[snapetom]

I'm a pessimist and when I look at the graft half-life in your article, it puts a wet blanket on things. For example, half of kidney transplants from a deceased donor fail in 7-9 years. That's not a lot of time. A lung gets you on average less than five years.

I would be interested in whether it's survivorship bias, or lack of in this case.

[hpagey]

The average lifespan of deceased donor kidney is 10 to 15 years and for live donor is around 15 to 20 years. People normally get multiple transplants throughout their lives.

[jxramos]

I thought all donors had to be living with a beating heart, are deceased non-heartbeat donors viable for some subset of organ transplants? How does this work exactly?

[throwaway81523]

They collect the organs from people who have just died, such as in car crashes. In the paperwork for getting a California driver license, you check a box saying whether you are willing to be an organ donor. If you check yes and you are later killed in a crash, they immediately bring your remains to a hospital that is always awaiting such deliveries, and a transplant operation gets going right away.

Motorcycles are sometimes called "donorcycles" because of the high likelihood that any given crash will be fatal, and that the rider is young and healthy and thus a highly desirable source of transplant material.

[NoImmatureAdHom]

It's important to understand that there are some very strong selection biases here in the U.S.

While fatalities per passenger-mile may be 24x cars (as below), you have to realize that the population riding motorcycles in the U.S. is not a random sampling. These people aren't trying to get around, they're acting out an image. For that behavior I don't blame them, but it is what it is.

Anecdotally, a little less than half of U.S. motorcyclists are fat, bald, drunk dudes riding Harleys or Harley look-alikes with the legal minimum protective gear (which in some states is none at all), while another little less than half are young, shirtless dudes on sportbikes. To their credit, they are wearing full-face helmets (because you can't go 200mph without one). Also, something like half of motorcycle fatalities involve alcohol[0]. Yikes.

<10% of motorcyclists are riding reasonable, well-maintained bikes with a modicum of skill and all of the proper protective gear.

So while motorcycling qua motorcycling may be more dangerous than driving a car per vehicle-mile, the difference is probably a lot smaller when controlling for differences in the behavior of people doing it. To put it in perspective, in the U.S., if motorcycling is ~30x deaths per vehicle mile compared to cars, bicycling is ~20x (though you do get exercise, which extends your life). And miles per motorcycle (or bicycle) are << miles per car per year in the U.S. People don't realize, but moving to the suburbs and driving everywhere vs. living in the city is taking the same sort of risk one might by motorcycling. </rant>

[0]: https://en.wikipedia.org/wiki/Motorcycle_safety

[btilly]

People needing organ donations are sometimes told to move to Florida.

Florida motorcyclists are not generally required to wear helmets. Therefore they more efficiently get to the "donor" stage.

[hyperpallium2]

A friend studying prosthetics told me half the recipients are motorcyclists.

Riding a motorbike is amazing fun, but if you ride long enough, something terrible will happen. Every rider has a story of an accident. Although you are more manoeuvrable than a car, can get out ahead of traffic, are smaller, can see more, and are more keenly alert... a little tap you'd hardly notice in a car can kill you.

[AmericanChopper]

A doctor friend of mine would joke about it being good organ transplant weather when it was raining, because they’d get dead motorcyclists turning up in the rain so frequently.

[Causality1]

It's rather astonishing that all the safety regulations for cars manage to exist in the same legal system that allows motorcycles on public roads at all. Last I read the death risk ratio was about 24x.

[JohnBooty]

Surely it's because: on a motorcycle you usually only hurt yourself?

In a car you tend to hurt other people including any kids, etc that may be along for the ride.

[Causality1]

More likely it's just because cycles existed before the safety regulations and there would be too much backlash to banning them. Plenty of other things that only harm yourself, like drugs or unpasteurized milk are also illegal.

[taneq]

I’m still amazed by this one. My first thought on riding a 250 was “how is this possibly legal?” And then the jump to a big bore (non-cruiser) is completely insane.

[_carbyau_]

As a motorcycle rider (every day commuter) I often think that if motorcycles didn't already exist, they wouldn't be allowed to.

As per sibling comment, maybe the only reason they are tolerated is that the risk is statistically largely to the rider themselves.

IE the person taking the risk is largely the target of the consequences.

If motorcycles somehow magically penetrated into peoples cars in a crash I think people would rule them out pretty quick.

[mechanical_bear]

> called “donorcycles”

Only by ghouls.

[_carbyau_]

As a rider, I too dislike people labelling me as having a deathwish. Clearly, I do not.

But calling names the other way won't help and I can see why the donorcycle term has stuck. There is enough of an element of truth to make it stick.

[short12]

Organ donation is based on recently dead people. Heart, liver, kidneys, eyes etc are all up for grabs as soon as possible

I learned yesterday that a heart has a shelf life of about 6 hours and liver is 12

[klipt]

Fun social engineering fact: countries that make organ donation (on death) opt-out instead of opt-in have much shorter waiting lists for organs. The USA could save thousands of lives by switching to opt-out.

https://en.wikipedia.org/wiki/Organ_donation#Opt-in_versus_o...

[njarboe]

Funnier social engineering fact: If it's legal for people sell their kidneys, wait lists for kidneys goes to zero[1]. Too bad only one country in the world does that.

Another fun fact. The US government spends more on dialysis than the budget for NASA.

