tag:blogger.com,1999:blog-4405345292513335071.post7002789990329912505..comments2024-03-19T18:44:15.041+08:00Comments on Little Stories: Old Kidneys and Young KidneysGilbert Koh aka Mr Wanghttp://www.blogger.com/profile/01027678080233274309noreply@blogger.comBlogger30125tag:blogger.com,1999:blog-4405345292513335071.post-13491034764507971622008-10-22T15:23:00.000+08:002008-10-22T15:23:00.000+08:00I know this may sound out of topic but i need some...I know this may sound out of topic but i need someone to buy my kidney for me to be able to pay some unwanted debts. hope u can help me. contact me at madz_nov@yahoo.com. thanksmadzhttps://www.blogger.com/profile/00862407902343315594noreply@blogger.comtag:blogger.com,1999:blog-4405345292513335071.post-69565236447221586462008-07-28T16:27:00.000+08:002008-07-28T16:27:00.000+08:00BBC's Visions of the Future (2 of 3) The Biotech R...BBC's Visions of the Future (2 of 3) The Biotech Revolution. Regeneration of organs is a question of when.<BR/>http://video.google.com/videoplay?docid=-5040988246744133463Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4405345292513335071.post-26394887488687813922008-07-23T00:44:00.000+08:002008-07-23T00:44:00.000+08:00As for kidneys from over-60 cadavers, I should add...As for kidneys from over-60 cadavers, I should add, as a point of interest, that over-60 people are currently not allowed to be on the waiting list for cadaveric kidneys. In a sense, it is a little unfair to people who are over 60.Foxhttps://www.blogger.com/profile/04726805279916950590noreply@blogger.comtag:blogger.com,1999:blog-4405345292513335071.post-38522871175187966722008-07-22T15:15:00.000+08:002008-07-22T15:15:00.000+08:00"Compared to organ trading, the Spanish model is m..."Compared to organ trading, the Spanish model is more attractive and acceptable even though it is much simpler than the Iranian model to administer."<BR/><BR/>I am just curious if you DO know what the Spanish model is? <BR/><BR/>As far as I know, there is NO Norway model. Only that there are many willing live donors, but how they 'created' that many live donors was never fully explained. <BR/><BR/>Our HOTA without age limit would supersede the Spain model, which is still an opt in model. As mentioned by fox in a previous post, it is still short on the number that is needed. <BR/><BR/>To add on to fox's statistics, each year, 20-30 go overseas to do transplants. They do follow ups in Singapore, hence they is how the figure is derived.lobohttps://www.blogger.com/profile/12613401572475647603noreply@blogger.comtag:blogger.com,1999:blog-4405345292513335071.post-2936453766885985732008-07-22T10:53:00.000+08:002008-07-22T10:53:00.000+08:00If you withdraw from HOTA, it doesn't make a diffe...If you withdraw from HOTA, it doesn't make a difference to the rest of us who are in HOTA. By withdrawing from HOTA, although you reduce the potential availability of a cadaveric organ, you are also excluding yourself from the waiting list for cadaveric kidneys (which means one more kidney for the rest of us in HOTA). <BR/><BR/>On the other hand, you better count on having relatives with a good match since you are, presumably, believe it to be unethical to pay for a donated kidney.<BR/><BR/>By the way, in the unforeseeable future, you might also need a heart, a pancreas, etc, which are NOT available from live donors or relatives.Foxhttps://www.blogger.com/profile/04726805279916950590noreply@blogger.comtag:blogger.com,1999:blog-4405345292513335071.post-73490264047038512802008-07-21T20:51:00.000+08:002008-07-21T20:51:00.000+08:00If organ trading is legalised in Singapore, I will...If organ trading is legalised in Singapore, I will withdraw from HOTA. I will not trust the government with my organ, not even after death. If they choose to solve problems with money, with no regard to ethics, I will not want to be exploited.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4405345292513335071.post-59395251142381329302008-07-20T05:12:00.000+08:002008-07-20T05:12:00.000+08:00The goal is to save lives. We can simultaneously p...<I>The goal is to save lives. We can simultaneously pursue different paths to that goal.</I><BR/><BR/>How altruistic! What a refreshing breath of idealism in the land of economic pragmatism!<BR/><BR/>Saving lives is an outcome that may contribute positively to economic imperatives.<BR/><BR/>In the words of some famous person, "It's not that simple."Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4405345292513335071.post-36262265763385774662008-07-18T21:45:00.000+08:002008-07-18T21:45:00.000+08:00"What I'm interested is finding different ways to ..."What I'm interested is finding different ways to increase that number, as opposed to finding one way to increase that number."<BR/><BR/>I don't think anyone has objections to finding ways to increase the number of kidneys available for transplant. More so, no one had insisted on only one way.<BR/><BR/>The key is to find the optimal combination, taking into account all that has been discussed - pros, cons, concerns etc. New and even innovative ideas may crop up but that does not mean they are good.<BR/><BR/>Compared to organ trading, the Spanish model is more attractive and acceptable even though it is much simpler than the Iranian model to administer.<BR/><BR/>This talk about old and young kidneys is a luxury. Those who get one should count their blessings instead of being choosy about the age of the organ.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4405345292513335071.post-86804071407717011752008-07-18T13:02:00.000+08:002008-07-18T13:02:00.000+08:00The above comment has been deleted for making unne...The above comment has been deleted for making unnecessary aspersions about me.<BR/><BR/>Do not be ridiculous. I have no need of an extra kidney and I have nothing to gain by the legalisation of the sale of kidneys.Gilbert Koh aka Mr Wanghttps://www.blogger.com/profile/01027678080233274309noreply@blogger.comtag:blogger.com,1999:blog-4405345292513335071.post-9943520533536470292008-07-18T10:01:00.000+08:002008-07-18T10:01:00.000+08:00This comment has been removed by a blog administrator.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4405345292513335071.post-73628730204653763912008-07-18T10:00:00.000+08:002008-07-18T10:00:00.000+08:00I suspect some readers are misunderstanding my mai...I suspect some readers are misunderstanding my main post (and the ST article).<BR/><BR/>Look at this again:<BR/><BR/>"Professor A. Vathsala, director of the kidney transplant programme at the National University Hospital, said Singapore should expand its organ donation programme first.<BR/><BR/>She has visited Norway and Spain and believes that some of their practices, <B>such as removing the age restriction on cadaveric donation </B>, could be adopted here."<BR/><BR/>Cadaveric means that the person is already dead.<BR/><BR/>Example 1: A <B>59-year-old</B> man dies in a road accident. Under the HOTA rules, his kidney may be used for transplantng into a kidney patient.<BR/><BR/>Example 2: A <B>61-year-old</B> man dies in a road accident. Under the HOTA rules, his kidney may NOT be used for transplanting into a kidney patient. <BR/><BR/>What Prof Vathsala is saying is that we could raise the 60-year-old limit for cadaveric kidneys. For example, it could be raised to, say, 75 years. Then more kidneys would be available.Gilbert Koh aka Mr Wanghttps://www.blogger.com/profile/01027678080233274309noreply@blogger.comtag:blogger.com,1999:blog-4405345292513335071.post-42870899968000788072008-07-18T09:27:00.000+08:002008-07-18T09:27:00.000+08:00Mr Wang, the other question not asked is, can olde...Mr Wang, the other question not asked is, can older donors recover from the lost of 1 kidney as well or fast as young patients?<BR/><BR/>If they need extra care or have higher risk of infections etc, then it adds on to the equation.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4405345292513335071.post-84336938392407433482008-07-18T06:33:00.000+08:002008-07-18T06:33:00.000+08:00The issue of organ trading aside, you do mention a...The issue of organ trading aside, you do mention allowing older people's kidneys to be used for transplants. I reckon that we will (in more countries than just those) have to take those steps as a large part of the western population ages (baby boom generation) and as average life spans increase. There may just be too few people available for transplants like that. Of course, in the coming years, odds are that more older people will require kidneys, so perhaps getting a 75 year old's kidney(or hell, a 68 year old's) when you're 70 may actually work out in your favour. I don't know the relative betterness of a younger person's kidney, but it seems logical to me that the ages will be moved upwards.Ammar Ijazhttps://www.blogger.com/profile/12419897067330637368noreply@blogger.comtag:blogger.com,1999:blog-4405345292513335071.post-33358553754575710432008-07-18T01:11:00.000+08:002008-07-18T01:11:00.000+08:00This discussion about legalising organ sales is im...This discussion about legalising organ sales is important, but I think that a larger issue that has been overlooked is the holistic care of our citizens with chronic illnesses, which includes renal (kidney) failure patients.