‘Your gift is the best one ever - the gift of life' - Scotsman.com News
Your gift is the best one ever - the gift of life'
HONOUR: Shaw and Rachel at the Anthony Nolan Trust awards
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View GalleryBy SANDRA DICK
THE letter was simply addressed: “Dear Mr Donor”, and as Shaw McIntyre read on, the sudden realisation of what he had just done became overwhelming.
“My daughter will be three years old this month,” he read, “and your gift is the best one I could ever have asked for: the gift of a new life.”
There aren’t many things that can shake a burly West Lothian roofer to the soles of his working boots, but for father-of-three Shaw, discovering he had just helped save the life of a little girl 6000 miles away was enough to bring a lump to his throat.
“My daughter was the same age at the time it was happening,” recalls the 45-year-old. “I thought how I would feel if it were any of my children going through all of that, and it brought home what it all meant to this family.”
Today, the letter has pride of place on the wall behind the desk of Shaw’s Whitburn offices. The little girl his bone marrow helped save – whose chances of survival at the time were put at less than 50 per cent – is now a pretty teenager growing up in Virginia, USA.
Their connection might well have ended there, with little Rachel Rack on the road to recovery and Shaw’s name back on the bone marrow donors’ roll just in case anyone else could benefit from his kindness.
Instead, Shaw’s selfless donation to a sick leukaemia patient has developed into a transatlantic friendship and a unique bond between two families.
Every year, he and his family – wife Liz, 43, sons Phillip, 18, Stewart, 16, and Amanda, 13 – make the trip to Virginia to visit the Rack family, where they are made welcome by Rachel’s grateful parents.
Just recently, Rachel and her mother Mary made the emotional journey to Scotland to pay their own tribute to the man who saved her life.
For Shaw, the friendship that has blossomed between two families on different sides of the Atlantic has been an added bonus. It has been a bittersweet footnote to what started off as a family tragedy of his own – the sudden death of his mother-in-law. Shaw and his wife were still grieving for her mum June Hynds when they made the joint decision to try to help others.
“My mum-in-law died of a brain tumour when she was in her early 60s,” Shaw said. “It was a difficult time and it made us realise how terrible it is when a member of your close family becomes really ill.
“Around two weeks after she died, we noticed something in the paper about the Anthony Nolan Bone Marrow Trust, and thought it would be something we could do. I’d been a blood donor for a long time, and this felt like an extension of what I was doing.”
It was January 1996 when the couple gave a small sample of blood, which was then analysed and entered on to the register. By April, Shaw had been identified as a partial match for Rachel. Further tests would confirm that he was a suitable donor.
“It was a bit of a shock to find it was going ahead,” he recalls. “There was a lot of emotion, even though I didn’t know where my marrow would go, and there was a great fear of anything going wrong. It didn’t matter at the time who got it – whether it was a young girl or an older man – it was just the fact that it was hopefully going to help someone.”
In Virginia, Rachel’s family had been struggling to cope with her illness. “It was October of 1994 when I found a small bruise on Rachel’s thigh,” recalls her mum. “The doctor carried out a biopsy and we received a call a few days later that Rachel had lymphoma. She was ten months old.”
She received six months of gruelling chemotherapy before finally going into remission for a year. But there was bad news when doctors confirmed her lymphoma had transformed into B-cell leukaemia, and her 92 per cent survival chance had plunged to 50 per cent.
“We were devastated,” adds Mary. “The doctors got her into remission again but we were desperately seeking a bone marrow donor. None of the family matched her.”
But despair turned to hope when Rachel was placed on the International Bone Marrow Transplant Registry at around the same time as Shaw was entering his details. Within weeks the match was made and Rachel received Shaw’s bone marrow – along with an angel brooch, which he had asked to be sent along with it – on Hallowe’en 1996.
Grateful to the anonymous donor who had selflessly helped save her daughter’s life, Mary sat down to pen her emotional letter – the one that today sits in Shaw’s office.
Rules on bone marrow donations mean it can be as much as two years before donor and recipient are able to find out each other’s identities. But the special circumstances of Shaw and Rachel’s case – and with both sides desperate to learn more about each other – the families were soon appealing for the rules to be relaxed.
The moment Shaw received Mary and dad Ed’s details, he picked up the phone to call.
