Sebelius: I Can’t Step Into Girl’s Transplant Case (When Other Children Are Just As Sick.)

[Yo_Mama]

15. When I was hunting around

I found out the following - some places have had success with stapling off the margins of the lungs. But that is apparently in a situation in which there is a bit of a closer fit. I imagine how much you have to staple determines survival rates. If you have to staple a whole lot, I imagine you are actually cutting off a lot of the actual lung capacity, which just doesn't work. The internal structure of the lung - the major airways - can't be disrupted, so it looks like you always have to trim the margins, which are where most of the oxygen transfer takes place.

Also I was looking at the single/lobe thing wondering if we couldn't use the publicity in this case to help her that way, but then I ran into this overview in Canada that says it just doesn't work in CF. They have to do a bilateral for CF cases. Not a lobe and not a single.

Therefore, I'm going to object to your characterization of this as "arbitrary". It's anything but arbitrary. Vanderbilt Tennessee's list has age greater than 65 or less than 14 as an absolute contraindication, for example. But of course that's for adult organs - when they find one that can fit, pediatric patients would be transplanted even if they don't do it there:
http://www.vanderbilthealth.com/transplant/25964

Wiki has some more info. This seems rather awful, but it is not arbitrarily awful:
http://en.wikipedia.org/wiki/Lung_transplantation

For the younger/smaller patients, what they are actually using is size. So what you are saying they should do is what they are already doing. If lungs small enough to work for her become available, she will get them. It's just that it is less likely, because this kid probably has a chest capacity close to that of an average 8 year-old, and not too many donations from kids occur, due to lower death rates.

I sympathize with everyone's distress. I was up for hours reading about this because I couldn't sleep, and I wondered perhaps if she were transported to another place whether she'd have a better chance. But it doesn't appear that's much of a factor.