| The Nasty Side of Organ Transplanting Second Edition Norm Barber Copyright Chapter 4 Organ Rejection The human body rarely accepts the transplanted organ, seeing it as an alien tumour, and spends the rest of its life trying to kill it. The immune system responds to a transplant with B cell anti-bodies, which can attack within minutes, and the new organ may turn black and blotchy even before surgeons have sewn up the wound. Invariably the organ and patient survive this immune attack and there is a brief "honeymoon period". The patient feels so improved and may be trotted out to the media to thank the doctors, nurses and donor family and say how fresh the air smells and that organ transplantation is a glorious experience. The immune system ends this "honeymoon" when the T cell lymphocytes or killer T cells fully mobilise and attack what is sensed to be the alien and malignant organ. Transplant coordinators quickly shoo away the media because the patient no longer feels well or grateful for the transplant. Doctors subdue this T-cell response by attacking and disabling the recipient’s immune system with a series of toxic anti-rejection drugs. The most popular immune-suppressant is cyclosporin. It is produced from a poisonous Norwegian fungus that attacks the immune system by disabling the killer T-cells. Not unexpectedly it has unusual side-affects like making gums grow over the teeth and increased growth of hair everywhere. Some patients leave hospital looking like apes and transplant patient guides even have sections on how to remove hair. Using cyclosporin is also an effective way to get lymphoma cancer and other deadly diseases. Cardiologist Yoshio Watanabe says, "one cannot ignore the fact that cyclosporin causes hypertension, renal failure and left ventricular hypertrophy in 76% of recipients of any organ."21 Two biologically derived anti-rejection drugs are Azathioprine and OKT3. They are made by injecting human blood products into mice, rabbits and other animals whose own immune responses produce anti-bodies to kill the human anti-bodies. Lab technicians then drain the blood from these animals and isolate their anti-bodies that are fully primed to kill human anti-bodies. Doctors inject these aroused anti-human anti-bodies into the transplant recipient’s blood stream and they surprise and devastate the killer T cells leaving the patient’s immune system injured and unable to quickly attack and destroy the transplanted organ. These drugs mentioned above plus other anti-rejection drugs like Cortico-steroids, Anitithymocyte globulins, cyclosporin, Tacrolimus (Prograf), also produced from soil fungus, and Mycophenolate mofetil collectively have side-effects such as kidney and liver failure, high blood pressure, high cholesterol, diabetes, hypertension, chipmunk cheeks, skinny arms and legs, large weight gain and bone marrow damage. Psychological effects may be exaggerated fears and panic attacks to the point of psychosis, blood and guts nightmares, wild mood swings, bad tempers and hallucinations and insanity.22 Steroids also cause vertebrae collapse and slipped disk symptoms which are treated with painkillers.23 These are a few of the ghastly contra-indications of anti-rejection drugs. Organ Recipients get AIDS-like Diseases Organ recipients getting AIDS-like diseases is the open secret of the transplant industry, a secret they choose not to share with the donating public. Most recipients die of diseases caused through immune suppression rather than from transplant organ failure. The immune system is not an optional extra and by weakening its ability to kill the transplanted organ it also becomes too weak to kill anything else. The patient becomes vulnerable to the same illnesses that kill HIV-AIDS sufferers. This means a common cold, a scratch, microbes from semi-cooked meat, raw eggs and uncooked dough may become a life-threatening disease. Transplant recipients can expect, and I emphasise, can expect, malignant cancer tumours caused by a suppressed and damaged immune function.24 Clint Hallam and The Thing Clint Hallam was in a New Zealand prison serving time for financial fraud when he accidentally sawed off his hand. He joined a very short waiting list for hands and transplant coordinators found him a brain-injured boy in France. Doctors declared the boy “brain dead”, sawed of his hand and sewed it onto Clint’s stump. Clint had a strong, healthy body and was overjoyed with the transplant until the anti-rejection drugs gave him diabetes. Then, to add insult to injury, the French hand attacked his skin and intestines in what is called Graft-Versus-Host Disease. Clint might have accepted bad health and an ungrateful hand but The Thing looked so weird and failed to perform like a normal hand. It was soft, white and hairless, had little sensation and couldn’t grip properly. Clint wanted to play piano and ride motorbikes, but The Thing couldn’t do anything except look weird. Clint felt so silly he began wearing a glove over The Thing until it just got too much. Clint told the transplant doctors to chop the weird thing off. They were furious. They wanted to complete the experiment. The drug companies were also angry, as Clint was what they called a post animal-model clinical trial subject, or, as we call it, a guinea pig. The first one. The surgeons followed Clint’s orders and sawed The Thing off. They had to. He had command of the mass media that were waiting to do a horror story on The Thing. Now that The Thing has gone Clint has become healthier and stronger no longer needing anti-rejection drugs. He does have just one hand but The Thing was useless anyway. Oddly enough, the surgeons had considered the transplant a complete success. Their aim was to transplant a hand. Clint Hallam’s personal health was a secondary matter. Matching Donors and Recipients The ferocious reaction from the anti-bodies rejecting a stranger’s flesh is minimised by matching the recipients and donors so that blood types are compatible and Human Leukocyte Antigen (HLA) tissue matches are as close as possible. Often based on a level of one to six the higher the antigen matches the less rejection the organ will experience. The immune system is less ferocious towards body tissue most similar to itself. Immediate rejection is also reduced by catching the immune system by surprise and through injecting the recipient with anti-rejection drugs prior to transplant. Immunologists adopt a third precaution by avoiding transplanting an organ that has similar antigens to a previous transplant or even a blood transfusion because the immune system is already sensitised to these antigens and forewarned and forearmed against them. A fourth factor is pregnancies. A woman’s immune system initially reacts towards a foetus as a foreign growth that should be killed. The foetus responds, without damaging the mother, by disabling the woman’s immune system towards it but not to other growths or infections. The danger is that a transplanted organ may have the same antigen characteristics as a woman’s foetus. The immune system remembers this type from years before and is ready for the kill but this time the transplanted organ can’t healthily disable the immune system attack, as did the foetus. These factors have to be considered before a transplantable organ is allocated to a patient. Louis Washkansky It was pneumonia that killed Louis Washkansky. Denise Durvall's heart transplanted perfectly but Christian Barnard and his team used excessive cortisone to protect it from rejection. Along with pre-transplant irradiation this weakened Louis’ immune system so that a minor infection, caused from holes drilled into his legs to drain excessive fluid, rampaged throughout his body. Barnard’s team then over-used wide-spectrum antibiotics that killed a whole range of microbes but not the one they were aiming for. This left his body open and vulnerable. The infection got worse and turned to pneumonia. The patient’s lungs clogged up, his feet turned blue and the famous Louis Washkansky was dead eighteen days after his historic 1967 transplant. 25 Transplant recipients are never cured. Their life is like walking a tightrope between rejection of the organ and deadly diseases arising from immune suppression. It is exchanging one medical condition for another. And 95% of patients lose to one or the other. Inga Clendinnen says, in Tiger’s Eye, of her transplant that, "We know that for us health is an artificial condition. We will remain guinea pigs, experimental animals for as long as we live or, if you prefer, angels borne on the wings of our drugs, dancing on the pin of mortality. We know that today is as contingent as tomorrow". 26 I go to the clinic every couple months. I count my pills, swallow them carefully. I intend to live. 27 Christiaan Barnard said,"You cannot stay in the laboratory forever" 28 He, like Inga Clendinnen, was a realist and saw beyond the donation agency hype. There is always a point where a range of medical procedures are still experimental but that the donation agencies will try to persuade the public into thinking otherwise. |