“I’d been told it was a little girl who received the donation – that was particularly emotional because she was the same age as Amanda,” said Shaw, of East Main Street in Whitburn. “I’d had regular updates on how she was, but this was the first time I was able to speak to them. Mary answered the phone and I could tell it was a total shock to hear my voice. It was very emotional.
“I asked her how her little girl was and explained that I’d just found out her name.
“But I don’t think either of us was really able to have a proper conversation.”
Mary agrees it was among the most exciting phone calls of her life. “We had just got his name and address too and saw that he was from Scotland, when we received a phone call,” she recalls.
“The person on the other end of the phone had a strange accent and I thought to myself – this is him. I was so excited to hear his voice.
“He asked how Rachel was doing and wanted to come over for a visit. We were going to get to meet the man that saved Rachel’s life. From the moment we met him he was like family to us. He has been over to see us every year since then.”
The families were reunited recently when both were guests of honour at the Anthony Nolan fundraising ball in Glasgow. Shaw was recognised that night as one of the charity’s most hardworking fundraisers, having raised more than £10,000 by completing a string of intimidating challenges, from climbing Mount Kilimanjaro to completing the Inca Trail in Peru.
Today, he remains on the bone marrow register along with Liz and their son, Phillip – and he says he would urge anyone to think seriously about doing the same.
“You never know who might be out there who needs help,” he stresses. “It’s been wonderful to be able to help Rachel and I’ve met a fantastic family as a result of it.”
As for Mary and Rachel, they can’t thank Shaw enough. “You know, I really can’t put into words what Shaw and his family mean to us,” says Mary. “He is family. We can never repay him for what he has given to Rachel and our family, but he will always hold a
Promoting Organ Donations the Gift of Life
Friday, January 11, 2008
globeandmail.com: New organ donation rules don't exclude gay men
globeandmail.com: New organ donation rules don't exclude gay men
New organ donation rules don't exclude gay men
CARLY WEEKS
From Thursday's Globe and Mail
January 10, 2008 at 4:37 PM EST
New Health Canada regulations won't prohibit sexually active gay men from donating their organs, but will merely formalize standard industry practice to prevent transmission of disease, according to several Canadian transplant associations.
"We will still consider all organs and all donors," said Mark Meloche, head of the surgery section at the British Columbia Transplant Society. "We still consider the use of them, depending on the circumstances. It's all part of a risk assessment."
The federal government has come under fire this week over the rules, which came into effect last month and are designed to protect recipients from contracting HIV, hepatitis B or C and other serious diseases.
Under the regulations, men who have had sex with another man even once in the past five years, in addition to intravenous drug users, people recently in jail and others, are considered unsuitable to donate their organs.
But the rules don't actually ban donations by sexually active gay men or other groups deemed to be in "high risk" categories.
In fact, there are exemptions that allow doctors to conduct transplants even if the donor is in a risk category. In those instances, health officials work to gather information about a person's behaviour and potential risk factors in order to determine whether to proceed.
It's part of a rigorous screening policy designed to minimize disease transmission that has been industry practice for several years, according to Health Canada.
There have been documented cases - including four in Chicago last year - in which recipients have contracted HIV from a donated organ.
Even so, one transplant group is accusing Health Canada of unnecessarily singling out the gay community in the regulations. Gary Levy, director of the transplant program at the University Health Network, said sexual orientation has always been a factor in screening donors, but that being gay doesn't exclude individuals from donating.
Any organs that are considered for donation in Canada are subject to tests and screening to determine if they contain disease, say experts involved in transplantation.
But some groups are at a higher risk for HIV or hepatitis, so extra measures are put in place to assess their risk factors. In order to determine the level of risk and whether to proceed, health officials will test organs, speak with the donor's family or friends to get information about their behaviour, as well as explain the situation and potential consequences to the recipient.
New organ donation rules don't exclude gay men
CARLY WEEKS
From Thursday's Globe and Mail
January 10, 2008 at 4:37 PM EST
New Health Canada regulations won't prohibit sexually active gay men from donating their organs, but will merely formalize standard industry practice to prevent transmission of disease, according to several Canadian transplant associations.
