Six Months Old, Eight New Organs

AEton writes "According to the BBC, Dr. Andreas Tzakis has just successfully replaced six-month-old Alessia Di Matteo's liver, stomach, pancreas, small and large intestine, spleen, left kidney, and right kidney in a record-setting operation. The child is so far doing fine with a one-year-old baby's organs. Tzakis is no stranger to multiple-organ transplants; in 1997 he set the previous record of seven organs by replacing seven of a two-and-a-half-year-old's organs. It must be a little odd to know that a growing plurality of your tissue used to be someone else's."

Comments

Antirejection drugs

[baryon351]

Do kids who get transplants this young need to be on anti rejection drugs for the rest of their lives? I know they're exceptional at healing & recovering from major surgery at extreme young ages, but don't know if there's an extra ability to 'adapt' to foreign tissue.

Re:Antirejection drugs

[tomreagan]

Yes, but not nearly as many. It's not 'adapting' so much as 'not learning' - the immune system is much more immature and you can keep it from learning that the foreign organs are present.

very old people need fewer drugs as well, as their immune systems are simply weaker.

Re:Antirejection drugs

[frazzydee]

I believe that they do have to take antirejection drugs- regardless of their age. this site says (on the 7th page) "Again, as with the tiny premature babies and the dialysis patients, that up-front cost gives us an expanded capability to keep people with failed hearts alive a lot longer so they can receive even more care. Transplant patients can live for a very long time. The post-transplant follow-up care?including ongoing antirejection drugs . . ." So there you go. In addition, this site also claims that "Babies who now receive an incompatible blood-type heart still must take immunosuppressant drugs to ensure their bodies don't reject the donor heart. All transplant recipients, regardless of their age, blood type or the organ they receive, must do so."

Re:Antirejection drugs

[LordPhantom]

Unfortunatly, yes they do. I am no doctor, but from knowledge I picked up due to personal experience with a kindey transplant patient, and a few references I found through a quick google (http://www.scienceblog.com/community/older/2003/B /20036915.html, http://surgery.uchicago.edu/patients/ped/p_ltc3.ht m, and so on) implies that. Basically, because any transplanted organ is a 'foriegn' object (it _is_ from someone else's body), the body's immune system recognizes that it is not part of it's body and attacks it in much the same way it would attack an infection. Because of this, all transplant recipients (including small children) must take drugs to lower their immune system's response to such things so that the body dosen't kill the new organ.

Re:Antirejection drugs

[Necromancyr]

This is actually wrong. Unless you replace ALL of the immune system in a person, their immune cells will recognize and attack a foreign body - it's recognized as non-self. Anything non-self is attacked.

What your stating is based on a flawed (but common) misconception that the immune system 'learns what is dangerous' or attacks what is dangerous, which hasn't been shown by any real facts/supporting research.

In addition, a childs immune system is only 'immature' based upon the fact that it hasn't been exposed to as many antigens as an adult - which allow for a rapid secondary response when re-exposed to those antigens. An example is chicken pox - once you get it, your exposed to the antigens and your body can rapidly respond if exposed to it again so you only get the chicken pox once (most of the time.

Lastly, for the first few months alive, babies also have passive immunity that is gained from their mother. So, this would add an entire other level of complexity if the 'maternal' antibodies were to attack the new organs as well - though I have no idea if they would still be present at 6 months after birth. (As a side note, it also sometimes occurs that a mother's immune system will reject the baby and have to be treated with certain drugs to reduce/stop the killing of the fetus via the mothers immune reaction).

So, IMHO, yes, the child has to take the drugs for their entire life.

One last comment - very old people need more drugs because their bodies are failing because they are...OLD. Organs and cells do not have infinite lifespans. They simply can't deal with being sick at all - whereas a younger person can deal with the flu. Given the same level of immune response, the frail old person would die while a young healthy person would live.

Come on Tzakis

[Anonymous Coward]

I know you can do 9...

Ship of Theseus

[arvindn]

Reminds me of the Ship of Theseus : When every component of the ship has been replaced at least once, is it still the same ship?

The same question could be asked about this baby :)

Of course we can't yet do brain transplants, so I guess one can say its the same person as long as its the same brain.

--
Wanna play some word games?

Re:Ship of Theseus

[pholower]

Well, depends if all the parts were replaced at the same time! But I suppose it is a lot different when thinking of people. Obviously they are the same people no matter what organs are replaced, except, I suppose, for the brain. We are our brains.

Seems kinda like replacing parts on cars. It dosen't matter what you replace the car will always have its mileage, until of course you change the engine.

Our brains are our engines. Damn, now I sound like a gear-head.

Re:Ship of Theseus

[cperciva]

When every component of the [baby] has been replaced at least once, is it still the same [baby]?

Yes. The law says that it is the same ship (err, baby); laws are a codification of social norms; and identity is nothing other than a social norm.

This becomes even more obvious when you consider that replacing elementary particles is a no-op.

Re:Ship of Theseus

[kylegordon]

Not neccesarily... My old Land Rover has a new engine, but still has the mileage (and it's clearly evident).
The gearbox is still the original, along with most of the drivetrain. But the wheels, engine and odometer have all been replaced. It's still the same Land Rover though, in terms of its registration number and VIN plates.

I don't think you can clearly draw the line in this kind of situation. Various authorities have guidelines to follow when trying to determine if something has changed significantly, but if it looks and behaves the same, and has the same identification marks then it's generally considered to be 'the same'. This doesn't account for originality of all the parts though, which I guess is the real question here. I guess we should just be happy that our cars still work, and that the kid is alive :-)

Re:Ship of Theseus

[betelgeuse-4]

A significant proportion (I've heard estimates of 98%) of the matter that you consist of right now wasn't part of you this time last year.

Re:Ship of Theseus

[Lust]

consider this: what fraction of the molecular content within you (including your brain) will be there within a year? Replacing one liver, one cell, or one amino acid at a time...philosophically no different, although biologically very different. A proton is a proton, provided it gets put back in the right place. :)

Re:Ship of Theseus

[rsidd]

This becomes even more obvious when you consider that replacing elementary particles is a no-op.

Nope. This is a logical fallacy called the Paradox of the heap.

I think you misunderstood the earlier post. Grains of sand are not identical; replacing every grain of sand in a heap, one at a time, gives you a different heap (though it may "look" the same. Actually, it would probably be impossible to replace each grain with a new one in the exact same position, because of packing issues.) However, elementary particles are identical, in a very fundamental and non-trivial sense. It doesn't mean anything to talk of "replacing every electron in your body by a different electron": in programming terms this really is a quantum mechanical NO-OP (or at most a change of sign in the overall wavefunction of the universe, if the number of electrons being replaced is odd, but this doesn't affect anything).

