Virtues such as heroism, altruism and self-sacrifice have thus been displaced by the culture of instant gratification, while true feeling for others has been replaced by false emotion or mawkish sentimentality.
Throughout this dismaying process of cultural decline, the Armed Forces have remained virtually the last redoubt of Britain’s vanishing virtues such as courage, orderliness, stoicism and an unshakeable belief in the greater good.
But all around, the rest of British society has been losing its belief in the nation — and its willingness to fight and die to defend it. And if the public no longer supports the aims for which the Armed Forces wage war, these suffer a catastrophic slump in morale. As Chief of the Defence Staff, General Sir David Richards has ominously warned about the premature withdrawal of troops from Afghanistan: ‘If we lose this war, it will be in the homes of this country, as people tire of it.’
Rightly or wrongly, the war in Iraq shattered public trust in the political and defence establishment ever to tell the truth about why a war is necessary in the national interest. Now Britain is mired in Afghanistan, many think that, too, is a war we should not be fighting.
Personally, I happened to support both wars, and still do. But catastrophic mistakes have been made in explaining precisely why these were so necessary. In particular, there has been an almost total failure to convince people that we are living in a very different world with a very different kind of warfare that doesn’t fit the old assumptions.
We are up against an enemy we can’t identify easily because it doesn’t wear the uniform of a country’s army, and it often chooses to operate under the false flags of one geographical conflict after another.
This is what General Richards was getting at this weekend when he said that Al Qaeda and Islamic extremism could never be defeated. What he meant was that there could be no clear-cut victory, where British troops would march into the capital of a country it had vanquished or liberated.
As for Islamic extremism, an idea, however dangerous, cannot be defeated through military means. But as the general said, it can certainly be contained so that people are protected from it. But that means an open-ended military commitment. And that depends crucially on popular support. Without that support, Britain and the West will lose — to an enemy that is fighting on many fronts to bring down the West.
General Richards says: ‘Don’t give up, folks.’ But many are doing precisely that. Not just over Afghanistan or Iraq, but over the very idea that this country’s political and military commanders can be trusted never to put its soldiers in harm’s way unless it really is in the national interest to do so.
A country that no longer understands what it is fighting against — or even more crucially, what it is fighting for — will not, in the long term, survive.
This is all so desperately tragic. This is Britain we are talking about — that land of the lion-hearted that lit the lamp of liberty for the world and whose greatest nobility lay in ensuring that its light was never extinguished. Yet now that mighty heart is all but broken. Almost the last place in which it still continues to beat on is in our Armed Forces.
Yes, we must, of course, mourn our fallen soldiers. But in order to respect their ultimate sacrifice, we must recognise and support the cause — our national cause — for which they continue to lay down their lives.
‘Bonkers’ green energy policies risk power shortages in Scotland
Scotland is in “serious danger” of suffering power shortages over the next decade thanks to Alex Salmond’s “bonkers” green energy policies, the head of one of the country’s largest generators has warned.
Rupert Soames, chief executive of Aggreko, said Scotland’s lights will be “perilously close” to going out because a huge proportion of existing coal, oil and nuclear power stations are due to shut down over the next eight years.
He accused politicians of “holding hands and singing Kumbaya to the great green God” but warned the reality is it will be many decades before renewable energy can plug the gap left by traditional sources of power.
Unless Mr Salmond ends his ‘wishful thinking’ and draws up alternative plans, Mr Soames warned Scotland will be in “deep trouble” by 2018
But SNP ministers dismissed his claims last night and argued their target of generating 80 per cent of electricity from renewable sources by 2020 was realistic, despite the cost and unproven nature of the technology involved.
Mr Soames, the grandson of Winston Churchill and brother of the Tory politician Nicholas Soames, was speaking at business conference at the Scottish Parliament.
Although his comments addressed an impending energy crisis across the UK, he suggested the problem is more acute in Scotland. The SNP has refused to allow the construction of new nuclear power stations north of the Border.
“How is Scotland going to react to the fact the national grid, on which we all depend, will lose 30 per cent of its generating capacity by 2013?” he asked delegates. “We may wish the replacement to be wind, we may wish the replacement to be tidal but wishing isn’t going to make it happen and I think you have responsibly to have a Plan B. We have to move on from the days of holding hands and singing Kumbaya to the great green God or believing that Scotland is going to be the centre of the universe for renewables.”
The largest offshore wind farms are actually being built off the east coast of England, he said, which is closer to the major centres of energy demand.
Mr Salmond’s policies fail to recognise “the cold realities” of financing and engineering expensive new forms of green technology, Mr Soames continued. He warned it will require Scottish politicians to display considerable leadership to “avert a very real energy crisis that will hit us in less than ten years time.”
