Trump orders overhaul of organ transplant and kidney dialysis systems

The initiatives Trump is scheduled to outline include five new payment models to encourage doctors to treat patients earlier and encourage home peritoneal dialysis; a crackdown on some of the 58 non-profit organizations that do a poor job of collecting organs for transplant; and a public awareness campaign aimed at patients. About 40 percent of people with kidney disease do not know they have it, officials said.

In the United States, most people receive hemodialysis, a treatment that requires a device to filter waste and toxins from their blood. Most receive it in clinics or private facilities that serve dozens of people each day.

Currently, the U.S. system creates incentives for clinic-based hemodialysis. Two companies, Fresenius Medical Care and DaVita, dominate the lucrative market. Physicians generally are reimbursed at higher rates for care of dialysis patients than for treatment of patients with kidney disease who do not yet need dialysis.

Average life expectancy for a person on dialysis is five to 10 years, though some live much longer.

A less expensive option is peritoneal dialysis, a treatment that uses a fluid infused through a catheter implanted in the abdomen, often while the patient sleeps. The process is used by only a small percentage of U.S. kidney patients.

A key to boosting transplantation will be cracking down on “organ procurement organizations,” the 58 nonprofits that collect organs from deceased donors and send them to transplant centers for implantation. Each OPO holds a monopoly over a chunk of U.S. territory and collects and reports its own data on how successful it is. Some poor performers have manipulated the numbers, researchers have shown.

Another Trump proposal would increase payments to live donors of kidneys and livers to cover more of their expenses, possibly including lost wages and child care.

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From experience, daily peritoneal dialysis allows a more normal life but requires a patient and assistant who will follow protocol to prevent infection. I could not trust hospital staff to do this properly, as they put all their trust in the open box of gloves which numerous people put hands into daily. also, storage space is needed for the for supplies and equipment. We travelled to Florida with basic kit in the trunk of a Camry and had enough supplies delivered for the stay. DaVita thought it exceptional that I did this 30 months with no infection.

I’m still trying to figure out how David Crosby got his new Liver so quickly. His Lifestyle destroyed the one that God originally gave him. I wonder if it had anything to do with his Fame and Politics? When People say “it’s who you know”, it really is who you know.

I know a young woman (31 now) who received part of a liver from a living donor a couple years ago, but then almost died due to rejection. She was blessed to receive a second chance with a new liver that became available. She married (2nd marriage) in January, and has a young son. Years ago I worked with a gal, also in her 20s, who had Type 1 diabetes. She ended up in very bad shape with cardiomyopathy added to her ailments. She had an extensive, multiple organ transplant. I think she got a heart, lungs, pancreas, and maybe others. She seemed to be on her way to a fairly normal life at the time, got married.

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Source: Freerepublic.com

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