Wednesday, December 26, 2012

In case you didn't notice...

It's been pretty quiet in this corner of the world. Partially because I've been otherwise and occupied and also because I decided to stop repeating myself and confine all my posts to the blog's new (sorta) location at www.livingdonorsarepeopletoo.com.

Read, comment, subscribe to the rss, or set up a google alert and follow along.

xoxo
C

Sunday, November 18, 2012

Hollywood's Age-Old Age Problem



Recently a friend and I were discussing films, most specifically the age difference between men and women actors whose characters are romantically/sexually interested in one another (so hetero pairings). My friend, who watches a lot of old, old films, espoused the opinion that modern films are egalitarian in their casting. I disagreed.
So, out of curiosity, I conduced a very nonscientific* experiment where I consulted a smattering of films released in 2012 via IMDB,com and consulted the ages of the players I knew to be romantically/sexually linked in the films. Emphasis is noted on an age difference of more than 5 years.

Skyfall:
James Bond/Daniel Craig - 1968
Eve Moneypenny/Naomie Harris (sexual tension) - 1976
Severine/Berenice Marlohe (sex in the shower w/ Bond) - 1979
Flight: [note: didn't include the ex-wife, but it wouldn't have helped the case; she's much younger too]
Whip Whitaker/Denzel Washington - 1945
Katerina Marquez/Nadine Velaquez (sex partner in film's opening scene) - 1978
Nicole/Kelly Reilly (Love interest and sex partner later in the film) - 1977
Argo:
Tony Mendez/Ben Affleck - 1972
Christine Mendez/Taylor Schilling - 1984
(only seen in one scene, at the end)
Taken 2:
Bryan Mills/Liam Neeson - 1952
Lenore/Famke Janssen - 1964
Here comes the Boom:
Scott Voss/Kevin James: 1965
Bella Flores/Salma Hayek: 1966 (I'm going off the commercials that these characters get involved)

Ted:
John Bennet/Mark Wahlberg - 1971
Lori Collins/Mila Kunis - 1983

Total Recall:
Douglas Quaid/Colin Farrell - 1976
Lori Quaid/Kate Beckinsale (aka the pretend wife) - 1973
Melina/Jessica Biel (the real love interest) - 1982
Savages:
O/Blake Lively - 1987
Chon/Taylor Kitsch - 1981
Ben/Aaron Johnson - 1990
Looper:
Joe/Joseph Gordon-Levitt - 1981
Sara/Emily Blunt - 1983
Suzie/Piper Perabo - 1976
The Amazing Spider Man:
Peter Parker/Andrew Garfield - 1983
Gwen Stacy/Emma Stone - 1988
The Avengers: [note: Even though there is technically no hanky-panky, I wanted to include The Avengers to show the broad age range (and quantity) of the male characters as compared to the female, and the again, highlight age differentials]
Iron Man/Robert Downey Jr - 1965
Capt America/Chris Evans - 1981
The Hulk/Mark Ruffalo - 1967
Thor/Chris Hemsworth - 1983
Black Widow/Scarlett Johansson - 1984
Hawkeye/Jeremy Renner - 1971
Agent Maria Hill/Cobie Smulders (just to throw another woman in) - 1982

Silver Linings Playbook:
Pat/Bradley Cooper - 1975
Tiffany/Jennifer Lawrence - 1990

Rock of Ages:
Sherrie Christian/Julianna Hough - 1988
Drew Boley/Diego Boneta - 1990
Mike Whitmore/Bryan Cranston - 1956
Patricia Whitmore/Catherine Zeta-Jones - 1969
Stacee Jaxx/Tom Cruise - 1962
Constance Sack/Malin Akerman - 1978
The Five-Year Engagement:
Tom Solomon/Jason Segel - 1980
Violet Barnes/Emily Blunt - 1983
The Vow:
Paige/Rachel McAdams - 1978
Leo/Channing Tatum - 1980
This Means War:
Laren/Reese Witherspoon - 1976
FDR Foster/Chris Pine - 1980
Tuck/Chris Hardy - 1977
Arbitrage:
Robert Miller/Richard Gere - 1949
Ellen Miller/Susan Sarandon - 1946
This is 40:
Pete/Paul Rudd - 1969
Debbie/Leslie Mann - 1972
Hope Springs:
Kay/Meryl Streep - 1949
Arnold/Tommy Lee Jones - 1946
Playing for Keeps:
Stacie/Jessica Biel (the estranged wife, son's mother) - 1982
George/Gerard Butler - 1969
Denise/Catherine Zeta-Jones (the femme fatale) - 1969
The Odd Life of Timothy Green:
Cindy Green/Jennifer Garner - 1972
Jim Green/Joel Edgerton - 1974

Results:
21 films, 40 different couplings.
20 of those couplings/matches have actors within 5 years or less of each other
20 of the male/female actor pairs are 6 years or more apart in age  (woo-hoo basic math)
8.325 = average year/age differential of all 40 pairs.
14.4 = average of those with a 6-plus year gap..