Re:Ship of Theseus

[Morel]

The idea behind this sort of thing reminds me of the Holy Cross
splinters you find in churches and museums all over the world.

You see, a long time ago the cross where Christ was crucified was
chopped up into small splinters. Everyone wanted a piece, and the
splinters were spread out all over the place. Since a LOT of
people wanted to own a splinter, the Church came up with a wonderful
scheme to make more splinters: Take Holy Splinter and insert it into
new wooden cross, wait 25 years and Presto! The entire cross is now
holy and undistinguishable from the original. Chop into small splinters
and repeat the process exponentially.

The same way a club retains its identity, even though today's members
are not the same people who originally founded it, the Holy Splinters
and the Ship of Theseus propagate their identity to all of their
constituent parts.

Cheers,

Morel

However...

[Slapdash X. Hashbang]

The one-year-old baby is not doing so well.

Psycological difficulties

[MrWim]

This is going to be really wierd/difficult when she grows up telling her that half of her organs come from someone else, a dead somone else. I wouldn't know how I'd react to hearing somthing like that. Wow

Re:Psycological difficulties

[Anonymous Coward]

My mother has a transplant - the organ is from a cadaver: a 30 some-odd year old woman who died in a traumatic way (likely auto accident, but we don't know).

Of course it is pretty disconcerting to know that someone has died, perhaps in a traumatic way. Especially a relatively young person who likely had a family that was grieving. Especially a person who died mere hours earlier.

But the donor didn't die because my mom was the recipient - my mom was the recipient because the donor died.

That's a pretty big difference.

My girlfriend at the time was "against" organ transplant due to a combination of religious beliefs and a lack of faith in the medical profession. In a nutshell, she claimed that someone was put to death so my mom could get a transplant.

Of course, that's a pretty dark and closed-minded way to think, and that's the primary reason why she is no longer my girlfriend.

Hmm, this is a tough one

[mu-sly]

I know this will sound harsh, but if your child is born with so many problems that they would die without eight organ replacements, one has to wonder what their long-term chances of survival realistically are.

I know we can work wonders with organ transplants these days, but how much is too much? What are this child's chances of having a reasonable quality of life after being born with so many potentially fatal problems?

It's sad to see your loved ones die, but I can't help wondering if the parents did the right thing under these circumstances.

No doubt my feelings on this would be much stronger if it was my own child in question, but it would seem we as a species very often let our emotions get in the way of rational thought, and I'm just not sure these parents made the right decision for their child.

This is most definitely a difficult issue - I could well be wrong, but I'm throwing my initial thoughts into the pot to see what others think.

Re:Hmm, this is a tough one

[pholower]

I can understand the thought you are having. I am having a similar one right now. But we as humans can not simply look at the world and "cut our losses" Sure, she may have it rough, if she lives past a year old.

But this is a person, a child, and you should let your emotions get in the way. Saving her life was not vain. But it does two things. And it does these two things well.

1) It gives this girl a second chance at life. There is a posibility that she will be fine, and live a normal life.
2) It gives surgeons, and scientist a base on which to look from. We can see how far we can go in order to become more acurate in treating this types of conditions. If we didn't who knows where we would be today. I mean hell, open heart surgery 50 years ago was considered barbaric, now it is an everyday procedure, and usually quite succesful.

Re:Hmm, this is a tough one

[xxdinkxx]

...atleast the child was _alive_ when born.
I wasn't .. not for 8 minutes atleast. (having the umbellical cord wrapped around your neck and snapped will do that).I had also lost more then 90% of my blood. This kid has more ofa chance then medical science will ever give him.
good luck to the kid. O btw. the doctors said that I would turn out to be nothing more then a vegetable when I did survive, but last I checked vegetables don't score 127 on i.q test ( not that i think i.q test really measure intelligence).

Re:Hmm, this is a tough one

[DavittJPotter]

I agree with you about if it's the "right" thing to do. Now, if this baby grows up, gets married, and reproduces, it's passing on the same flawed genetic material that it inherited n years ago.

I fear that because we can fix things, we're weakening our species as a whole. Survival of the fittest means that the weak die so they can't reproduce.

These new miracle cures, drugs for fixing all the ills of the body, etc. are wonderful money makers and boons to the afflicted, but nobody seems to be thinking long term on this issue.

All the parents will scream "but what if it was *your* baby?!?" That's exactly why I don't have children. I know my genetic code has some flaws in it. I will do what I can to make it through this life, and then die. The 'weird' and otherwise imperfect DNA will die with me instead of being perpetuated.

Re:Hmm, this is a tough one

[op00to]

No doubt my feelings on this would be much stronger if it was my own child in question, but it would seem we as a species very often let our emotions get in the way of rational thought, and I'm just not sure these parents made the right decision for their child.

Alright, Data.

Re:Hmm, this is a tough one

[whovian]

Losing a child is no doubt difficult. I know some women who many years after the fact still have strong emotions over miscarriages. Yet, they managed to make other babies that turned out healthy from the start.

Re:Hmm, this is a tough one

[DAldredge]

No. It isn't. If we as a society can not protect and do what is right for the weakest amongst us, then are we truely a civilized society?

Re:Hmm, this is a tough one

[mu-sly]

No. It isn't. If we as a society can not protect and do what is right for the weakest amongst us, then are we truely a civilized society?

It's all very well to come out with quotes like that, but the fact is that if this child had been born in a less affluent part of the world, she would have died, no question about it.

Worldwide we should be doing a lot more to help people less fortunate than ourselves. The money spent on saving the life of one baby who may just die in a few years anyway could have been used to help a much greater number of people.

I'm not saying that the two are mutually exclusive (they aren't) but eight other babies could have been saved with the same number of organs, or with the same amount of money a starving village could have been fed for a month.

Is it fair that if you're born with a whole load of problems but your parents have the money, we can fix you up, whereas if you're born with nothing wrong with you but your parents can't even afford to feed you, you should die?

We should protect and do what is right for the weakest among us, but defying the laws of evolution is pretty far outside of that.

Re:Hmm, this is a tough one

[phasefx]

I'd rather our species maintain a diverse gene pool. Who knows when a certain genetic tidbit could come in handy (for say, survival of the species). Think sickle cell and malaria.

