Tuesday, September 4, 2018

Ignazio Marino on global kidney exchange

Ignazio Marino, the veteran transplant surgeon who also happens to have been Mayor of Rome, kindly shared with me this post from his blog.  He writes about kidney exchange and his hopes for global kidney exchange, pioneered by our colleague Mike Rees.  He writes about the great benefits that global kidney exchange could bring, and some of the international support it has received, but also about the fact that it has generated opposition in some quarters.

Here's his post:
Organ transplants: the revolutionary proposal of a Nobel Prize,
which concludes with these paragraphs:

"One of the objectives of the Global Kidney Exchange program is to provide quality health care , including but not limited to transplantation, for patients with end stage renal disease in the least developed countries, who would have no access to dialysis or transplantation. and would die.

"If I can transplant the kidney to an Italian patient because I find another compatible couple in Ethiopia, where a patient may not even have the possibility of hemodialysis, the person in Ethiopia will live because he will have a new kidney, and the person in Italy will live better - once transplanted - costing much less to the National Health Service. I think this is a good example of what in English is defined as a win win situation , in which everyone wins.

"However, there are criticisms. One of the concerns raised by great professionals like Francis Delmonico, professor emeritus at Harvard University, is how to control this international exchange of organs from an ethical and legal point of view.

"If an international chain of people is established, whose motive is always affection, but in which even people who are not always emotionally related come into play, there is the risk that the horrible crime of organ trafficking may in some way creep up.

"I believe the difference between the crime of organ trafficking in some countries and the idea behind the Global Kidney Exchange Program lies in the fact that this project is completely transparent, verifiable and controllable, and that transplants occur or would occur only in well-identified and qualified medical centers.

"The Global Kidney Exchange in 2017 had the endorsement of the American Society of Transplant Surgeons (the society that brings together all American surgeons in the transplant community). The first chain has already been built in the United States and success rate has been 100%.

"On 22 January 2018 the president of the Istituto Superiore di Sanità, Prof. Walter Ricciardi, in his role as a member of the Executive Board of the World Health Organization, promoted this idea.

"I am convinced that we should not be afraid of innovation simply because we are afraid of ourselves and of our inability to monitor ethical aspects. Especially when the benefit for human beings, rich or poor, regardless of citizenship, could be really great.""

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