Wednesday, October 31, 2007

Kidney Transplant

A new day dawns tomorrow. And with it, a new rotation. This time I'm going back to Brigham & Women's Hospital and trying my hand at the Kidney Transplant service. I've already done 2 weeks of Transplant but at a different hospital (Mass General) where I'm sure the protocols are a little bit different.

One of the fun things to think about with the field of Kidney Transplant are all the juicy ethical issues it brings up. For instance, there is a big gender inequality in terms of who gets a kidney transplant: women are much less likely than men to get a kidney transplant. The reasons are both biological and societal. On the biological side: one of the biggest barriers towards being a good immunologic "match" towards a potential donor kidney is if you have pre-formed antibodies circulating in your blood. Most people don't have these, but if you've had blood transfusions before--or, if you've had children and have been exposed to their foreign material--you may develop antibodies. So women who have had children are at a disadvantage in terms of being able to accept a kidney from the pool of donors out there. Societally, women also get the short end of the kidney transplant stick. It is becoming increasing common and possible for one to donate his/her kidney to a spouse. For reasons that are not entirely clear, wives donate to their husbands about ten times more commonly than husbands donating to their wives.

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