About the whole topic about transplantation and covid vaccine. I got a kidney transplantation a few years ago - one of my relatives was my donor so maybe my insight might help you to understand the complexity of the topic.
- Bad covid cases that require hospital care can lead to kidney faillure and a fair share of covid patients in ICU need dialysis. A transplanted kidney is even more sensitive to this kind of problem.
- When you are getting a kidney, you need to pass a big amount of tests. You will be asked to stop smoking/drinking and change your diet. If you have any health problems you will need to be treated prior any transplantation. You will also have a psychiatric assesment - and if you have a living donor, they will also have a big amount of tests to be sure they are healthy. They will also have a psychiatric assesment.
- You will be also requested to get vaccinated. After the transplantation you will be immunocompromised for the rest of your life. Immunosuppressant drugs are the only way to prevent the body to reject the transplant. Any vaccine you'll receive after will be less effective while at the same time - being immunocompromised you are more at risk from any disease. At the time of the transplantation you will receive extra strong doses of immunosuppressants. Those will be reduced after a while. Took me 18 months to be on a very low dose. So the months after the transplantation, transplanted patients are at an even higher risk of catching something that will have a nasty outcome (not great in the time of a pandemic). Plus in the event of the rejection of a transplant you will again receive ultra strong doses of immunosuppressants. Transplanted people also receive every year flu shots because they have much higher chances to develop a bad outcome than someome not immunocompromised. In the case of covid, transplanted patients are much higher riks to need hospital care. I have heard quite bad stories from transplanted non-vaccinated people with kidney faillure and so.
- By the way immunosuppressants can make you more at risk of developping a cancer and create other health issues. That's a fact. But giving a longer life expectancy and a better quality of life trump for most of people the possible side-effects. I have every year a few check-ups to be sure everything is fine. If someone is against the covid vaccine well to me it doesn't make sense to be then ok to get immunosuppressants as there are more chances of bad outcomes from those than the vaccine.
- If you are getting a transplant from a dead donor, you might pass 4-5 years on a waiting list. Sadly there are more people who need a kidney than kidneys donors. So every year some people die because they couldn't get transplanted. To be put on a waiting list you need to meet all the requirements I described. Your age, your health but also your aptitude to take care of yourself are criterias. Those criterias are chosen on a ethical basis. Not everybody can be transplanted so the priority is given to the people that are the most suitable candidates to a successful transplantation that will last.
- In the case of a living donor, there is a commission that checks there is no money involved between the donor and the receiver. The surgery is no joke and even though risks are low, they are still present. To perform this surgery on a healthy person that won't benefit from it is contrary to the hypocrate sermon. But you can save a life and free a spot on the waiting list that will benefit another receiver. Those benefits are taken into account but it is then requested to the receiver to meet the susmentionned criterias to ensure that this surgery is worth the costs to the donors. It can look unfair but from the doctors' point of view, they take a big responsability by opening up someone perfectly healthy so they have to make sure they are doing that for a good reason.
- At the end of the whole process to be eligible for a transplantation, an ethic committe will review your case to either assess if you can be put on a waiting list or receive a transplant from a living donor.
- Since I have been transplanted I cannot eat raw meat, raw cheese, raw eggs, vegetables not washed with vinegar. I need to protect my skin from the sun as being under immunosuppressants my chances of getting a skin cancer.
All those conditions - and the process (it took me 10 months to complete it) can look harsh but they are the fruits of intense ethical debates. They are important because black organ markets are strong around the world. It is amazing people can be saved because of transplantation. But the whole system can be so easily perverted and it needs to highly controlled to limit the abuse and as a receiver there will be more expectations towards you than any other surgery that doesn't involved other potential receivers or an other healthy human being (as a living donor). You can be of course against and those rules are not in stone. But there is a logic behind it and it doesn't seem to be the worse option when you sss what's happening when there are not regulations.
Being transplanted is not just a surgery. It's a change of lifestyle. I am young and without this transplantation my life would be completely different (or I would already be gone). I consider this transplantation as a gift and I take great care of my health and my transplant because I want to enjoy as much as I can from this second opportunity to have a good and fulfilled life.