TITLE: Nepal villagers duped into selling kidneys and told organ would regrow - now country faces new health crisis
https://news.sky.com/story/nepal-villagers-duped-into-selling-kidneys-and-told-organ-would-regrow-now-country-faces-new-health-crisis-13098662
EXCERPT: The village of Hokse in Nepal has a unique and exceptionally troubled history. It's known as Kidney Valley because someone from almost every household has sold a kidney.
Brokers have been visiting the area for years, persuading people to part with an organ, despite the fact it's illegal.
Locals have desperately tried to shake that infamy in recent years - they feel duped, damaged by it. Some say they were exploited, some claim they were even told their kidneys would regrow. Some have died as a result of what was done to their bodies.
And now tragically, poverty is fuelling another health crisis in Nepal - with kidneys again at the heart of it.
Increasing numbers of Nepalis have chosen to work overseas in the Gulf States and Malaysia to make more money for their families back home. But that's come with its own jeopardy.
Young, once healthy men are returning to Nepal in desperate need of a kidney transplant. Some scientists say it is the result of exposure to extreme heat and severe dehydration.
A few years ago, Suman, 31, was so broken financially and emotionally, he considered ending his life. He felt he had "no option" but to travel to India to sell his kidney to a woman pretending to be his sister.
It was a physically excoriating process that has scarred him. He was paid £3,000.
"I felt weak and I lost consciousness," he says. "When I woke up, it was really hurting. Now I can't work and I try to tell anyone I can, not to sell their kidney."
Suman was not certain if the doctor knew what he was doing but Indian law is clear - donors must be related and they must present the relevant paperwork.
Organ trafficking remains a major concern in India. It is fuelled by a wide gap in demand and supply.
The lack of donors has given rise to a black market, with doctors and hospitals among those exposed in investigations into "cash for kidney" rackets.
But it is not unique to India. Estimates suggest that globally, one in 10 transplanted organs have been trafficked.
TITLE: A biased test kept thousands of Black people from getting a kidney transplant. It’s finally changing
https://apnews.com/article/kidney-transplant-race-black-inequity-bias-d4fabf2f3a47aab2fe8e18b2a5432135
EXCERPT: At issue is a once widely used test that overestimated how well Black people’s kidneys were functioning, making them look healthier than they really were — all because of an automated formula that calculated results for Black and non-Black patients differently. That race-based equation could delay diagnosis of organ failure and evaluation for a transplant, exacerbating other disparities that already make Black patients more at risk of needing a new kidney but less likely to get one.
A few years ago, the National Kidney Foundation and American Society of Nephrology prodded laboratories to switch to race-free equations in calculating kidney function. Then the U.S. organ transplant network ordered hospitals to use only race-neutral test results in adding new patients to the kidney waiting list.
“The immediate question came up: What about the people on the list right now? You can’t just leave them behind,” said Dr. Martha Pavlakis of Boston’s Beth Israel Deaconess Medical Center and former chair of the network’s kidney committee.
Pavlakis calls what happened next an attempt at restorative justice: The transplant network gave hospitals a year to uncover which Black kidney candidates could have qualified for a new kidney sooner if not for the race-based test — and adjust their waiting time to make up for it. That lookback continues for each newly listed Black patient to see if they, too, should have been referred sooner.
Between January 2023 and mid-March, more than 14,300 Black kidney transplant candidates have had their wait times modified, by an average of two years, according to the United Network for Organ Sharing, which runs the transplant system. So far more than 2,800 of them, including Evans, have received a transplant.
But it’s just one example of a larger problem permeating health care. Numerous formulas or “algorithms” used in medical decisions — treatment guidelines, diagnostic tests, risk calculators — adjust the answers according to race or ethnicity in a way that puts people of color at disadvantage.
Given how embedded these equations are in medical software and electronic records, even doctors may not realize how widely they impact care decisions.
“Health equity scholars have been raising alarm bells about the way race has been misused in clinical algorithms for decades,” said Dr. Michelle Morse, New York City’s chief medical officer.
TITLE: Surgeons Implant Pig Kidney Into First Living Human Patient
https://www.healthday.com/slideshow/surgeons-implant-pig-kidney-into-first-living-human-patient-2
EXCERPTS:
· The pig kidney, provided by eGenesis, underwent 69 genetic edits to remove harmful pig genes and add beneficial human genes.
· Retroviruses in the pig donor were also inactivated to eliminate the risk of infection in humans.
· The recipient, Rick Slayman, 62, underwent a four-hour surgery and is recovering well, expected to be discharged soon.
· Slayman, who is Black, agreed to the transplant as a potential breakthrough for ethnic minority patients facing unequal access to kidney transplants due to organ shortages and systemic barriers.
· The genetically altered pig kidneys offer hope for addressing the organ shortage crisis, with over 100,000 people in the US awaiting organ transplants, primarily kidneys.
· More than 1,400 patients at MGH alone are on the kidney transplant waiting list, highlighting the urgent need for innovative solutions like xenotransplantation (transplanting organs from other species).