"We will still consider all organs and all donors," said Mark Meloche, head of the surgery section at the British Columbia Transplant Society. "We still consider the use of them, depending on the circumstances. It's all part of a risk assessment."
The federal government has come under fire this week over the rules, which came into effect last month and are designed to protect recipients from contracting HIV, hepatitis B or C and other serious diseases.
Under the regulations, men who have had sex with another man even once in the past five years, in addition to intravenous drug users, people recently in jail and others, are considered unsuitable to donate their organs.
But the rules don't actually ban donations by sexually active gay men or other groups deemed to be in "high risk" categories.
In fact, there are exemptions that allow doctors to conduct transplants even if the donor is in a risk category. In those instances, health officials work to gather information about a person's behaviour and potential risk factors in order to determine whether to proceed.
It's part of a rigorous screening policy designed to minimize disease transmission that has been industry practice for several years, according to Health Canada.
There have been documented cases - including four in Chicago last year - in which recipients have contracted HIV from a donated organ.
Even so, one transplant group is accusing Health Canada of unnecessarily singling out the gay community in the regulations. Gary Levy, director of the transplant program at the University Health Network, said sexual orientation has always been a factor in screening donors, but that being gay doesn't exclude individuals from donating.
Any organs that are considered for donation in Canada are subject to tests and screening to determine if they contain disease, say experts involved in transplantation.
But some groups are at a higher risk for HIV or hepatitis, so extra measures are put in place to assess their risk factors. In order to determine the level of risk and whether to proceed, health officials will test organs, speak with the donor's family or friends to get information about their behaviour, as well as explain the situation and potential consequences to the recipient.
Edwards and Organ Transplants - WSJ.com
Edwards and Organ Transplants - WSJ.com
Edwards and Organ Transplants
By SCOTT GOTTLIEB
January 11, 2008; Page A11
Campaigning in the primaries, former Sen. John Edwards is leveraging the tragic story of Nataline Sarkisyan -- the 17-year-old California woman who recently died awaiting a liver transplant -- to press his political attack on insurance companies and argue for European-style, single-payer health care. But the former trial lawyer, accustomed to using anecdotes of human suffering to frame his rhetoric, is twisting the facts. Organ transplantation, like many areas of medicine, provides a poor basis for his political thesis that single-payer health care offers a more equitable allocation of scarce resources, or better clinical outcomes.
Late last year, Ms. Sarkisyan developed liver failure, apparently a result of blood clotting that stemmed from the high doses of chemotherapy and a bone marrow transplant she had received to treat relapsed leukemia. She was put on life support as her doctors at the University of California-Los Angeles tried to get her a new liver, and asked CIGNA, the insurer that was acting as administrator to her father's employer-provided, self-insured health plan, to pay for the transplant. CIGNA deemed the transplant unproven in its medical benefit and ineffective as a treatment. It recommended that her father's employer not cover the procedure.
After an appeal, CIGNA hired an oncologist and transplant surgeon to review the case. According to CIGNA, these experts agreed that the transplant exceeded appropriate risk-taking, with little support from existing medical literature.
CIGNA never reversed its administrative decision. But after significant pressure from the California Nurses Association, a powerful union lobby -- and legal threats -- it made a clumsily-announced concession, a one time "exception" to pay for the transplant itself, despite sticking to its judgment that the procedure constituted an experimental use of a scarce organ. But CIGNA's concession came too late. The same day it was made Ms. Sarkisyan was taken off life support and died.
From here, facts are in dispute. Her family says a liver became available while CIGNA wrung its hands over the matter. Some news accounts question this turn, since institutions like UCLA would typically proceed with transplants, even before insurance plans are settled, once an organ becomes available.
Mr. Edwards seized on the case. "We're gonna take their power away and we're not gonna have this kind of problem again," he said on Dec. 21. "These are living and breathing examples of what I'm talking about and there are millions more just like them," Mr. Edwards told reporters on Jan. 6. An edited video of his attacks on CIGNA has posted on YouTube.
Research provides little support to Mr. Edward's underlying premise that single-payer health-care systems would do better. On balance, data suggests that in the U.S. transplant patients do quite well compared to their European counterparts, with significantly more opportunities to undergo transplant procedures, survive the surgery, and benefit from new organs.