-- Jason

Re:Hmm, this is a tough one

[Jugalator]

The problem as *I* see it is that these parents can doom this child for a very trobled future. I wonder how much the parents have reflected not over *their* feelings, but over the *childs* feelings. By doing what they are, they're saying: YES, you should have 8 organs replaced with all the implications this can cause, and YES, you should grow up on anti-rejection medicines, and YES you should have a high risk of dying in a near future. These decisions were all made by the parents before this child was even born, as the observations was made while she was in her womb.

Now, that can be pretty heartless to me.

Re:Hmm, this is a tough one

[tehanu]

To add to your comment, there are current debates going on, at least in Australia, and I imagine in other Western nations on whether it is feasible to try to give the best medical treatment possible to everyone. Of course they are only talking about government funds here, not private treatment.

The points being raised is there is only X amount of dollars available in the government for health. Yet with the ever increasing sophistication of medical treatment, the cost of treatments is going up. People who before would have died rather rapidly are now hanging on with new treatments. Ailments that were not life threatening but affected quality of life are now curable or much more treatable. And of course everyone wants the best treatments available. Also people are living longer and of course elderly people require more treatments. Add to this the ever increasing imbalance between the elderly and working tax paying members of society and some people think that we could be heading to a budgetary catastrophe in the future.

This raises the question of whether every medical treatment should be available to everyone. Whether or not we should ration our public health dollars to give the best return ie. bumping up the queue those who have the best chance of survival, who require the least money to treat, treat working age citizens and reasonably healthy children before the elderly and those who are very sick etc.

This of course is a controversial topic. The idea of having a committee choose who will live or who will die or telling someone that they can't get treatment because they are too old and no longer working and therefore no longer useful to society or I guess in this case, telling parents their kid will die because those 7 organs could be used to treat and cure 7 kids rather than just one, is very emotive and raises a lot of uneasy feelings and questions about the criteria to be used not to mention the uncomfortable closeness to eugenics and euthanasia. However it might be possible that in the future, if the public health $$ starts running out, we may be forced into this type of system.

Re:Hmm, this is a tough one

[dnoyeb]

I would simply do as every other animal on the face of this earth, and try again. This is definitely going too far, and I will not praise the doctor for carrying out such a grand experiment on this unfortunate family.

Its not difficult to me. Unless she could never have another child, its elementary.

Yes its sad to see your loved ones die, but life is not always better than death. Are they thinking of the child or themselves. I question.

Re:Hmm, this is a tough one

[lockholm]

I've thought about the same issue many times, and I think there's a couple of points that might be worth making.

The use of medical technology to sustain those who might otherwise die and not pass on their genes isn't some kind of anti-evolution, where we make the population into a bunch of weak slobs who cannot survive, their bodies riddled with diseases. We're simply stopping, piece by piece, the natural selection that eliminates those with unfavorable combinations of genes. However, in many cases, those genes would still be present in the gene pool even if we were undergoing natural selection. The genes in question are recessive, and sometimes there can come some benefit to the species in the long run for those who have one copy each of the "normal" and "abnormal" genes. A great example of this is sickle cell anemia: the prevalence of SCA increases in areas where malaria is endemic, because to be a carrier of SCA protects you somewhat against the disease, even though to have two recessive sickle cell genes means you will die early. (Natural selection at work in our world)

So if we were to, say, eliminate the disease malaria, perhaps - or find a way to save sickle cell patients who would otherwise die young, what would happen. Well, we know that the sickle cell gene would not disappear completely - look at populations for whom malaria is not a problem. The gene still exists, preserving the genetic diversity that allows our species to respond to the demands of natural selection, if and when they impose themselves.

So to allow humans with diseases that would have killed them before reproducing to reproduce - even then it does not necessarily mean that their children will have that condition. For one thing, a number of these conditions render the bearer infertile. For another, it takes two parents to make a child. Perhaps we would see an increase in negative genes in the general population - but the prevalence of these genes is not high in the first place, and to require medical care to live is also not the most attractive lure to a potential mate.

All of this does not take into account other aspects of life, such as whether we should strive to save the children of rich people (who we will then care for probably the rest of their lives) when we can help many poorer folk with simpler medical conditions. Honestly, I don't think I would have made the choice these parents did - but not because I'm sure it will spell the doom of our species. I'm confident that if and when our civilization crumbles and we are cast into the dark ages, natural selection will assert itself, and our gene pool will respond accordingly. But until then, perhaps continuing to save those who would otherwise not is only going to give them lives they might otherwise never have had.

ps: I can't tell from the details in the article, but many babies born with defects have those defects from developmental abnormalities, rather than genetic conditions - thus saving them doesn't change the gene pool.

Re:Hmm, this is a tough one

[yet another coward]

I know one thing that does not happen to Darwin's theory. It does not get learned very well.

There is no all powerful nature to reverse. There is just what happens. Through evolution, some individuals have more offspring; others fewer. Some species grow; others diminish or disappear. Consequently, the characteristics of populations change through time.

Evolution is not a moral law; it is a fact of life. Best and worst are defined by what actually happens, not by ideas of diversity or quality. Fit is defined by living long and reproducing fruitfully. If intelligence allows someone to accomplish those two tasks, then fitness depends on intelligence. If people survive and reproduce without much regard to how intelligent they are, it does not matter. If less intelligent people have more offspring, which is a completely reasonble proposition based on empirical data instead of egocentrism, then intelligence is not a positive survival trait.

I have neglected social impacts of traits when I strictly should not have. Traits that do not allow someone to live long or reproduce themselves might somehow allow others around them to do so. If their genes get passed along through parallel lineages, those genes might be beneficial for survival.