<BR/><BR/>Those who work the wards will tell you that based on anecdoctal evidence, renal (kidney) failure patients with poor health are largely from a disadvantaged socioeconomic background. They usually have high blood pressure or diabetes, but could not afford the intensive medical care required to delay the onset of complications (ie medications and regular medical checkups). As a result, they progress to renal failure much earlier, which needs to be treated with dialysis.<BR/><BR/>Dialysis alone may buy the patient a good 10-15 years. However, it is very expensive, and again, many of these patients cannot afford the cost, and worse, do not have the health to work to pay for their treatment. It ends up as a chicken-and-egg situation resulting in a downward spiral, leading to the patient's death.<BR/><BR/>How then do we avoid this whole mess? Prevention is really better than 'cure', as in this case, kidney transplants are so limited, and essentially priceless. But the prevention is also expensive. <BR/><BR/>The question really then, is how much is the government willing to step in to provide cheap healthcare to the people who need it, but are not able to afford it. Based on our national healthcare budget, it doesn't seem to be a lot, compared to other areas such as defence. <BR/><BR/>If there's only one advice I can give, it would be: buy all the healthcare insurance you can comfortably afford. Healthcare costs WILL go up, and your CPF will NOT be enough.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4405345292513335071.post-75493467607078281002008-07-17T22:44:00.000+08:002008-07-17T22:44:00.000+08:00I should add that my previous post was not written...I should add that my previous post was not written to disparage over-60 cadaveric kidneys but to demonstrate numerically its inadequacy in meeting the needs of the kidney waiting list.Foxhttps://www.blogger.com/profile/04726805279916950590noreply@blogger.comtag:blogger.com,1999:blog-4405345292513335071.post-37707038112326247352008-07-17T22:32:00.000+08:002008-07-17T22:32:00.000+08:00Every year, on average, about 600 patients, poor a...Every year, on average, about 600 patients, poor and rich, suffer kidney failure. About half of them (-300) will join the waiting list for kidney transplant. <BR/><BR/>Every year, 55 to 60 kidney transplant operations take place, of which about half the donated kidneys are from cadavers. So, we get about 30 kidneys from cadavers. Meanwhile, 240 patients on the waiting list will just have to die.<BR/><BR/>According to the ST article, in Spain, a third of the cadaveric kidneys are from people over 60 years old. Suppose we use kidneys from older cadavers in Singapore, that will increase the supply of cadaveric kidneys by 15 to 20, assuming the Spanish model holds in Singapore. <BR/><BR/>The additional 15 to 20 kidneys are welcomed but no way will they meet the needs of the other 240 patients on the waiting list.Foxhttps://www.blogger.com/profile/04726805279916950590noreply@blogger.comtag:blogger.com,1999:blog-4405345292513335071.post-41042300208871756002008-07-17T22:06:00.000+08:002008-07-17T22:06:00.000+08:00Onlooker: "remember there is also the risk of post...Onlooker: "remember there is also the risk of post transplant diabetes"Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4405345292513335071.post-4168249782544507892008-07-17T19:34:00.000+08:002008-07-17T19:34:00.000+08:00"$50k will still be exploiting your poor fellow si..."$50k will still be exploiting your poor fellow singaporeans"<BR/><BR/>True, if we were abducting them in the night and forcibly removing their organs. However, I was referring to legalised organ trading predicated on willing buyers and sellers.Gilbert Koh aka Mr Wanghttps://www.blogger.com/profile/01027678080233274309noreply@blogger.comtag:blogger.com,1999:blog-4405345292513335071.post-37755125210611993562008-07-17T19:32:00.000+08:002008-07-17T19:32:00.000+08:00"I meant it will not be FOC .. for the recipient."