Hannah Knowles, Caroline Anders
A Colorado-based health system says it is denying organ transplants to patients not vaccinated against the coronavirus in “almost all situations,” citing studies that show these patients are much more likely to die if they get covid-19.© iStock/iStock Doctor close-up of a doctor showing a picture of a kidney on a tablet in a hospital
UCHealth’s rules for transplants entered the spotlight Tuesday when Colorado state Rep. Tim Geitner (R) said it denied a kidney transplant to a Colorado Springs woman because she was not vaccinated against the coronavirus. Calling the decision “disgusting” and discriminatory, Geitner shared a letter that he said the patient received last week from UCHealth’s transplant center at the University of Colorado’s Anschutz Medical Campus in the city of Aurora.
The letter said the woman would be “inactivated” on a kidney transplant waiting list and had 30 days to start coronavirus vaccination. If she refused to be vaccinated, it said, she would be removed.
Geitner did not identify the patient allegedly denied a transplant, but Leilani Lutali told 9News that it was her and said she is “being coerced into making a decision that is one I’m not comfortable making right now in order to live.”
UCHealth declined to discuss particular patients because of federal privacy laws. But the health system confirmed Tuesday that nearly all of its transplant recipients and organ donors must get vaccinated against the coronavirus, in addition to other vaccinations and health requirements. A spokesman, Dan Weaver, said that other transplant centers in the United States have similar policies or are transitioning to them.What is ivermectin, and how did people get the idea it can treat covid?
The policy illustrates the growing costs of being unvaccinated and wades into deeply controversial territory — the use of immunization status to decide who gets limited medical care. The mere idea of prioritizing the vaccinated for rationed health resources has drawn intense backlash, as overwhelmingly unvaccinated covid-19 patients push some hospitals to adopt “crisis standards of care,” in which health systems can prioritize patients for scarce resources based largely on their likelihood of survival.
Conditions on organ transplants are not new. Weaver noted that transplant centers around the country may require patients to get other vaccinations, stop smoking, avoid alcohol or demonstrate that they will take crucial medications in an effort to ensure that people do well post-surgery and do not “reject” organs for which there is fierce competition.
More than 100,000 people are on the transplant waiting list, and only a fraction of those seeking a kidney got one in 2020, according to the federal government. An estimated 17 people die every day waiting for an organ.
Lutali, whom The Post could not immediately reach, said she was concerned about the health consequences, though the vaccines have been shown to be safe and effective in large trials. She and her donor both told the 9News that they object to the vaccine on religious grounds, citing the use of fetal cell lines in vaccine development and testing. Fetal cell lines are lab-grown and trace back to cells from decades-old elective abortions.
CBS4 reported Wednesday that Lutali and her kidney donor are looking out of state for other options, as they have not found a Colorado hospital that will perform the procedure before they are immunized. CBS4 said Lutali has end stage renal disease, in which dialysis or transplant are probably necessary for survival.
Multiples studies show that covid-19 is especially deadly for recipients of kidney transplants. Weaver said the mortality rate observed for transplant patients who develop covid-19 ranges from about 20 percent to more than 30 percent — far higher than the 1.6 percent fatality rate observed generally in the United States.
“An organ transplant is a unique surgery that leads to a lifetime of specialized management to ensure an organ is not rejected, which can lead to serious complications, the need for a subsequent transplant surgery, or even death,” Weaver wrote in an email. “Physicians must consider the short- and long-term health risks for patients as they consider whether to recommend an organ transplant.”
Living donors could also pass a coronavirus infection to an organ recipient, threatening the patient’s life, Weaver said.
Organ donations in the United States are coordinated through a national network run by the nonprofit United Network for Organ Sharing. UNOS does not set requirements for listing or removing someone as a transplant candidate, said spokeswoman Anne Paschke, so transplant centers such as UCHealth’s “make such decisions according to [their] individual medical judgment.”
Solid organ transplant recipients at the University of Washington medical centers also must be fully vaccinated prior to their procedures, according to the organization’s website, unless they have a specific medical exemption. Religious exemptions do not apply.
An FAQ about vaccination and transplants explains that vaccination requirements prior to transplants are not new: “UW Medicine has long required patients awaiting a solid organ transplant to be current on all critical vaccinations prior to their procedure," it says.
Weaver did not clarify Tuesday what might qualify someone for an exception to the coronavirus vaccination rule.
Geitner said in a Facebook Live video that he has spoken with UCHealth and that there is “very little” it would do to accommodate those without coronavirus vaccinations.
Geitner did not respond to inquiries Tuesday.
Geitner also criticized UCHealth for firing unvaccinated staff, who represent less than 1 percent of the health system’s workforce, according to the Denver Post. Hospitals with mandates have said they appear to be successful, with almost all employees staying on, despite concerns the rules could deepen staffing strains.
While more than a third of Americans have yet to get one dose of a coronavirus vaccine, leaders and businesses have increasingly embraced vaccine mandates over intense opposition from Republicans, who champion personal choice. The unvaccinated may face unemployment or more expensive health insurance and in some places are barred from parts of public life, such as indoor dining.
Then there are the risks of the coronavirus. Cases, hospitalizations and deaths have spiked around the country this summer and fall as the highly contagious delta variant dominates, though Colorado has seen less of a surge. Current covid-19 hospitalizations in the state remain well below a peak from winter of 2020.
A recent report from the Centers for Disease Control and Prevention found that people who were not fully vaccinated this spring and summer were 10 times more likely to be hospitalized and 11 times more likely to die of covid-19.
As covid-19 cases stretch medical resources, being vaccinated can also count against patients in some cases. Faced with a recent federal push to conserve monoclonal antibodies, a highly effective covid-19 treatment, some officials have urged health-care providers to give them first to people who are unvaccinated.
Putting the unvaccinated first can “rub people the wrong way,” Karen Bloch, medical director of the antibody infusion clinic at Vanderbilt University Medical Center, told The Post last month.
But the reality is clear, she said: Those without shots are far more likely to die of covid-19.
No comments:
Post a Comment