Re:Hmm, this is a tough one

[BioChemDork]

I used to think the same way too... 'till we ran to this case while doing rounds during my edical ethics class: A teenage girl was dying from heart failure (we were not told what this was caused by, since the this was an undergraduate ethics class) and required a heart transplant. Her cardiologist requested one from UNOS (United Network for Organ Sharing), and got one. The operation went reasonably well, but as I understand it, multiple clots eventually developed in her bloodstream post-surgery. Some lodged in her brain, causing multiple strokes of varying severity, rendering her comatose. Others lodged in varying organs, including her newly transplanted heart, causing it to slowly fail. Since her cardiologist was an attending physician at a large medical school, he had quite a lot of connections. He pulled some strings, and got the girl back on the heart transplant list. Second heart was found and flown in. (Second verse, same as the first, a little bit louder, a little bit worse...) After a few days... turns out it's incompatable. The girl starts rejecting the second heart, and it slowly begins to fail. Dr. Promenent Attending Physician with Connections pulls more strings (he's got a lot invested in this girl), and she's back up on the heart transplant list. Our professor, who was the pediatric neurologist called, assessed that the girl had no significant chance of recovering due to multiple strokes. And yet there she was, high up on the transplant list for her third heart! Morals of the story: 1) connections matter; if you're gonna get a transplant, go to a major teaching facility and get the attending physician to do it. 2) resource allocation of something as precious as a heart isn't as cut and dry as, say, deciding who gets a scholarship to college. You give away multiple grants to somebody, and everybody else who applied will scrape by and find another way to fund their education; you give away multiple organs to one person, and there's a good chance that many, many people will die waiting. Your argument presents a false dichotomy of either save the kid, or don't save the kid. (Who in their right minds would, without any other piece of information, say "don't save the kid"?) In reality, the case is this: Save the kid, or save a kid who needs a stomach, a kid who needs a liver, two kids who need kidneys, etc... Until the day that we are able to grow organs, scarcity will be an issue. And regardless of how "feel good" it is to perform heroic measures to save somebody, it is ethically remiss to give multiple transplants to the same person, whether it be in the form of three consecutive hearts, or a half dozen organs. Chosing one organ recipient over another because of their health, importance to society, etc., is an ethical gray area. But how anybody can claim that it's better to save a kid by giving her multiple organs, over saving eight separate kids each of whom needs one organ transplant, is beyond me.

Re:Hmm, this is a tough one

[UserGoogol]

Evolution is nowhere near the best way of making things better. It works, but it's slow, cruddy, and shortsighted. We have a new technique: intellegence. There's no reason to "weed out the weak" now that we can apply our mighty brains to the matter. Intellegent Design might not have been how we got here, but that doesn't mean we can't start doing some of it ourselves. Just because someone is not particuarly evolutionarily fit does not make them unvaluable to society.

Within a few generations, we'll be able to manipulate the genetic code directly. So whatever crap we might accumulate in these few generations isn't that big a deal in the long run.

Re:Question

[Anonymous Coward]

Also if new parts were brought in, old parts must have been removed. What happened to them? America needs to stay competitive in this free market world, and there is a huge cannibalism market opening up in Germany.

Re:10 years?

[HeghmoH]

"Has lived" normally indicates that the person lived for 10 years and continues to do so today. If the patient died, the quote has a bad (because it causes misunderstanding) grammar problem.

It reminds me of a joke...

[JamesP]

Doctor: I'm sorry to say, but your baby was born with no arms...

Mother: Oh, doctor, I don't care, I'll still love him...

D: I'm afraid he doesn't have any legs either...

M: Never mind, he's still my son...

D: He doesn't have a trunk...

M: Ah...

D: And no head, either...

M: But, what does he has...

D: An ear...

(doctor brings the ear)

M: OH MY SON, MY BEAUTIFUL SON...

D: It's no use screaming, cause he's deaf...

"your tissue used to be someone else's"

[Black Parrot]

> It must be a little odd to know that a growing plurality of your tissue used to be someone else's.

In rare cases, the cells of non-identical twins in the very early stages of development can merge into a single embryo, and develop into a normal "patchwork" adult, called a chimera.

IIRC this phenomenon was only discovered recently, when modern DNA testing revealed that these people have different DNA in different parts of their body.

Re:eh

[su2ge]

And you thought that being told you were adopted was bad..... just wait until this starts making it into the common pool of things to be told while you are growing up.

Re:10 years?

[Anonymous Coward]

Did that patient only last 10 years, or are they currently alive after 10 years? Would be very sad if 10 years is all this baby Alessia has to hope for.

I'd be pretty pissed if she died after 10 years. Think of how amazingly expensive this procedure probably was for their insurance company! That's money that you and I have to foot the bill for. At 6 months old, wouldn't it make a hell of a lot more sense to let her die and start over? If your computer is SO fucked up that you need a new motherboard, CPU, memory, hard drive, DVD-ROM, floppy drive, and there's a huge ass dent and scratch in your case and the plastic front is all cracked, wouldn't you just say fuck it and start from scratch? It may sound cruel and heartless, but this kind of surgery is just ludicrous for a baby. She's going to be fucked up for the rest of her life now whereas if they would've just let her die peacefully they could've started fresh.

Mutli Organ stuff

[Re-Bigulator]

I'm a med student working on the multi-organ transplant service in Toronto. I wonder what the real goal of these kinds of commmando surgeries are. The more organs transplanted, the greater are the hemodynamic derangements, the more compensation that has to be made for natural fluid balances and what not. The more organs, the more likely it is for her immune system to react and reject the foreign organs. I wonder what their plan is for the child's immune system. A 6 month old immune system is fairly weak, and in a normal infant it would gradually develop and become capable of defending the infant from your regular run of the mill pathogens. I'm not sure what would happen in this case; Alessia will certainly need lifelong suppression of her immune system with drugs like Tacrolimus (or steroids for bouts of acute rejection) which have their own side effects. The flip side is that a weak immune system predisposes you to develop systemic infections, sepsis and other nasty things. I know that in infants with HIV and other immunocompromising illnesses, they still get most of their vaccinations (except the live vaccines), so she may still be protected against those. It comes down to a dilemma not unknown to those who work in Neonatal Intensive Care Units. How far should we go to save these unfortunate children? I've seen in my time the so-called "Sick Kids Specials", children at our Hospital for Sick Children who were born incredibly premature (24 weeks versus 36-40 weeks for normal gestation) and sustained in increasingly advancing NICU's. These children rarely turn out normal, and in some cases, have up to 12 different major medical problems (kidney failure, cerebral palsy) etc. etc. What kind of future is in store for Alessia? I don't think a particularly long one; she will most certainly require re-transplantation of many of her organs (things like kidneys can last 10 years or so, small bowel transplants are so rare that I don't think there's that many studies of them). When you consider the cost, the mental anguish to both parents and to this increasingly developing child, and the cost to the public health system, I wonder if the right decision was made.

Re:Mutli Organ stuff

[Doctor Beavis]

You raise some good points. However, the same arguments could have been made years ago about any transplants, or severe burn victims, or any of a number of problems that were once considered incurable or prohibitively expensive and time-consuming to treat. It is primarily through such pioneering work that that advances can be made routine, safe, and affordable.