[1]https://en.wikipedia.org/wiki/Kidney_trade_in_Iran

[ricardobeat]

From news sources I found, it looks like the system in Iran works exactly as one would expect: the poor and desperate end up with one less kidney while not significantly benefitting from the trade.

Which is precisely the reason such sales are outlawed worldwide.

[taneq]

Surely for the budget of NASA, the U.S. government could just buy or build their own dialysis machines instead of paying for hospitals to do it.

[whimsicalism]

Presumed consent would effectively end waiting lists for most organs.

[disabled]

Yep. I have type 1 diabetes for 27 years, and so far, no complications.

I recently contracted a shiga toxin producing E. coli strain which was cultured from my bowels. I also cultured entericocci (ETEC) but that’s not relevant to the discussion. I am lucky Shiga toxin E. coli (remember this famous Jack In The Box Breakout, FTW https://en.m.wikipedia.org/wiki/1993_Jack_in_the_Box_E._coli... ) did not affect my kidneys.

I am a dual US|European Union (Croatian) national. Croatia has one of the highest (ethical) transplant rates in the world. Let it be known that I would get it in Croatia over the USA.

[singlow]

I learned today that one can be a living heart donor. There is a special type of donation where a person who needs lungs gets a lungs+heart donation from a deceased donor, while the living person's healthy heart is transplanted to another person whose heart needs to be replaced. It seems this has advantages both for the lung recipient and the heart-only recipient and allows for compatibility in cases where the lungs and heart of the deceased person will not work separately for the two recipients.

[ectopod]

Sure, but "dead" is a Humpty Dumpty word. Some organs need the donor to be legally but not colloquially dead. In other words, you are dead and your heart is still beating.

[jxramos]

can you share a link, I'd like to learn more about this "organ shelf life". Very fascinating. Maybe I was mistakenly applying the sudden death of the brain without blood perfusion to hold likewise for every other organ. Like a heart attack when blood ceases to flow into it turns the myocardium to scar tissue. But that must not be an instant process, probably takes some time. I know temperature can keep tissues viable longer too, so that's another variable to consider.

[jxramos]

This article is pretty fascinating, never knew about so called preservation solution https://www.livescience.com/how-long-can-donated-organs-last...

[Someone]

The brain doesn’t die suddenly without blood perfusion, either.

If it did, heart transplants wouldn’t work at all.

[rcxdude]

For the brain it's pretty damn quick (minutes before significant damage). heart transplants rely on being able to run an artificial heart and lung machine to oxygenate and pump the blood while the heart is stopped, removed, and replaced.

[jdsully]

Where I am being on an organ donor list also makes you eligible to be used as a cadaver. I’m not comfortable being prodded by med students but would give an organ.

[generalizations]

Considering that some people have been revived without side effects after multiple hours of being brain-dead (e.g. famous example of women who drowned in icy water), how 'dead' is 'dead', in the context of being an organ donor?

I've heard it said that "you're not dead until you're warm and dead", but 6-12 hours doesn't seem like a lot of time, to make sure you're not coming back.

e.g., I drown in an icy pond, and I'm found after 5 hours. I might be revived, I might not...but the heart only has an hour before it's toast.

[manquer]

Clinical Death != brain dead, Clinical death has a very well defined and nearly irreversible process [1].

The longest human is known to be revived is only in the range 10-15 minutes. Brain damage is quite likely at this point. The longest for an animal is for cat - 1 Hour.

Only clinically dead people are eligible for organ transplantation

[1] https://en.wikipedia.org/wiki/Clinical_death

[generalizations]

That's what I'm concerned about. Clinical death is apparently survivable.

> Reduced body temperature, or therapeutic hypothermia, during clinical death slows the rate of injury accumulation, and extends the time period during which clinical death can be survived. The decrease in the rate of injury can be approximated by the Q10 rule, which states that the rate of biochemical reactions decreases by a factor of two for every 10 °C reduction in temperature. As a result, humans can sometimes survive periods of clinical death exceeding one hour at temperatures below 20 °C.[20] The prognosis is improved if clinical death is caused by hypothermia rather than occurring prior to it; in 1999, 29-year-old Swedish woman Anna Bågenholm spent 80 minutes trapped in ice and survived with a near full recovery from a 13.7 °C core body temperature. It is said in emergency medicine that "nobody is dead until they are warm and dead."[21] In animal studies, up to three hours of clinical death can be survived at temperatures near 0 °C.[22][23]

I'd rather not be harvested too quickly, when I could have been revived without issue.

[sbierwagen]

>how 'dead' is 'dead', in the context of being an organ donor?

Doctors occasionally jump the gun: https://www.fox6now.com/news/father-accused-in-hours-long-st...

[larrik]

I'm assuming it's that you can get a kidney transplant from a family member who is lying in the OR next to you. Deceased donors are transported from wherever they died.

[robbiep]

Non-heartbeat donors can be for corneal, bone and skin grafts

[maxerickson]

I don't really understand your formulation here. How is your view about the benefit of organ transplantation pessimistic?

Patients living 7 years instead of dying in short order is a pretty good trick for doctors to be working. For pessimism to make sense, there needs to be some better option than that available.

[snapetom]

Did you read the original article? The context of this is in regards to dementia.

A dead 40 year old, regardless of whether they had a transplant at 30 or not, is probably not going to have dementia.

[maxerickson]

There's a reasonable sample of over 65s.