“My concern is that not the long-term vision is wrong, but policy-making is so focused on the end of the road that you can’t see the giant pothole 300 yards ahead,” he said.
He mocked the ever-increasing climate change targets imposed by politicians – Mr Salmond’s original 2020 green energy target was 50 per cent – as they suggest “all this can be achieved without any consequences, no matter how bonkers the policy”.
Instead he argued the deadlines for existing targets should be pushed back a decade, adding: “We cannot live without electricity and even brief shortfalls would be catastrophic.”
A third of the UK’s energy capacity from coal, two-thirds from oil and nearly three-quarters from nuclear generation will end over the next eight years, he said. “Without an immediate programme of building new power stations, with concrete being poured in the next two years, we will be in serious danger of lights going out,” Mr Soames said.
Without naming Mr Salmond specifically, he said anyone who believes nuclear power is dispensable and more than 10 per cent of energy will come from the wind, is talking “nonsense” and should be “banned” from formulating energy policy.
Similarly, he argued that it is unrealistic to believe that targets to cut energy consumption by 30 per cent by 2020 can be met, or that tidal power is going to make a “meaningful contribution” in the next 15 years.
Glasgow-based Aggreko is a FTSE 100-listed company and operates in 29 countries worldwide. Mr Salmond also spoke at the conference, but had left by the time Mr Soames made his address.
A Scottish Executive spokesman said the First Minister “is confident of meeting our targets for the industry, and with some 7GW of renewable electricity in Scotland in production, under construction or consented, we are well on track to exceed our interim target for next year.”
He highlighted a new £70 million fund for green energy announced by Mr Salmond last week, saying this demonstrated his commitment “to ensuring Scotland seizes the once-in-a generation opportunity presented by renewable resources.”
But Gavin Brown, Scottish Tory energy spokesman, said: “The SNP needs to listen to the CEO of one of Scotland’s most successful companies, a real energy expert, and find a credible policy for our energy needs. “It is the SNP’s blinkered dogma which is threatening to turn out the lights across Scotland by refusing to consider continued nuclear power as part of the energy mix.”
The £2-a-day heart pill that could save thousands of lives a year (?)
A bit of understandable but quite excessive enthusiasm about some very limited findings. The journal article is “Eplerenone in Patients with Systolic Heart Failure and Mild Symptoms”. The study was not of a normal population but of people who already had heart disease and who were taking the pill in conjunction with other heart medications. The pill reduced deaths or hospitalizations from 25.9% to 18.3% in the patients concerned. A worthy start but not a lot to write home about for the man in the street.
It’s also a pity that the study was terminated early. That was ethically cautious but not very scientific. Trends observed over a short time period often do not persist over a longer period. See one rather spectacular example of that in the sidebar here.
Note also that the hazard ratio (.76) was well below what is acceptable as indicating causation (2.0). Even at this stage then, the finding is a weak basis for public or private policy.
A heart disease pill costing just £2 a day could save tens of thousands of lives a year, scientists claim. The drug promises to revolutionise the treatment of Britain’s biggest killer and prevent many people being admitted to hospital. Eplerenone apparently reduces the risk of death by almost 40 per cent. Patients are also far less likely to need long-term care or need surgery such as bypass operations.
Researchers say their findings have ‘huge public health implications’ and could potentially cut millions from the NHS bill for treatment. Currently, doctors give patients the pill, also known Inspra, only if the standard medications do not work.
Heart disease patients are normally prescribed treatments including aspirin and anticoagulants to prevent the blood clotting, statins to lower cholesterol and beta blockers for high blood pressure.
However, the researchers say that if all heart disease patients were also prescribed the drug it would save millions every year through cost of treatment and loss of earnings.
The daily pill costs between £1.50 and £2 a day. It works by reducing the effects of the potentially harmful hormones cortisol and aldosterone, which are produced excessively in those with heart disease.
The University of Glasgow researchers – in collaboration with doctors from France, the U.S., Sweden and the Netherlands – compared the effects of the drug on almost 3,000 patients over four years. Their study, published in the New England Journal of Medicine, showed that those who took the drug were 37 per cent less likely to die or need hospital treatment.
Researcher Professor John McMurray, from the Institute of Cardiovascular and Medical Sciences at the University of Glasgow, said: ‘This trial will change the way we manage our patients. ‘Everyone with heart failure should be considered for treatment with a drug of this type – it will make patients feel better, stay out of hospital and live longer. ‘Eplerenone is not expensive and there is a related, generic drug, spironolactone, with similar properties, which is likely to have similar effects. ‘This type of treatment should be available and affordable across the globe. ‘Our trial has huge public health implications.’
There is a BIG new lot of postings by Chris Brand just up — on his usual vastly “incorrect” themes of race, genes, IQ etc.