Miraculous. But...

[occamboy]

For starters, I'm awed that a child's life can be spared.

However, the cost of doing things like this is astonishing, even in countries outside the US where medical treatment is priced more sanely. How many infants and other folks people could be saved by spending this money elsewhere? For example, from today's NY Times:

Terror of Childbirth

I feel I will be flamed as a heartless bastard....

[Y-Crate]

however as much as I wish to see this girl survive and live a healthy, happy life you have to wonder if those organs might have been better used saving multiple children with one major organ failing instead of someone who seems to have a body that seems to be almost completely non-functional. Think about what this girl's long term prospects are - considering her body's frail state. Hardly anything inside of her works. Will she live a year and die, taking the truckload of transplanted organs with her, while others with one or two problematic organs and much better chances to survive long-term post-transplant are forced to wait and quite possibly die?

the only exception that i'm aware of...

[ecalkin]

is an identical twin transplant. i've read several references over that years that if one twin donates a kidney to the other that anti-rejection drugs are not needed.

eric

What is wrong?

[thogard]

I know a guy who started the whole "lets use computers to map the human geome" thing. I know about 20 bio people that have the brains to do good real science.

Not one of them are in the field anymore. it turns out that real science doesn't pay. We could pull of great things but we keep running off the people who can help. How many great biochemsists are working filling perscriptions at the local drug store? Too many and we will all pay at some point.

Humans contribute more than genes

[lildogie]

I have hemophilia, and I am not reproducing. Still, people around me seem to feel that I'm contributing substantially through my career and in my community.

When I was young, I'm sure everyone thought I'd die young from such a terrible disease. Now I have a normal lifespan and a relatively normal lifespan.

I have to say that issues around what the "right" thing to do are very complex, and distorted by health care financing, organ shortages, religious values, etc.

I recognize that I survive based on the generosity and altruism of blood donors. On the other hand, the medicine that makes my blood clot normally comes from paid plasma donors, some of whom donate in spite of having HIV, and the manufacturer accepting these donations accepts this.

You also have to consider that the picture is always different when looked at from an individual standpoint, in contrast to looking at it from public policy. It's been said that the cure for hemophilia is to let the bleeders die before they breed more bleeders. I have to say that this logic would have been an injustice to me, since I'm not reproducing (yes, I'm sure about that).

Re:Humans contribute more than genes

[ball-lightning]

It's been said that the cure for hemophilia is to let the bleeders die before they breed more bleeders.

Probably uttered by someone who is completely ignorant of genetics. Since hemophilia is caused by a recessive gene, just "letting the bleeders die" isn't going to do much. Just because someone has some bad genes, doesn't mean they don't have any good ones. My grandfather has usher's syndrome (which means I'm probably a carrier). He's also a genius (literally). Since genetics allows for the possibility that good genes will be passed on, while bad ones won't (at least in a portion of the offpsring) I don't see any reason to "selectively breed" people.

Re:Humans contribute more than genes

[Nimrangul]

Indeed, not everyone that donates is paid. Here in Canada I donate blood every two and a bit months. All I get out of it is some free Coke and a stored karma feeling (some day I'll be able to go on a homocidal killing spree and still be a good person for the lives I've helped).

I've been giving blood ever since legally allowed. A+ blood isn't the most in demand, but because I feel there are people that may need it at any given time and I like to think it's not a matter of being paid for most people elsewhere and that people are just decent folk.

Though I really hate the way commecials try to guilt-trip people into giving blood, it's not something that anyone should feel obligated to do. "It's in you to give" almost makes me want to stop giving blood in protest of them being asses about a kindness people do.

Re:Humans contribute more than genes

[sugar and acid]

But if a man with hemophilia were to pass on his genes to the next generation it will increase the prevalence of hemophilia in his grandchildrens generation. He can't pass it to his son, but any daughter he has will be a hemophilia carrier guaranteed. Also if his marries a women with the recessive hemophilia genes it will then be 50% probability that his children, both male and female could be affected, not just males. Should a daughter with hemophilia have children, then all her sons will have it, and all her daughters will be carriers.

transplant, ego and greed

[harvey the nerd]

Seriously ethically challenged: With no real prospect for long term survival, this little girl sounds like some ego driven maniac's insurance fueled biology experiment drawing scarce medical resources from the system. Kinder and better for everyone but the doctors to let this one go... Biologically a dead end, if the mother is still able she would be better off trying again. Societies that can't accept hard facts and choices, whither.

Could say the same about anti-biotics . . .

[Idou]

or incilin or any human advancements that have allowed people to live who would have otherwise died.

Everyone who draws the line of what is too far, like you just did, conveniently places that line to exclude any kind of technological help their survival has depended on.

There are plenty of people living in dirt, eating trash to survive for what will probably be a pretty short life. Maybe until such people decide that THEIR quality of life is so low that they start drowning themselves and their children in muddy puddles, we can implement a "quality of life" policy and put those poor souls out of their misery if they fall below the definition of "liveable". Until then . . . I say you are playing God with out any of the usual minimal requisites to play the part.

If you are going to argue against this, please, oh please, say that the same money could have been better spent to save many more lives in some developing country.

But making judgement on someone's quality of life is all fun and games until someone looks at YOUR marginal existence and says, "man, we should really put YOU out of your misery."

Is this why the U.S. can bomb people and say it is saving those same people at the same time? Under a dictatorship their quality of life is so low that it is well worth risking their death in an attempt to raise their quality of life to a level worth living? How noble . . .

I sympathize that you were merely trying to discuss the issue, but your assumptions reveal a value that has been the root of all types of exploitations of other people. The quality of life argument has been used to inslave, to kill, and to exterminate entire civilizations. And now, I fear it has been used to turn the U.S. into a tool to allows poorly educated politicians play God.

I fear God's retribution for such blasphemy . . .

Re:Could say the same about anti-biotics . . .

[Behrooz]

Quality of life, cost, and expected return should all be involved in making decisions about medical treatment.

It's not a moral question, it's a social question. Can society justify expending X resources to save the life of one individual? Can those resources be more efficiently spent in other applications which may benefit/extend the lives of a greater number of individuals? In this case, the answer appears obvious to me.

Withholding extreme medical care is not the same as killing someone, morally, ethically, or physically, and the primary criteria for the greater good of society is the collective good of its members. If you wish to personally fund extreme medical intervention on this scale, feel free... but don't insinuate that it is just or rational for society to compel other individuals to support it.

