Sunday, September 24, 2006

Transplants in Peru: ¿ Who put the bell to the cat?.

Right. Drawing taken from UPMC.

I had a relative affected of kidney bilateral insufficiency (year:2001), associated to malignant arterial hypertension. As she was assured in Essalud (state social insurance), she was put in the waiting list. They told her that kidney transplants - as happened until now- are carried out according to the arrival order. That’s to say that independently of the graveness of the case, those affected by this not well kidney disease have to wait on the average 2 years. If somebody has the bad luck that its kidney insufficiency is increased before the 2 years, she will die inexorably. For the above mentioned, my relative - like others similar patients- died to the 6 months for a uncontrollable hypertensive crisis. In Peru, the method of being transplanted according to the antiquity in the waiting list is cruel, because it doesn't keep in mind the patient's graveness and are ready to potential manipulations. In 1998, a Law was given in North America, applicable to liver, heart and lung transplants, that had into account the graveness of the patient and not the antiquity of the inscripction, in a waiting list. Soon after it, those affected by lung fibrosis or cystic fibrosis (of easy deterioration) are prioritized, postponing those who have emphysema -except if they are increased severity-. The things are now better. The lung transplants have also improved for spread measures to a better preservation of the donors' lungs. Now medications are administered to potentials donors affected of irreversible comas, to maintain their air sacks, open. By the way, the Peruvian Law of transplant of organs, needs to be perfected, according to previous statements. Which congressman will make the same thing here?.

Trasplantes de órganos ¿Quien le pone el cascabel al gato?.

Tuve un familiar afectado de insuficiencia renal bilateral (2001), asociada a hipertensión arterial maligna. Como estaba asegurada fué puesta en la lista de espera. Le dijeron que los trasplantes –al igual que ahora- se realizan de acuerdo al orden de llegada, de lo que resulta que independientemente de la gravedad del caso -los afectados por este mal renal- tienen que esperar 2 años en promedio. Si alguien tiene la mala suerte de que su insuficiencia renal se agrave antes de los 2 años, morirá inexorablemente. Por lo anterior, mi familiar -al igual que pacientes similares- murió a los 6 meses por una crisis hipertensiva incontrolable. En el Perú, el método de ser transplantado de acuerdo a la antigüedad en la lista de espera es cruel, porque no tiene en cuenta la gravedad del paciente y se presta a potenciales manipulaciones. En 1998, se dió una Ley en Norteamérica, aplicable a trasplantes de higado, corazón y pulmón, que tiene en cuenta la gravedad del paciente y no la antigüedad de la inscripcción, en una lista de espera. A raiz de ello, los afectados por fibrosis pulmonar o fibrosis quistica (de rapido deterioro), son priorizados, posponiendo a los que tienen enfisema -excepto si se agravan-. Las cosas estan mucho mejor ahora. Los trasplantes de pulmón tambien han mejorado por medidas tendientes a una mejor preservación de pulmones de los donantes. Ahora se administran medicamentos a potenciales donantes afectos de comas irreversibles, para mantener sus sacos aereos abiertos. Por cierto, la Ley de trasplante de órganos peruana, necesita perfeccionarse. Que congresista hara lo mismo aquí?.


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