While my sample is far too small and limited, I'd be interested to analyze age statistics in regards to the film's target audience (both age and gender), because I suspect there is a bell curve sort of thing happening. In other words, I theorize that films with young male protagonists (20s) and/or those with older female protagonists (50s+) will have actors more closely aligned in age. Those in the middle, where character age is more elastic, will have greater discrepancies between their male and female actors, with females overwhemingly being the younger of the pair.

I have no idea if contemporary films are more egalitarian than older films, but I'm not sure that matters. The pertinent question is whether an 8+ or almost 15 year age gap between sexual/romantic partners is an accurate reflection of our society. If it's not (which it isn't), we should ascertain the reasons why Hollywood continues to perpetuate this myth, and what it says about our values regarding gender, beauty standards, and profit.


*Not only is this unscientific for the obvious reasons, it's also because I don't have intimate knowledge of EVERY film released in 2012 so I couldn't include everything.

Saturday, November 03, 2012

Ten Year Kidney Donor Data Causes a Scandal


Recently, I posted information from the Swiss Living Donor Registry on the health and well-being of kidney donors ten years post-donation. Well, it seems that the researchers at the registry, who owe their paychecks and employment to the Swiss government, are more than a little ticked off about their numbers being made public.
As I understand the situation, Dr. Thiel (of the Swiss LD Registry) gave a bunch of data to the german tv show REPORT MAINZ in April 2011 for a July 2011 broadcast focused on living kidney donor chronic fatigue (remember that?).
The Swiss Federal Office of Public Health (BAG) released their annual report in December 2011*, which contained data from the Swiss Living Donor Registry. Problem is: the data reported to BAG didn't match the data given to REPORT MAINZ by Thiel some months earlier. BAG omitted the statistics on long-term fatigue, everything on cardiovascular events and disease, and minimized the incidence of hypertension.

I did mention the Swiss government commissioned the data collection on living donors, right? That the Swiss government is funding the registry and its subsequent product, yes?

Given the situation, the folks at REPORT MAINZ did what any good investigative reporters would do - they released the data in a July 2012 broadcast, specifically the information on hypertension, cardiovascular events, and chronic kidney disease stage 3/4.
The remaining Swiss living donor registry doctors, when confronted with this, reacted like any person caught in subterfuge would react - they protested, yelled, stomped their feet, and when they didn't work, they sued.

First they claimed that releasing the data was a violation of their copyright. (WTF? It's TAXPAYER FUNDED RESEARCH).
Then Nolte, one of the Swiss LD Registry researchers, said that publicizing the data jeopardized her future publications (even though she presented the fatigue data in 2009).
When that didn't work, Steiger, who took the helm after Thiel's death, demanded a correction, stating that the incidence of cardiovascular disease among living kidney donors wasn't an issue because it was equal to that in the general population. (Except that living kidney donors are supposed to be HEALTHIER than the general population, so if they're experiencing cardiovascular events and disease at the same rate, and reduced kidney function is associated with a higher risk of CV events and disease, removing a living donor's kidney increased their incidence of cardiovascular disease!).

And now a lawyer has issued a Cease and Desist letter, and threats are flying at the journalists.

By all accounts, Thiel was a caring and respected doctor and researcher. It's not likely he would knowingly give false information to a reporter, or participate in concealing truthful data from the Swiss govt or public. If the remaining researchers can prove the data Thiel gave to REPORT MAINZ in mid-2011 is false, or at least, way over-exaggerated, why don't they just do it? Why all the weird, side-stepping threats?

I don't have any answer for any of that, but I thought the controversy important enough for you to know. As more rolls in, I'll keep you updated.


*Thiel died in January 2012, so it's likely he had very little to do with the numbers given to BAG for publication.

Abecassis, M., Fisher, R., Olthoff, K., Freise, C., Rodrigo, D., Samstein, B., Kam, I., Merion, R., & , . (2012). Complications of Living Donor Hepatic Lobectomy-A Comprehensive Report American Journal of Transplantation, 12 (5), 1208-1217 DOI: 10.1111/j.1600-6143.2011.03972.x

Thursday, November 01, 2012

Public Kidney Donor Solicitation Redeux

We've had a visitor.

Remember the 2010 post on public solicitation, using a real world example? Well, the recipient's sister found the post and gave us her thoughts. You might find them interesting.

Read all about it here.


Just a reminder: the blog's new home is www.livingdonorsarepeopletoo.com. I've maintained this location for quite awhile, but I can't promise I'll do so indefinitely.

