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Amit Gupta Could Have Marrow Transplant by End of Year

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Re: Amit Gupta Could Have Marrow Transplant by End of Year

#41

Post by preamble »

leddt wrote: post #28
naz wrote: post #26

Earlier quoted context omitted.

How wrong it is to flake is irrelevant. You can't really force someone to undergo surgery.

It's basically a 6 hours long blood donation. Hardly what most people think as surgery. I agree you can't force them to go through with it, but the effort needed versus the outcome if successful are not even comparable.

No it's not like a blood donation. It's misinformation like this that cause people to sign up to donate, and then back out when they find out what they really have to do. Bone marrow donation is a surgery. PBSC donation requires you to get injected with a drug for 5 days, and then have your blood drawn out from one arm, go through a machine, and passed back to you through the other arm. If you have thin veins it'll even require a central line (tube in your neck).

Re: Amit Gupta Could Have Marrow Transplant by End of Year

#42

Post by kens »

One interesting thing about Amit Gupta's efforts to get people to register their bone marrow is he's actually helping other people much more than he's helping himself. The key point is that everyone who needs bone marrow is more likely to find a match because of the additional registrants.

Serious question: is there a game-theoretic name for this? It's kind of the opposite of tragedy of the commons or free-rider. Amit's actions actually seems structurally similar to contributing to open-source software: he's trying to solve his own problem, but at the same time helping thousands of other people.

In any case, you should sign up - wouldn't it be great to save someone's life in this way?

Re: Amit Gupta Could Have Marrow Transplant by End of Year

#43

Post by maxharris »

tdoggette wrote: post #22
callmevlad wrote: post #18

"But we’re sort of in wait-and-pray mode because historically, only half of South Asians who are tested actually agree to donate." Not only is the chance of finding South Asians to get a DNA test very low, but that chance is further sliced by half because a matched donor can get cold feet. I really hope that those people who were identified as a match come through for Amit (or others in need).

Look, if you sign up, you sign up to actually give marrow if there's a match. Period. Unless you're not healthy enough, there's no excuse for welching on a deal that involves someone's life.

But it's not really a deal if you don't get paid.

Up until today, it was illegal to seal the deal (i.e., pay your donor). Now that people actually have a rational financial reason to trade a little bit of their own lives to strangers (needlesticks aren't painless, and donors need to sit for hours to actually donate the cells), they'll go through with it a lot more. The donors win, and the recipients win. That's a great thing!

Re: Amit Gupta Could Have Marrow Transplant by End of Year

#44

Post by law_of_poe »

leddt wrote: post #28
naz wrote: post #26

Earlier quoted context omitted.

How wrong it is to flake is irrelevant. You can't really force someone to undergo surgery.

It's basically a 6 hours long blood donation. Hardly what most people think as surgery. I agree you can't force them to go through with it, but the effort needed versus the outcome if successful are not even comparable.

It appears that there are two methods: 75% of the time it is PBSC, which is the 6 hour long blood donation. 25% of the time it is through surgery under general anesthesia. The doctor decides on which one based on the patient.

http://marrow.org/Registry_Members/Donation/Steps_of_Donatio...

Re: Amit Gupta Could Have Marrow Transplant by End of Year

#45

Post by ars »

uptown wrote: post #38
patio11 wrote: post #33

You guys may be interested in Flynn vs. Holder, which is a court case attempting to strike down the federal prohibition on selling bone marrow. If you could buy and sell bone marrow, all parties agree that that would happen more frequently than bone marrow donation. The side that believes that would be bad won. (A brief sketch of the concern: if you allow money into the equation, either a) people who won the marrow l…

I'll admit I haven't read the case you references, but once you build a financial marketplace around something, it will get controlled, manipulated and exploited. Why stop at bone marrow? Everybody's got a couple kidneys ... why not let people sell one? What about the donors who regularly give blood donations today? Would they stop doing so without being paid? I believe it's an oversimplification to just say that the…

> Why stop at bone marrow?

I would draw a very clear line: Renewable tissue and organs can be sold, non renewable ones can't.

Blood, sperm, marrow: All sellable.

Kidneys: Nope, donation only.

Liver, skin: On the fence. (They renew, but only with scarring, and can be taken only a limited number of times.)

