My ULWR blog

Wednesday, February 24, 2010

Native beliefs about organ donation

Excerpt:

Yet, in many indigenous cultures, including Native American, the placenta, umbilical cord, and umbilical cord blood have sacred symbolic value associated ...

Abstract:. Religious discussion of human organs and tissues has concentrated largely on donation for therapeutic purposes. The retrieval and use of human tissue samples in diagnostic, research, and education contexts have, by contrast, received very little direct theological attention. Initially undertaken at the behest of the National Bioethics Advisory Commission, this essay seeks to explore the theological and religious questions embedded in nontherapeutic use of human tissue. It finds that the "donation paradigm" typically invoked in religious discourse to justify uses of the body for therapeutic reasons is inadequate in the context of nontherapeutic research, while the "resource paradigm" implicit in scientific discourse presumes a reductionist account of the body that runs contrary to important religious values about embodiment. The essay proposes a "contribution paradigm" that provides a religious perspective within which research on human tissue can be both justified and limited.

Campbell, Courtney S. 1956- "Religion and the Body in Medical Research"
Kennedy Institute of Ethics Journal - Volume 8, Number 3, September 1998, pp. 275-305
The Johns Hopkins University Press.

Now I need to find this resource.

Scientific science, cont'd

From the report in the last post:

As of 1999, the rate of renal transplants for American Indian/Alaska Native ESRD patients was 0.7
transplants/100 patient years on dialysis compared to a rate of 1.8 transplants/100 patient years for Caucasian
Americans. At 79.

There is a "Growing need for renal and other organ and tissue transplantation among Native Americans." At 79.

Genetic similarity "among the Sioux increases the likelihood of finding well matched donors among the Sioux or other Native Americans." At 87.

Scientific science says Native-to-Native organ transplants could increase success

From Press Release, Johns Hopkins Medicine, "Hopkins Researchers Identify Transplantation Antigens Among Sioux Indians" (2004). Available at hopkinsmedicine.org.

"The Native American population has one of the greatest needs for organ donors because of a high incidence of diabetes and end-stage renal disease, yet many are reluctant to donate a kidney because of a belief that they need to take their body intact to the spiritual world when they die. If they donate, many believe, their spirit will be restless.

Researchers with the Johns Hopkins Immunogenetics Laboratory say characterizing the specific HLA genes among different Indian tribes will identify their similarities and differences with other populations, helping to ensure compatible organ transplants. Their new report, published in the January issue of the journal Human Immunology, identifies two new alleles, or alternate gene forms, among the Lakota Sioux tribe.

"Because so many Native Americans volunteered to be in this study, we hope that their awareness of the value of tissue compatibility may make the message of donation more welcome," says Mary S. Leffell, Ph.D., lead study author and professor and director of the Hopkins laboratory. "Our study provides the first look at the HLA proteins and alleles present among the Sioux people at a time when their need for transplantation is rapidly increasing. The findings show that there is a much higher probability of finding a really good organ match among other Native Americans than among other racial/ethnic groups. Certain Asian populations share some of the same HLA proteins as the Sioux and also could be good donor choices."

The study is cited as Leffell, M.S. et al, "HLA Alleles and Haplotypes Among the Lakota Sioux: Report of the ASHI Minority Workshops, Part III", Human Immunology, January 2003, Vol. 65, Issue 1, pages 78-89.

Natives at risk of worse organ transplant outcomes

From C.L.C. Weber et al., Kidney Transplantation Outcomes in Canadian Aboriginals, 6 Am. J. of Transplantation 1875 (2006).

"Aboriginals (i.e. Native American Indians) experience a very high rate of chronic kidney disease and comprise a
disproportionate number of individuals receiving renal replacement therapy." At 1875.

Natives are at risk of worse long-term outcomes after kidney transplants, at 1877. One of the factors is longer wait times, at 1878. Also, Natives are generally unhealthier ("Other than renal disease, Aboriginals are disproportionately affected by diabetes, hypertension, substance abuse, trauma and many other conditions."). At 1880.

Minorities less likely to get a living organ transplant

From OPTN/UNOS Minority Affairs Committee, Report to the Board of Directors, November 18-19, 2008,
St. Louis, MO, at 10.

However, an analysis of the CMS 2728 form showing the likelihood of being informed of kidney transplantation, being placed on the kidney transplant waitlist, or of receiving a living donor transplant, revealed that approximately 73% of patients beginning renal replacement therapy for the first time (in July-Dec. 2005) were informed of their kidney transplant options (Figure 3), while 1.75 percent received a preemptive living donor transplant (Figure 4). In addition, the data showed that African Americans, Hispanics and Asians were more likely to be informed than Native Americans and Whites. However, African Americans, Hispanics, Asians, and Native Americans were less likely to be placed on the waitlist or receive a living donor transplant than Whites.