..."I meant it will not be FOC .. for the recipient."<BR/><BR/>You might be right. However, getting a Panadol is also not FOC in Singapore. So I am not too sure what your exact in-principle difficulty is.Gilbert Koh aka Mr Wanghttps://www.blogger.com/profile/01027678080233274309noreply@blogger.comtag:blogger.com,1999:blog-4405345292513335071.post-24274350559008228532008-07-17T19:28:00.000+08:002008-07-17T19:28:00.000+08:00I don't agree with your view, except that yes, the...I don't agree with your view, except that yes, the biggest limit is the number of available kidneys. <BR/><BR/>What I'm interested is finding different ways to increase that number, as opposed to finding <I>one</I> way to increase that number.Gilbert Koh aka Mr Wanghttps://www.blogger.com/profile/01027678080233274309noreply@blogger.comtag:blogger.com,1999:blog-4405345292513335071.post-84390017695954596282008-07-17T19:09:00.000+08:002008-07-17T19:09:00.000+08:00"...there are many ways to skin a cat, and they do..."...there are many ways to skin a cat, and they don't have to be mutually exclusive."<BR/><BR/>"We can simultaneously pursue different paths to that goal."<BR/><BR/>I beg to differ. As you have mentioned, the paths are not mutually exclusive but your last point does not take that into account. Each path has the potential to affect the effectiveness of other paths, directly or indirectly. We do not have unlimited resources and donors.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4405345292513335071.post-32488509923630320752008-07-17T19:05:00.000+08:002008-07-17T19:05:00.000+08:00Dear Mr WangIt is admirable that you have a workin...Dear Mr Wang<BR/><BR/>It is admirable that you have a working moral compass. Unlike me. But you are obviously using a yardstick which is greatly different from many. your point 1 currently irrelevant. There will be no major dispute if they(officials) are adequately compensated. Even if they make some noise (and there will be many excuses) there will be no repercussion. Unless we decide to rub them the wrong way from our high horses.<BR/><BR/>Just using a random number .. say S$50k is not a big sum in SG but will be more $ than many families will ever see (in Thailand\Indonesia). $50k will still be exploiting your poor fellow singaporeans but will be manna for thais\indonesians.<BR/><BR/>NoNameAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-4405345292513335071.post-41174150913797853742008-07-17T18:45:00.000+08:002008-07-17T18:45:00.000+08:00Obviously the dead cant buy or sell. I meant it wi...Obviously the dead cant buy or sell. I meant it will not be FOC .. for the recipient.<BR/><BR/>Sorry, u are the zen guy while i am highly cynical. With your exp as DPP, u may have greater confidence in our various regulators. you may well be correct.<BR/><BR/>And yes it would be great if the Gahmen increase the availability by accepting old donors (live or otherwise).<BR/><BR/>But I much prefer they get out of the way of organ trading, until they show that they are capable of transparency.<BR/><BR/>Sorry for deviating from your article but my experiences with public healthcare under Ministar Khaw's leadership have been singularly bad. Its not something elites like urself will ever understand.<BR/><BR/>NoNameAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-4405345292513335071.post-67614646351699796732008-07-17T15:36:00.000+08:002008-07-17T15:36:00.000+08:00Um, the problem with this entry is... you are actu...Um, the problem with this entry is... you are actually kind of right. <BR/><BR/>It's a little premature and ill-informed to discuss in too much detail right now without knowing that much about old and young kidneys. It's just kind of blind speculation and guesswork without the info, no?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4405345292513335071.post-20664896897442414302008-07-17T14:43:00.000+08:002008-07-17T14:43:00.000+08:00"Singapore, for sure, could start by buying a few ..."Singapore, for sure, could start by buying a few kidneys, corneas from its neighbours; in fact it could, like it did for water; negotiate a 100 year price per ton of kidneys."<BR/><BR/>Please refer to Point 1 of my earlier <A HREF="http://mrwangsaysso.blogspot.com/2008/06/issue-of-human-organ-trading-in.html" REL="nofollow">post</A> on 29 June.Gilbert Koh aka Mr Wanghttps://www.blogger.com/profile/01027678080233274309noreply@blogger.com