Some of the best data pits the U.S. against the U.K. and its National Health Service. A study published in 2004 in the journal Liver Transplantation compared the relative severity of liver disease in transplant recipients in the U.S. and U.K. The results were striking. No patient in the U.K. was in intensive care before transplantation, one marker for how sick patients are, compared with 19.3% of recipients in the U.S. Additionally, the median for a score used to assess how advanced someone's liver disease is, the "MELD" score, was 10.9 in the U.K. compared with 16.1 in the U.S. -- a marked gap, with higher scores for more severe conditions. Both facts suggest even the sickest patients are getting access to new organs in the U.S.
On the whole, the U.S. also performs more transplants per capita, giving patients better odds of getting new organs. Doctors here do far more partial liver transplants from living, related donors, but also more cadaveric transplants (where the organ comes from a deceased donor). In 2002 -- a year comparative data is available -- U.S. doctors performed 18.5 liver transplants per one million Americans. This is significantly more than in the U.K. or in single-payer France, which performed 4.6 per million citizens, or in Canada, which performed 10 per million.
What about the differences in outcomes between ours and single-payer systems, an issue Mr. Edwards hasn't directly addressed? One recent study found that patients' five-year mortality after transplants for acute liver failure, the type from which Ms. Sarkisyan presumably suffered, was about 5% higher in the U.K. and Irleand than the U.S. The same study also found that in the period right after surgery, death rates were as much as 27% higher in the U.K. and Ireland than in the U.S., although differences in longer-term outcomes equilibrated once patients survived the first year of their transplant.
These findings aren't confined to transplanted livers. A study in the Journal of Heart and Lung Transplantation compared statistics on heart transplants over the mid 1990s. It found patients were more likely to receive hearts in the U.S., even when they were older and sicker. The rate was 8.8 transplants per one million people, compared to 5.4 in the U.K. Over the same period, about 15% of patients died while waiting for new hearts in the U.K. compared to 12% in the U.S. In 2006, there were 28,931 transplants of all organ types in the U.S., 96.8 transplants for every one million Americans. There were 2,999 total organ transplants in the U.K., 49.5 transplants for every one million British citizens.
What about Mr. Edwards's implicit thesis, that U.S. organ allocation is dictated by someone's ability to pay? When it comes to livers, the majority of U.S. transplants are for chronic liver disease, usually resulting from hepatitis C or alcoholism. These are diseases disproportionately affecting lower-income Americans who predictably comprise a comparatively higher number of people getting new organs.
Ideally, everyone who can benefit from an organ transplant would receive one, especially a young patient like Ms. Sarkisyan. But with more patients than available organs, some form of allocation procedure involving administrative judgments is inevitable. In Ms. Sarkisyan's case, that judgment was made by CIGNA, in an advisory capacity to her father's employer, interpreting the terms of the employer's health-insurance contract. In the U.K. and other European systems -- and in the U.S. single-payer system favored by Mr. Edwards -- those judgments are made solely by a government agency. The available data suggests that the government allocation procedures do a somewhat worse job, as far as health outcomes are concerned, than private allocation procedures in the U.S.
As in all events, the inevitable trade-offs and ethical dilemmas cannot be wished away. Our system in the U.S. for allocating scarce resources remains imperfect. But taken as a whole, statistics show that organ access, our willingness to transplant the sickest patients, and our medical outcomes are among the best in the world. Probably superior to the single-payer systems that Mr. Edwards would have Americans emulate -- and certainly better than the facts that Mr. Edwards wants us to believe.
Dr. Gottlieb is a practicing physician and resident fellow at the American Enterprise Institute.
Edwards and Organ Transplants
By SCOTT GOTTLIEB
January 11, 2008; Page A11
Campaigning in the primaries, former Sen. John Edwards is leveraging the tragic story of Nataline Sarkisyan -- the 17-year-old California woman who recently died awaiting a liver transplant -- to press his political attack on insurance companies and argue for European-style, single-payer health care. But the former trial lawyer, accustomed to using anecdotes of human suffering to frame his rhetoric, is twisting the facts. Organ transplantation, like many areas of medicine, provides a poor basis for his political thesis that single-payer health care offers a more equitable allocation of scarce resources, or better clinical outcomes.