Re: Amit Gupta Could Have Marrow Transplant by End of Year

#46

Post by patio11 »

uptown wrote: post #38
patio11 wrote: post #33

You guys may be interested in Flynn vs. Holder, which is a court case attempting to strike down the federal prohibition on selling bone marrow. If you could buy and sell bone marrow, all parties agree that that would happen more frequently than bone marrow donation. The side that believes that would be bad won. (A brief sketch of the concern: if you allow money into the equation, either a) people who won the marrow l…

I'll admit I haven't read the case you references, but once you build a financial marketplace around something, it will get controlled, manipulated and exploited. Why stop at bone marrow? Everybody's got a couple kidneys ... why not let people sell one? What about the donors who regularly give blood donations today? Would they stop doing so without being paid? I believe it's an oversimplification to just say that the…

Not to fight this battle with you in the comments, but a) you only get two kidneys but bone marrow is, like blood cells, a replenishable resource and b) it is absolutely, unequivocally the case that paying people for blood, plasma, and gamete donations (all of which we do, but we're circumspect about saying so) increases the amount of people who are willing to participate in blood, plasma, and gamete donation.

The biology of plasma is different than the biology of bone marrow, which complicates things considerably, but the biology of plasma did not solve the plasma problem. We used to have plasma shortages, too, because plasma donation is inconvenient and strikes some people as "icky." So we increased people's willingness to engage in it by using our traditional method of encouraging inconvenient, icky things: we paid them money.

Re: Amit Gupta Could Have Marrow Transplant by End of Year

#47

Post by maxharris »

preamble wrote: post #41
leddt wrote: post #28

Earlier quoted context omitted.

It's basically a 6 hours long blood donation. Hardly what most people think as surgery. I agree you can't force them to go through with it, but the effort needed versus the outcome if successful are not even comparable.

No it's not like a blood donation. It's misinformation like this that cause people to sign up to donate, and then back out when they find out what they really have to do. Bone marrow donation is a surgery. PBSC donation requires you to get injected with a drug for 5 days, and then have your blood drawn out from one arm, go through a machine, and passed back to you through the other arm. If you have thin veins it'll e…

Thanks for explaining this!

This is why Flynn vs. Holder is so damn important.

If the goal is to actually save human lives, more people need to choose to let doctors invade their bodies to take the cells they need, take the time off of work, away from their goals, etc. The only way that most people could do this for a stranger is to be compensated. I predict great things to come!

Re: Amit Gupta Could Have Marrow Transplant by End of Year

#48

Post by bentlegen »

maxharris wrote: post #37
patio11 wrote: post #33

You guys may be interested in Flynn vs. Holder, which is a court case attempting to strike down the federal prohibition on selling bone marrow. If you could buy and sell bone marrow, all parties agree that that would happen more frequently than bone marrow donation. The side that believes that would be bad won. (A brief sketch of the concern: if you allow money into the equation, either a) people who won the marrow l…

As you've pointed out, the alternative for those who need these cells (but can't get them) is death. I agree completely. But the argument for the other side isn't sound. Poor people (with the right haplotype at the right time) could become quite rich if we don't try to interfere with bone marrow sales. Do you know what I'd pay for cells that would save my life if I needed them? Quite a lot more than I paid for my car…

I think it is more likely that some company would get quite rich - not the people who initially possessed the marrow.

Re: Amit Gupta Could Have Marrow Transplant by End of Year

#49

Post by yogrish »

kens wrote: post #42

One interesting thing about Amit Gupta's efforts to get people to register their bone marrow is he's actually helping other people much more than he's helping himself. The key point is that everyone who needs bone marrow is more likely to find a match because of the additional registrants. Serious question: is there a game-theoretic name for this? It's kind of the opposite of tragedy of the commons or free-rider. Ami…

Yes Amit is in a way helping people who are getting registered. So guys, pls help Amit. Btw, Nice parallel drawn.

Re: Amit Gupta Could Have Marrow Transplant by End of Year

#50

Post by gajomi »

kens wrote: post #42

One interesting thing about Amit Gupta's efforts to get people to register their bone marrow is he's actually helping other people much more than he's helping himself. The key point is that everyone who needs bone marrow is more likely to find a match because of the additional registrants. Serious question: is there a game-theoretic name for this? It's kind of the opposite of tragedy of the commons or free-rider. Ami…

>Serious question: is there a game-theoretic name for this?

From the view of evolutionary game theory he might be called a "neutrally fit cooperator" or "nearly-neutrally fit cooperator".

In public goods games cooperators increase the amount of public goods available to everyone, but if there is some cost to producing the good they can be subject to invasion by defectors. Amit's campaign definitely benefits everyone in the community more or less equally, but the cost to him (determined by the additional opportunities he might have had to find a donor for himself through some other means) are presumably quite low to the point where we can consider them to be zero. Since both cooperators and defectors pay nothing but receive the same benefit, they are equally fit and no relative fraction of strategies employed by the population is preferred (although having more cooperators should contribute to a higher overall payoff).

The interesting little twist to the story, if we are thinking in terms of evolutionary game theory, is that players that reach a certain payoff (e.g., by getting there transplant), leave the game with some probability! This is the opposite of what usually happens in games in evolutionary biology, since higher absolute payoff is typically associated with larger population sizes.

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