A bad NHS advert

[RedDwarfIV]

I was listening to the radio. The adverts were on.

This started playing:

'Black people in the UK are three times more likely than white people to need an organ transplant. That means black people have to wait longer for a transplant. We need more donors, so sign up at www.NHS.gov [or something] today.'

That\'s just silly. What it sounds like to me is that they are saying you can\'t give a black person a white person\'s organs. To my knowledge, the biggest barrier to transplants is ensuring the donor is a match for the recipient so that the organ is not rejected by the recipient\'s immune system.

To quote Monty Python, 'The plumage don\'t come into it' - Basically, I don\'t see how having the pigment for black skin affects the transfer of a heart or lungs or somesuch from a white person to a black person.

Your thoughts?

[Thobewill10]

That\'s not at all what they\'re saying. They\'re saying, put in simple supply/demand terms, that any group that has an above-average demand for organs will, percentagewise, receive fewer organs as the supply is constant. They are simply asking you to increase the supply.

Think of it like this: There are 10 gerbils: 5 blue, 3 green, and 2 pink. They are all in need of cute gerbil hats. However, only 5 hats are available. If they are allocated \'fairly,\' so that 1 pink, 1 green, and 3 blue get hats, the percentage of blue gerbils that get hats is lower (30%), compared to the percentage of pink and green gerbils (50% and 33% respectively). If 7 hats were available, allocated so that 1 pink, 2 green, and 5 blue gerbils get hats, now that percentage has increased to 50%, simply due to the fact that more organs are available.

[Kryten]

There is actually a bit of that, but it\'s just due simple genetics. People of the same race are likely to be more similar to each other genetically than they would be to people of a different race (not too much, but enough to factor into something like this), which means higher chance of matching organs.

[popeter123]

the NHS is still a great thing

unlike the us were it costs something like $50\'000 for a transplant

where here in the uk in tax to the NHS we only pay like £30\'000 or something for everything free hosipital wise

[RedDwarfIV]

The point I\'m making is that they are making a distinction between black and white people.

If the organ matches, it usually gets put in that person. Whether they are black or white should not matter. You mentioned genetics - yes, that\'s true, but black skin only requires one or a few chromosomes to be active where in a white person they would not be.

If the NHS wanted more donors, they should say 'There is a shortage of organs for transplant. Please apply to become an organ donor at www.NHS.uk', not 'Black people\'s organs fail more often than white peoples\', so apply for a donor card.'

Its just unnescessary. And at worst, it gives out the wrong message.

[softweir]

There is a medical distinction between black and white people when it comes to transplantation: tissue types. The cells in all organs express a wide range of glycoproteins and lipoproteins on their surfaces, and these vary from person to person. If immune cells detect an unfamiliar tissue-type they attack it. If you put an organ with the wrong tissue-type into a person then there will be rejection. Immunosuppressants help by reducing the rejection so you can allow some mismatch between donor and recipient, but get it too badly wrong and they won\'t do a thing.

Some organs express fewer tissue-type factors than others, so blood can be very widely donated (if the white cells are filtered out), livers will work in a wide range of people, lungs need to be carefully matched, and bone marrow needs to be EXTREMELY carefully matched.

People of different ethnicity have different ranges of tissues types, which makes it very much harder to match organs and recipients from different ethnic groups. There is some overlap, so a small percentage of donations are cross-ethnic, but the majority of transplant recipients will get an organ from a person of the same ethnicity.

There is a particular shortage of bone-marrow transplants for black kids with leukaemia, which is especially sad given that bone-marrow can be donated through live donation - that is, you don\'t need to die to donate it, you can walk in, have a small procedure and walk out that evening. It\'s more uncomfortable than donating blood, but nowhere near as uncomfortable having toothache!

Sadly, people of mixed race have especial difficulty. A great many children with leukaemia receive bone-marrow from a close relative such as a parent or sibling. However, people of mixed race have extremely widely varied tissue types, and a child can end up with a mix of tissue types that are too much unlike their parents or siblings for them to receive bone marrow from them. They actually have a better chance of getting marrow from a total stranger who, by sheer chance, matches their mix of tissue types - but only if that total stranger has signed up to a register of potential marrow donors.

That is the main reason behind that NHS advert.

If you want a long read, go to: http://en.wikipedia.org/wiki/Transplant_rejection

[Ydoow]

Its just unnescessary. And at worst, it gives out the wrong message.

Not if it\'s statistically true...

They didn\'t look at the genome and say 'Hrm. Black genes should fail more often than white people.'

They looked at data over the past decade or two and saw that there was an average of 3:1 ratio of black people on the waiting list to white people.

I\'m not sure if this is being debated or not, but they aren\'t advertising for certain colored people to donate. They\'re just asking for people in general to donate in order to raise supply.

But truly, it\'s clearly targeted at black people as a bit of a \'scare tactic\' using available data to get them to consider donating.