Saturday, October 27, 2012

Live Liver Donors Placed on Transplant Wait List


Below is official OPTN data of living liver donors who have, subsequent to their donation, been placed on the deceased organ transplant list in need of a new liver.
What the chart doesn't include is the total number of living liver donors in the US during that particular year. Here you go:
1999: 257
2000: 406
2001: 524
2002: 363  <- two high profile deaths this year: Mike Hurewitz and Danny Boone
2003: 322
2004: 323:
2005: 323
2006: 288
2007: 266
2008: 249
2009: 219
2010: 282 <- two more high profile deaths: Ryan Arnold and Paul Hawks



N
%
Year of Donation
1
16.7
1999
2001
2
33.3
2002
1
16.7
2007
1
16.7
2008
1
16.7
Total
6
100.0
Year Listed
1
16.7
1999
2001
2
33.3
2007
1
16.7
2008
1
16.7
2010
1
16.7
Total
6
100.0
Days From Donation to Listing
1
16.7
2
5
1
16.7
7
1
16.7
8
1
16.7
20
1
16.7
2787
1
16.7
Total
6
100.0
Waiting List Removal Reason
1
16.7
Still Waiting
Deceased Donor tx, removed by tx center
3
50.0
Died
1
16.7
Cand. condition improved, tx not needed
1
16.7
Total
6
100.0

Wednesday, October 24, 2012

NY Says Kidney Donor Was 'Unjustly Fired' after Donating to her BOSS


Last spring, articles sprung up all across the web about a woman who participated in kidney swap so her boss could have a kidney transplant. "The surgery left her with damaged nerves in her leg, digestive problems and mental health issues" , Soon after returning to work, before her kidney transplant recipient boss, she was fired.
So she filed a complaint with the New York Division of Human Rights.
And they have just ruled that was she was 'unjustly fired', clearing the way for a hefty lawsuit.

Of course, my question then and now is: why didn't anyone at the hospital's transplant center or the National Kidney Registry (NKR) that arranged the swap, recognize the inherent coercion of the employer-employee relationship and put a stop to the donation in the first place? They should be held responsible too.

Tuesday, October 23, 2012

Do Kidney Donors Have Kidney Disease?


Short answer: We don't know.
Why Don't We Know?
Because after 60 years, we still have no reliable data.

The following are excerpts from Srinivas and Poggio's recent publication:

Unlike any other situation in the practice of medicine, living kidney donors undergo extensive evaluation, with the express and central goal of confirming suspected health instead of suspected disease.

No standardized reference values exist for each of the [GFR determination] procedures used in clinical practice. Thus, the decision of proceeding (or not) with donation is unfortunately often a matter of subjective interpretation rather than more precise science.

It is clear that the creatinine-based GFR estimation equations are not acceptable in the setting of living donor evaluation, mostly because a significant percentage of kidney function needs to be lost before there is a corresponding change in serum creatinine level. 

Although the creatinine clearance always overestimates true GFR..., this method has become the ‘‘standard of care’’ across most transplant centers mostly owing to the lack of a better alternative. This is a good approach as long as the clinician keeps in mind the common potential limitations of this test:
(1) it is reliable only when done properly,
(2) it overestimates GFR by an unpredictable percentage, and
(3) it is not usually interpreted in the context of age- and gender-specific reference values.

Currently, donor renal function is often evaluated without taking into consideration age- and gender-specific reference values, with the result that any value .80 mL/min/1.73 m2 is generally considered appropriate for proceeding with donation.
[Note: Which is exactly what the Joint Societies Consensus Document said, but OPTN stripped it out of the final proposed public policy in 2011]

Thus, the exact magnitude and proportion of risk attributable to donation in the postdonation development of medical conditions cannot be ascertained in the absence of well collected, documented, and retrievable predonation data and equally stringent and complete postdonation follow-up.

...absence of kidney disease or hypertension at the time of donation does not guarantee absence during the life span of the individual.

Thus, when evaluating the 25-year-old donor, one needs estimates of 50- to 60-year risk, not just the estimates of risk obtained from published studies of understandably limited duration (even those with up to 30 years of follow-up). Unfortunately, such data do not exist, and the absence of such data should be emphasized in the informed consent process(emphasis mine)

It is also counterintuitive to think that donation of half of one’s renal endowment would somehow guarantee safe passage in the face of unmonitored (or untreated) postdonation accumulation of comorbidities as donors age.

And there we go, yet another reason why living donors should be given the same 10-year registry as transplant recipients.


Srinivas, T., & Poggio, E. (2012). Do Living Kidney Donors Have CKD? Advances in Chronic Kidney Disease, 19 (4), 229-236 DOI: 10.1053/j.ackd.2012.05.008