Does your definition of "Playing God" include forcing other people to spend their lives doing what you think is right? Think about it.

Who really knows what the future holds for her?

[steveoc]

Id agree that it seems a bit over the top that this child is using up so many organs from donars that could conceivably save a lot of other lives.

She may only live another 6 months, 6 years, 30 years, whatever .. who knows ? Maybe she will fully recover in a few years time, and then get run over by a truck - who knows ? The world is an odd place indeed.

I met a girl not too long ago who by all rights should never have survived, and who's whole life could be seen as a drain of resources to the people around her.

But then again, she managed to write a way controversial film script, and convinced enough people to produce the film.

The film went into production, and made it to the Cannes film festival, where she was hauled up the steps and taken along the red carpet.

After the screening of the film, the stunned audience wiped away their tears and gave a standing ovation.

Her name was Heather Rose Slattery. ACPA Site Here

Or you can read my small contribution Here

RIP Heather .. Im sure you can read this where you are now.

So ever since meeting Heather, Ive learned that there is no relationship between someone's physical condition, and their productive value to the rest of society. Its all pretty random really.

Natural Law

[moojin]

If a baby who is 6 months old needs 8 simulatneous organ transplants, then shouldn't the baby just be allowed to die naturally? I consider a single transplant or a tweak of an organ to justifiable, but isn't transplanting 8 organs in a 6 month old baby breaking some type of natural law?

I know it would be difficult for the parents to bear the sadness of watching their child die, but what if the organs are rejected in the future and they have to watch their child slowly wither away, while be connected to all sorts of tubes and wires? Could those 8 organs have been used to save 8 babies or young children? Could the money that was used to pay for this multiple transplant be used to save others' lives?

My wife is 8 month pregnant and I hope we never are in a situation similar to this. It would be difficult, but being faced with 8 organ transplants, I would think that some higher power might be telling me something about this baby.

Some people aren't getting itit

[C. Mattix]

A lot of people are saying "organs should have gone to different kids." While this may be true, this is also a test bed for future technologies.

Think about stem cell research. If in the future (as it looks like it will be), it woudl be possible to grow those organs from a slightly modified version of the child's stem cells (with the smooth muscle disorder corrected), then those would all have to be transplanted into the body. The same applies for adults who say may have stomach cancer. A new stomach and gastrointestinal tract, just to be safe, would be grown and then transplanted in.

I am not so jaded as to thing that this is a publicity stunt, especially considering they did not release the fact that it was taking place until well after the surgery.

To the "natural selection" people: why even bother with any sort of medicine then? Any influence that we have is not "natural." The same arguments can be made for such simple things as pacemakers, dialysis, and insulin therapy.

Hmmm . . . I see things the COMPLETE opposite

[Idou]

I thought that species with a DIVERSE genetic base had the best probability of survival.If, through technology, we are able to maintain an even MORE diverse code base, then is that not better?

Good genes, bad genes . . . in the current environment it is easy for you to pass judgement, However, when the environment changes, so must your definitions of good and bad. Since change is uncertain, there is no way you can really know which genes are good or bad. Would it not be better to hold on to as many different genes as possible, just in case we need them later?

Besides, if your genes are really detrimental to your daily function, you will already have a disadvantage that will limit the spread of your genes compared to other "good" gened people. There's additional medical costs, social prejudice, and simply a higher risk of death for people with inferior genetic material. You may live a quite normal and happy life, but individuals with similar genetic material as you will automatically be limitted, relative to other "healthier" genes. Plus, you have to take in account how large and diverse our population is now. Evolution will continue whether you decide to help it or not. It is simply the way the world works, not a policy one should live their life by.

Finally, it really can be argued that evolution is no longer relevant to human survival. Evolution takes thousands and thousands of years to mold species. Technology, on the other hand . . .well, keeping in mind the progress of the last 100 years, can you call me crazy if I were to say that technology could cure all illness within the next thousand years? With that in mind, maybe your genetics gives you a disadvantage physically, but the mental advantages to your genetics is a far greater advantage to the human race. Or maybe just having your gene set to study will allow the human race to understand our code that much quicker. Technology is just so much faster than evolution that even if your contribution is very, very small (like teaching your kid to program OSS), it is enough to make up for any genetic deficiencies.

And maybe the environment will change and your son will be the only one left to impregnate an entire generation of women . . . nomatter how slight the possibilty, how could you rob such a possibility like THAT from ANYONE!

Wrong emphasis

[danila]

What always annoys me in such articles is that the journalists concentrate on the kid and ignore the medical science. Come on, who cares about Alissia? She is only 6 months old - a less than complete human being, and a defective one at that. Why isn't the public told about what medical achievements made it possible, what infrastructure was created in the hospitals in the past decade to make this possible, about the doctors, nurses, their training, education, about computers, about tools, etc., etc.? Why? Certainly all that is much more important than whether yet another human baby will live or die...

Call me heartless, but crap like that BBC article breeds stupidity among general public and teaches them it's ok to ignore how things happen in our world. And hence some of the readers will say the obligatory "wow" (if at all) and go back to opposing stem-cell research, genetics, budget extension for medical schools, and after that will send their kid to some quack or a faith-healing program after consulting with a professionally made horoscope, of course...

ZIM

[Valdrax]

Dib: You'll never... get away with this...
ZIM: You speak craziness, Earth boy. More organs means more human. It WILL work.

-- Invader ZIM, episode 7

That was someone's child

[Anonymous Coward]

I don't see how you can make that joke, and how people can think its funny. Someone obviously lost their child, which is a horrible thing to have happen. Just hope that you never lose anything with significant meaning, because only then will you even begin to comprehend the cruelty of your statement.

This is Totally Wrong.

[Anonymous Coward]

Are you joking or do you just have no idea what you're talking about? There are ENORMOUS waiting lists for organ transplants. It is VERY, VERY likely that there are other children waiting to get transplants.

Misconceptions

[ssummer]

1. The number of organs transplanted is NOT an indication of the pre-op condition/prognosis of the baby or an indicator of post-op "quality of life".

Her disorder is a single disease process that happens to affect most of her vital organs. All other things being equal, a baby born with several disorders, requiring fewer organs transplanted (even as little as 1 or 2), actually could be considered "sicker", have a much lesser chance of survival and be a greater "burden on society".

