October 23, 2021

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Unvaccinated against COVID-19? Forget about that transplant operation


As reported by Hannah Knowles and Caroline Anders for The Washington Post:

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.

According to the Post article, a patient identified as Leilana Lutali suffering from end-stage renal disease was advised by UCHealth’s Aurora, Colorado, transplant center that she would be temporarily “inactivated” from a waiting list for kidney recipients after it was determined that neither she nor her proposed kidney donor had been vaccinated against COVID-19. As reported by Denver’s 9News, Lutali was advised that she would have 30 days in order to begin the vaccination process. If she still refused to obtain a COVID-19 vaccine, she would be removed from the list of potential kidney recipients.

According to the 9News article, both Lutali and her proposed donor, Jaimee Fougner, cited religious objections to getting the shot, “because vaccine manufacturers used the fetal stem cell line in development.” Lutali acknowledged receiving her flu vaccine and “all” her childhood vaccinations (which likely used fetal cell lines during their testing and development), but claimed that God forgives “sins of ignorance.” Interestingly, she also claims she is wary of receiving the COVID-19 vaccine because she does not “have enough information to understand what the implications are to [her] health in the future.”

The hospital system, however, has substantial experience regarding the implications of providing organ transplants to patients who have not followed appropriate protocols to preserve and maintain their own health. The 9News reporting, by Wilson Beese and Steve Staeger, provides additional details underlying the hospital’s reasons for its policy:

In a statement, the hospital system said studies indicate the mortality rate for transplant recipients who test positive for COVID ranges from 18% to 32%, compared to a 1.6% mortality rate among all people who have tested positive.

UCHealth said the policy change was driven by the significantly higher mortality rate, as well as the concern that living donors could still pass on a COVID infection after testing negative.

“This is why it is essential that both the recipient and the living donor be vaccinated and take other precautions prior to undergoing transplant surgery,” the statement said. “Surgeries may be postponed until patients take all required precautions in order to give them the best chance at positive outcomes.”

As a UCHealth spokesman explained to the Post,  the hospital’s policy applies to both organ transplant donors and their recipients, and “other transplant centers in the United States have similar policies or are transitioning to them.”

Nor should this policy be a surprise to anyone. Donated organs are a fragile and precious commodity, which is why waiting lists for them are incredibly backlogged. As the authors of the Post article explain:

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.

Facing such a disparity in demand for transplanted organs, doctors and hospitals must apply their common sense, essentially asking themselves, “Is this recipient one who is likely to survive, and for how long?” While that may seem to be a cold calculation, it’s one that is unavoidable under the circumstances if the hospital is, as in the case of performing organ transplants, required to exercise its own medical judgment, even where, as in this case, a ready donor is available.

That is why uniform policies such as that being implemented by UCHealth are essential. If a hospital’s standards are to be fairly and consistently applied across the board for all patients, then they must be applied here as well. And while health care policies that prioritize the vaccinated have drawn “intense backlash” (as the Post article notes), the reality is that such polices are now also being driven by those who have refused the COVID-19 vaccine and are as a result taking up tremendous resources in hospitals throughout the country, which are tasked with treating wholly preventable coronavirus-related illnesses.

Predictably, a Colorado Republican, Congressman Tim Geitner, has waded into the fray, calling the hospital’s decision “disgusting” and discriminatory. Geitner, who has no medical background, is using Lutali’s situation to grandstand, haranguing the hospital system and posting about the issue on social media. The Post article notes that Geitner has criticized the same hospital system for its policy of firing unvaccinated workers.

UCHealth, however, isn’t budging, maintaining the strictures it applies to transplant recipients are consistent with respect to its requirement for other vaccines, such as requiring vaccination against measles, mumps, rubella, and hepatitis B.

“Patients may also be required to avoid alcohol, stop smoking, or prove they will be able to continue taking their anti-rejection medications long after their transplant surgery,” UCHealth said. “These requirements increase the likelihood that a transplant will be successful and the patient will avoid rejection.”

The Post article cites as an example the procedures in place at University of Washington hospitals, which have long had a policy of requiring full vaccination for transplant recipients. Put simply, “religious exemptions do not apply.” Period.

In essence, those who are eligible but still refuse the COVID-19 vaccine—for whatever reason—are putting themselves and others at risk, no matter how special Facebook or some religious figure has made them feel about their refusal. But the reality is that they’re not special, and they don’t deserve to be treated any differently from anyone else seeking something as important and far-reaching as an organ transplant. If they’ve voluntarily and unreasonably chosen to forego a vaccine based on their religious sensibilities, then they should be prepared for the consequences when those religious sensibilities collide head-on with established medical protocols.

According to the Post, both Lutali and Fougner, her potential donor, are now seeking to have the procedure performed outside Colorado.





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