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blanchasaur t1_iwbyjdu wrote

Prosthetics. The lower limbs are simple enough that you can use a fake one and still get around for the most part. They've even got those special legs for running that are banned in the Olympics for being too fast. It's just not worth the risks from transplants. With transplants, you have to take immunosuppressive drugs for the rest of life and your body will still eventually reject the donated organs.

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GolfandPoker t1_iwffa25 wrote

You seem like you know a thing or two about this.

What if it were from an identical twin?

Do you know how far away we are from growing organs with stem cells?

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blanchasaur t1_iwhp84l wrote

An identical twins organs should not be rejected but then then twin would be without their organs. With a leg the nerves and blood vessels won't have grown the same way so it would still be an incredibly complex procedure.

There is still a lot of research to be done with stem cell organs. Not sure why the other guy said it was prohibited. It's one of those things that is always a few years away so who knows.

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Orthopaedics21 t1_iwg0bhz wrote

It's quite rare to have a situation where an identical twin is available as a donor, and even if it's available, we don't compromise the life of a donor to benefit the recipient.

Growing organs from stem cells is strictly prohibited in the majority of countries to avoid misuse of technology, maybe research is going on but no way to know it's status unless govt allows to publish data.

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GolfandPoker t1_iwg84ug wrote

Hmmm, what about for a liver or kidney? People donate those all the time without dying.

What’s the point of stem cell research if not for organ replacement? That seems like the #1 reason to be researching them in the first place.

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Otherwise-Way-1176 t1_iwko42c wrote

“Growing organs from stem cells is strictly prohibited in the majority of countries to avoid misuse of technology”

No it isn’t. Where did you get this idea?

When I tried to find info about this, what I found are a number of sites that are quite excited that we might one day be able to grow organs to help people. That’s a pretty far cry from being banned.

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Orthopaedics21 t1_iwp0x8v wrote

Oh I was under the wrong impression. I looked for it It looks like promising area for researchers.

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limitless__ t1_iwc4qi0 wrote

People need to understand that transplants are never actually successful. When someone gets a new kidney/lung/heart the body wholeheartedly rejects it. The recipient has to take immunosuppressant drugs for the rest of their life which does nothing more than slow down the bodies ability to reject the organ. But reject it will. Consider that only half the people who get a lung transplant (for example) live 5 more years.

So you have that approach or you have a prosthetic. Prosthetic wins.

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scheav t1_iwd2efw wrote

Most transplant recipients die from unrelated causes. The statistic you used for lung transplants is out of date, and it was largely influenced by the first few people to receive lung transplants. The average life-span increases every year.

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If the first lung transplant were done 5 years ago you could say that no lung transplant recipient lived longer than 5 years and you'd be [technically] correct, but thoroughly misleading.

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Ophthalmologist t1_iwd44ov wrote

https://www.mayoclinic.org/tests-procedures/lung-transplant/about/pac-20384754

Mayo clinic states 5 year survival for lung transplant patients is around 50%. They usually keep their informational pages up to date.

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scheav t1_iwd6tyy wrote

Whether or not the statistic is out of date, my point still stands that most of these deaths aren’t due to rejection. The reason that lung transplants are needed in the first place is often the cause of other health issues. Some lung transplants are done for cystic fibrosis and the transplant isn’t a cure, as the new lungs will be damaged by the disease as well.

If you lose a leg due to diabetes you’ll likely have lower lifespan than if you lose a leg due to acute trama. Pointing to lung transplant survival as indicative of survival after a limb transplant is incorrect and disingenuous.

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Aviyara t1_iwh5rpu wrote

The three largest causes of death in solid-organ allografts (organ transplants) are cancer (which most immunosuppression courses are well-documented as increasing the incidence rate of), graft rejection, and infection.

I would not call any of these "unrelated causes." An allograft recipient is on immunosuppression for life.

You are correct, the prognosis of an allograft recipient gets better every year. This is not because allograft care in the late 20th century was spectacularly bad, and we're just making up for that statistical anomaly.

The first double-lung transplant recipient famously had her lungs outlive her.

Meanwhile, 41% of all lung transplant recipients in 2010 were dead by 2015.

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Ramjid t1_iwkgw9t wrote

Saying that they are "never actually successful" because they won't last a lifetime is pretty wild to be honest.

If that's your metric for success, you might as well call insulin shots or asthma inhalers or any kind of long-term treatment and surgical intervention "never actually successful".

I mean you're completely right: organ transplants aren't some kind of miracle cure and come with a huge heap of downsides and long-term consequences. They're a desperate measure for people in desperate situations.

But at least everyone involved knows this perfectly well and the stated goal here is never "to grant you a long and healthy life", but always "to improve your quality of life and prevent you from actively dying from organ failure right now".

It's important to remember that these are all people who've had years and often decades of suffering and therapy regimens and who have exhausted every "regular" treatment option available. With the possible exception of kidney recipients these are all people who went into surgery as severly ill as humanly possible without being dead.

These patients don't hope for or expect a long life free of illness. They just want to take a full breath again, leave hospital for a while and maybe get some independance back during whatever time remains.

And at that regard even lung transplants (which do have the worst long-term outcome of all) are hugely successful.

Many patients go from "permanently bed-bound, barely able to sit upright and literally dying" to not just "still alive" but to "fully independant, active, mobile and almost indistinguishable from a healthy person" in a matter of months and stay that way for years. And even those who don't recover quite so well or don't survive quite as long usually still end up with a way better quality of life than before and a longer life than they could have hoped for without a transplant.

Which by any sensible metric is a huge success indeed.

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Omnizoom t1_iwc0y8t wrote

Risk of rejection would be the biggest one , not to mention having to suppress your immune system.

And it’s all to get back something very simple and easy to replicate if not provide something that performs even better

Not to mention we already have a small supply of spare organs for transplants , it’s way harder for someone to donate that large of a chunk of tissue and survive

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Dande-l10n t1_iwcrrj0 wrote

And even if rejection wasn’t an issue, it’s not easy to connect all those blood vessels and nerves, especially between two different bodies. My dad had a surgery to transplant a piece of his quad from one leg to the other, and it took something like 10 hours of surgery to make all those tiny connections. Can’t imagine what the surgery time on an entire leg would be!!

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[deleted] t1_iwe91qd wrote

Nurse here that works in the operating room. I think one thing to consider here is the reason for amputation to begin with. For starters one of the biggest reasons for amputation is related to vascular problems i.e. PVD/PAD or Diabetic neuropathy. The patient is already not a great candidate for a limb transplant just because of limited healing factors related to the disease pathology. Now, trauma, brings another series of factors.

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[deleted] t1_iwg0iiq wrote

[deleted]

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Elhehir t1_iwgbh9n wrote

Lower limb amputations are far more frequently done secondary to diabetes and/or vascular insufficiency, than for trauma.

About 80% of amputations are done because of vascular insufficiency.

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R1GGRM0RT1S t1_iwinysx wrote

This has been my observation as well. Most of the time when looking at the diagnosis for these patients it's almost always related to vascular issues.

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