2. Of the eight organs transplanted, some might not have actually been "diseased" (more on this later).

3. The greater the number of organs transplanted is not proportional to the surgical difficulty.

Not to take away from Dr. Tzakis' great achievement, but technically the surgery might have been easier than transplanting a few non-contiguous organs. Here is why:
If you ask any transplant surgeon, the most difficult aspect of the surgery is doing the anastamoses (or "rejoinings"). Essentially taking the entire foregut and midgut en bloc significantly decreases the number of "rejoinings" one has to perform.

Tzakis likely only had to join this single unit of organs (the liver+stomach+pancreas+spleen+small bowel+large bowel) at two points (those being #1 the original esophagus-to-new stomach and #2 the new large bowel-to-original rectum) for complete continuity of the gastrointestinal tract and then probably about another 4 anastamoses for blood supply.

The entire blood supply for all the aforementioned organs (minus the kidneys) originate from only 2-3 arteries arising from the aorta. To leave the original pancreas and spleen (which are not significantly affected by her disorder) would have been several times more difficult than taking the "whole package" because the vascular supply for each organ would have to be dissected and reanastomed individually. This is more difficult because it's more vessels to join and the vessels are smaller i.e. more difficult to work with.

Transplanting even only 3 of these organs in non-continuity would have required 1-2 GI tract and 2+ vascular anastamoses for EACH organ. If you do the math you can quickly realize why it was probably easier to take all the organs, even if some were not diseased.

4. Transplanting both kidneys is NOT the transplant surgery standard of care. The baby would have done fine with one kidney and there has yet to be any studies proving that transplanting two kidneys vs. one improves a patient's post-op outcome. But if Tzakis did not take both kidneys he would be stuck at 7 and we wouldn't be talking about this whole topic right now (take it however you want).

So to make a long story short:
1. The baby was not as sick or doomed as one might think.
2. It's a great accomplishment but it wasn't "pushing the envelope".
3. The ethical issues raised are no different than those for any other medical procedure or treatment: should society help the inherently weak at the expense of the strong or should we fall into the Darwinian model of society were it's survival of the fittest? Or is there a middle-ground as to how much help we give the weak and who/what determines how much and what is too much help to give?

Organ Donors

[macdaddy]

This is a perfect example of why people should become organ donors. Have it noted on your driver's license. Tell your family that you want all or some of your organs to be used if needed to save someone else. Ok, I can understand if you don't want your face to be altered for open-casket reasons (ie cornea donor). That does make sense. Remember though that morticians can replace your eyes with very life-like and nearly identical fake eyes and no one would be the wiser. The important thing is that you choose to be a donor. I'm sure this little girl will be very grateful in decades of her life yet to come.

Jesus!

[cookiepus]

Why didn't they just make a new baby? It's fun, and cheao.

Diversity

[yet another coward]

I think there are some important exceptions to your ideas. There are cheetahs. All of them are nearly identical genetically, not that they are thriving tremendously. There are species that no longer have males. They have only females who produce only more females. That survival strategy is not conducive to diversity, but the species have made it this far.

The risk for death for each and every one of us is 100%.

I doubt that we can help or hurt evolution. Evolution is just what happens. It does not get better or worse. It's just a bunch of stuff that happens.

Re:10 years?

[johnlcallaway]

I had similar thoughts when I saw this report on TV. I have to admit, if the baby were my child I probably would do all I could do to keep my child alive.

But are we just talking about the cost, or is there another issue that we have to consider. Technology is getting to the point where just about everyone lives to breeding age. This means that the defective genes these children have are passed on. Are we de-evolving as a species because we improve the chances of living to breeding age?

The only way that I can think to balance this technological conundrum is via genetics. If we could identify and correct such issues in an embryo, or go to the level of the movie Gattaca and pre-select those embryos with the best genes, that would decrease the possiblity of such extreme surgeries. Of course, that then brings up a tremendous number of ethics issues, but none that cannot be worked through, or that some small country won't become a haven for.

Or, in a more cruel line, if you can't afford it, you can't have it. Is it really societies responsibility to make sure that every child has an equal chance at attaining adulthood? Or is it their parents.

The United States has been taking more and more of the responsibility of parenting away from the parent and to the state. Our children are currently taught moral values by state-run schools, sex ed for example. There are numerous examples of parents being brought up on charges for spanking(I'm not talking about beating, I'm talking about a swat on the rump that every American over the age of 40 has had at least two or three times in their lives) or denying health care due to personal or religeous beliefs. Where will it stop?

I don't have the answers, I don't think anyone does. I am of the opinion that if you can't afford it, all you get is basic health care to treat colds, broken bones, etc., and the more expensive health care that is needed for 6 organ transplants are not guarantees. If a family can raise the money or a hospital wants to waive fees so they can try new procedures, those options should always be available.

Disgusting and barbaric

[flikx]

More research and funding should be put towards developing more artificial organs. The thought of extracting eight organs from a recently dead [but goulishly kept living] infant is disgusting and barbaric. Not to mention the poor quality of this potato baby's extremely short expected life. (Anti-rejection drugs, etc.)

The sappy article does nothing but manipulatively stir emotion. It is mindless drivel for the mongoloid masses. It is completely devoid of any mention of the technology behind this process.

While the technology is there for artificial organs, a lot of the research and engineering has not caught up. (Thanks to the fact that people would rather ban medical research, and instead fund sports programs.) Besides, a new baby could be made for a lot less effort and cost. A six-month-old is ultimately replaceable, and it not much more tragic than the loss of a family pet. Yes, it's tragic, but people, get on with your meaningless lives!

Value of human life?

[Zathras26]

I'm seeing some people here saying that this baby should have merely been allowed to die, and the parents encouraged to just "have another one". Obviously I can't say for sure, but I'd hazard a guess that most of these people aren't parents. If they were, they'd realize that most parents become deeply emotionally attached to their children very quickly, usually at an early stage in pregnancy, in fact, so it's not as though a six-month-old girl can simply be scrapped and replaced as though she were a defective car.

Here's a more pertinent point: once you start saying that some people are too "physically defective" to live, where would you draw the line? I, for example, am among the most physically health people around -- my mother always said I was "disgustingly healthy". Even so, had I lived in Nazi Germany, I would have been exterminated due to my "physical imperfections" (and no, I'm not Jewish).

Then, on a more personal level, there's my wonderful girlfriend, who's beautiful, incredibly intelligent (IQ in the mid 170s), who graduated from Berkeley with honors, and who spends her time rescuing homeless cats and advocating for social services for autistics (not to mention the ways she's brought joy into my life, in more ways than I can count). She was also born with severe birth defects that required eight or nine major operations over a number of years at a total cost of several million dollars. Was it worth it? I don't even have to wonder about that.

