Because organs are scarce, hospitals choose patients who are most likely to survive a transplant.
A 31-year-old father lost his opportunity for a heart transplant because he refused to get vaccinated against COVID-19, according to CBS Boston.
David Ferguson told CBS that his son, DJ, whose heart is failing, has two children and a third on the way. The family said DJ was at the front of the line to receive a transplant at Brigham and Women's hospital in Boston. But he won't budge on the vaccine, which the hospital requires for transplant patients.
"It's kind of against his basic principles; he doesn't believe in it," Ferguson told CBS. "So because he won't get the shot, they took him off the list of a heart transplant."
Each transplant hospital has a selection committee that decides who is eligible for new organs. Because organs are scarce, they often choose patients who are most likely to survive a transplant.
Committees may evaluate criteria, including whether the patient takes their medication regularly, how much alcohol they drink, whether they smoke, and their vaccination records. Protection against infectious diseases can be critical for survival, since transplant patients must take immunosuppressants for the rest of their lives in order to prevent their bodies from rejecting the new organ.
"This is not a new issue," Dr. Alyssa Burgart, a transplant anesthesiologist and bioethicist at Stanford University, told Insider. "A patient's ability to fight off a lot of diseases can be compromised. And so for many transplant programs, this is seen as a way to protect the patient and the organ."
"I feel terrible for that patient, because he sounds like he is otherwise motivated for transplant," she added. "I think this really highlights how politically and societally entrenched it is for folks who are refusing vaccination, despite the overwhelming evidence of safety."
Brigham and Women's defended the decision in a statement to CBS, noting that the hospital follows similar protocols to other US transplant programs: "The COVID-19 vaccine is one of several vaccines and lifestyle behaviors required for transplant candidates in the Mass General Brigham system, in order to create both the best chance for a successful operation and also the patient's survival after transplantation."
Organs are scarce, so some hospitals prioritize vaccinated patients
Hospitals in Ohio and Colorado have also denied transplants to patients who refuse COVID-19 vaccination. The American Society of Transplantation strongly recommends that organ recipients and their household members be vaccinated against COVID-19. Experts at Loyola Medicine made the same recommendation in an ethics-based analysis earlier this month.
"Post any transplant — kidney, heart, whatever — your immune system is shut off," Arthur Caplan, the head of medical ethics at New York University's Grossman School of Medicine, told CBS. "The flu could kill you, a cold could kill you, COVID could kill you. The organs are scarce. We're not going to distribute them to someone who has a very poor chance of living, when others who are vaccinated have a much better chance post-surgery of surviving."
More than 106,000 people in the US are on the transplant waiting list for human organs, — waiting for the death of a registered organ donor who has a compatible kidney, lung, liver, or heart — according to the Health Resources and Services Administration. On average, 17 people die each day waiting for organs.
Transplant patients have a much higher risk of dying from COVID-19 than the average person, due to their weakened immune systems. Research has shown that kidney-transplant recipients with COVID-19 have a mortality rate between 13% and 39%. An early-2020 analysis of multiple studies found an average mortality rate of 20% among transplant patients with COVID-19. In comparison, the COVID-19 mortality rate in the general US population is around 1.2%.
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