The simple fact of the matter is, you can't tell which human lives are going to be valuable and which ones aren't when the baby is so young. As to the argument of "quantity" -- that you could have saved more babies with those eight organs -- well, let's use your own calculus. Why is it so important to save the maximum number of lives possible, especially considering, as you point out, that making babies isn't exactly a huge challenge? It's not as though human beings are in short supply these days -- far from it. And it's also not as though most people even want babies, considering (for example) that one-third of all pregnancies in the United States end in abortion.

I realize this post is a bit meandering, but you'll have to excuse my lack of coherence. There are people responding to this article who are essentially saying that my girlfriend (a slashdotter whom I love with all my heart and plan to marry someday) should be dead because she's "too defective" and repairing those defects wasn't worth the cost or effort. It's hard to write clearly when your emotional response to such comments is interfering so much.

Time Enough For Love

[wideBlueSkies]

In this book, Heinlein chronicles the 2000+ year life of Lazarus Long. The character has had every organ replaced, his skin, bone structure(can't remember if the brain was swapped out).

When reading the book, I got the impression that the character still had the sense that he was the same Lazarus who was born. Probably because he had the same spirit and consciousness. Myself I wasn't so sure because he had been almost entirely modified.

Great book for a weekend's reading.

BTW, that's a generic link to Amazon, not one of those 'sales' links that people around here post sometimes.

wbs.

Re:10 years?

[Nurseman]

Think of how amazingly expensive this procedure probably was for their insurance company! That's money that you and I have to foot the bill for.

You think we should let her die ? Are you a parent ? How much would your childs life be worth ? To give her 10 more years of life ? This is why we have insurance, to pay for these things. How about surgery on co-joined twins ? Should we stop that because they might die ? Who should decide ? You ? Some HMO ? It's a little easy here to compare a child to your computer. I would like to see you so casual when it is your child who is going to die

A time to be born, and a time to die

[annielaurie]

I have to say first of all that I fall right in line with the other posts from people who are parents. I'm very thankful that I was never called upon to make tough decisions regarding my own two, and my sincerest wish is that both of them will outlive me.

I was thinking, though, of a recent storm in my own community about a baby who was born with only the brain stem intact (anencephaly) and with a defect of the digestive system that made absorption of nutrients impossible. The doctors recommended providing fluids and painkillers only and allowing the child to die naturally rather than putting him through the suffering of an operation to repair the digestive tract. This caused a storm of protest in the larger community--the baby's life must be prolonged at all costs because, after all, "life is sacred." Never mind that the life would be no longer than a few weeks--the suffering that this small being would be put through was considered by many people to be worthwhile.

I've also witnessed the same thing at the other end of life. Frail, elderly people are put through the ordeal of being resucitated even though their lives are drawing to a natural close. It's rough; it's the equivalent of taking quite a beating. Why do it to a fragile body whose time to die has come? This was done to my grandmother some years ago. It bought her three additional days during which her dying process was marred by bruises and strains and other discomforts.

While I can't argue for "mercy killing" and am on the fence about suicide, I feel I can argue against needless human suffering. I truly hope that the child who has received these transplants has some expectation of a happy life. But I do have to wonder where and how we draw the line and who gets to draw it.

An excellent reason for private health care

[John Murdoch]

This raises the question of whether every medical treatment should be available to everyone. Whether or not we should ration our public health dollars to give the best return ie. bumping up the queue those who have the best chance of survival, who require the least money to treat, treat working age citizens and reasonably healthy children before the elderly and those who are very sick etc.

In short, your post is an extremely good argument for America's system of private health care. When we start deciding how our public health dollars are spent, it doesn't take long for the healthy to realize that they outnumber the sick. When people realize, for instance, the very large portion of medical expenditures targeted at the elderly--well, hey. They're not productive members any more. And let's not forget about the special ed kids in school: some kid drooling in a wheel chair is never going to hold down a job or pay taxes either. If we just stopped giving them medical services, they'd die--and stop costing us money. Right?

Years ago I attended an economics lecture given by Milton Friedman, the Nobel prize-winning economist. He described a situation much like this, and went on at great length about the "tyranny of democracy." What happens, he asked, when 51% of Congress votes to shoot the other 49? In much the same way, the tyranny of democracy is expressed when the young, the healthy, the tax-paying, the well-educated discover that they could pay a lot less in taxes if they just killed off the lame, the halt, and the feeble.

This isn't an abstract argument: a population phenomenon in the United States called the Baby Boom means that an abnormally large population of people was born between 1948 and 1960. The oldest Boomers are nearing retirement age--and when 2025 rolls around (when the youngest Boomers turn 65) a disproportionately large portion of U.S. citizens will be expecting retirement benefits. As we get closer and closer to that point, I fully expect to hear more people claiming to be "courageous" and "willing to take a stand" by demanding that we kill old people.

For now at least, we (collectively) have no say in whether or not an Italian baby can have a lot of organs transplanted. And I think that's a good thing.

Bad example though

[riptalon]

Once you have the Chicken Pox virus, the Varicella Zoster virus, you have it for life. Your immune system will eventually beat it back and the Chicken Pox symptoms will disappear, but the virus will hide out in the nerve roots around your spine for the rest of your life. If your immune system is weakened by age, chemotherapy etc. the virus can break out again, burning is way up the nerves, usually on one side of your body, until it reaches the skin and causes rash and blistering. This is known as Shingles and is very painful. Not something you are usually told when you get Chicken Pox as a kid.

Re:Chicken Pox Vaccine

[RedBear]

There's a chicken pox vaccine... kids don't have to get chicken pox anymore. Hundreds of kids die of encephalitis due to chiken pox every year. There's also the school time lost, the scrring, and the eventual possibility of shingles.

Nonetheless, parents still "vaccinate" their kids by exposing them to other kids who have chicken pox at a convenient time, like summer vacation. Insanity.

I guess this is one of those "spay or neuter your pet" announcements. Get the issue out there.

I just talked to someone two minutes ago who says that the vaccine you're talking about doesn't actually keep you from getting the virus but rather just lessens the symptoms. If this is true, the vaccine wouldn't protect you from the possibility of Shingles as an adult. I would be interested to hear from anyone who knows more about the specifics of whether the vaccine does or doesn't actually keep you from acquiring the virus or keeping it in your system.

Very interesting thread. I can safely say until this point I had no idea what the root cause of Shingles was. (See grandparent post.)