Late last year, Ms. Sarkisyan developed liver failure, apparently a result of blood clotting that stemmed from the high doses of chemotherapy and a bone marrow transplant she had received to treat relapsed leukemia. She was put on life support as her doctors at the University of California-Los Angeles tried to get her a new liver, and asked CIGNA, the insurer that was acting as administrator to her father's employer-provided, self-insured health plan, to pay for the transplant. CIGNA deemed the transplant unproven in its medical benefit and ineffective as a treatment. It recommended that her father's employer not cover the procedure.
After an appeal, CIGNA hired an oncologist and transplant surgeon to review the case. According to CIGNA, these experts agreed that the transplant exceeded appropriate risk-taking, with little support from existing medical literature.
CIGNA never reversed its administrative decision. But after significant pressure from the California Nurses Association, a powerful union lobby -- and legal threats -- it made a clumsily-announced concession, a one time "exception" to pay for the transplant itself, despite sticking to its judgment that the procedure constituted an experimental use of a scarce organ. But CIGNA's concession came too late. The same day it was made Ms. Sarkisyan was taken off life support and died.
From here, facts are in dispute. Her family says a liver became available while CIGNA wrung its hands over the matter. Some news accounts question this turn, since institutions like UCLA would typically proceed with transplants, even before insurance plans are settled, once an organ becomes available.
Mr. Edwards seized on the case. "We're gonna take their power away and we're not gonna have this kind of problem again," he said on Dec. 21. "These are living and breathing examples of what I'm talking about and there are millions more just like them," Mr. Edwards told reporters on Jan. 6. An edited video of his attacks on CIGNA has posted on YouTube.
Research provides little support to Mr. Edward's underlying premise that single-payer health-care systems would do better. On balance, data suggests that in the U.S. transplant patients do quite well compared to their European counterparts, with significantly more opportunities to undergo transplant procedures, survive the surgery, and benefit from new organs.
Some of the best data pits the U.S. against the U.K. and its National Health Service. A study published in 2004 in the journal Liver Transplantation compared the relative severity of liver disease in transplant recipients in the U.S. and U.K. The results were striking. No patient in the U.K. was in intensive care before transplantation, one marker for how sick patients are, compared with 19.3% of recipients in the U.S. Additionally, the median for a score used to assess how advanced someone's liver disease is, the "MELD" score, was 10.9 in the U.K. compared with 16.1 in the U.S. -- a marked gap, with higher scores for more severe conditions. Both facts suggest even the sickest patients are getting access to new organs in the U.S.
On the whole, the U.S. also performs more transplants per capita, giving patients better odds of getting new organs. Doctors here do far more partial liver transplants from living, related donors, but also more cadaveric transplants (where the organ comes from a deceased donor). In 2002 -- a year comparative data is available -- U.S. doctors performed 18.5 liver transplants per one million Americans. This is significantly more than in the U.K. or in single-payer France, which performed 4.6 per million citizens, or in Canada, which performed 10 per million.
What about the differences in outcomes between ours and single-payer systems, an issue Mr. Edwards hasn't directly addressed? One recent study found that patients' five-year mortality after transplants for acute liver failure, the type from which Ms. Sarkisyan presumably suffered, was about 5% higher in the U.K. and Irleand than the U.S. The same study also found that in the period right after surgery, death rates were as much as 27% higher in the U.K. and Ireland than in the U.S., although differences in longer-term outcomes equilibrated once patients survived the first year of their transplant.
These findings aren't confined to transplanted livers. A study in the Journal of Heart and Lung Transplantation compared statistics on heart transplants over the mid 1990s. It found patients were more likely to receive hearts in the U.S., even when they were older and sicker. The rate was 8.8 transplants per one million people, compared to 5.4 in the U.K. Over the same period, about 15% of patients died while waiting for new hearts in the U.K. compared to 12% in the U.S. In 2006, there were 28,931 transplants of all organ types in the U.S., 96.8 transplants for every one million Americans. There were 2,999 total organ transplants in the U.K., 49.5 transplants for every one million British citizens.
What about Mr. Edwards's implicit thesis, that U.S. organ allocation is dictated by someone's ability to pay? When it comes to livers, the majority of U.S. transplants are for chronic liver disease, usually resulting from hepatitis C or alcoholism. These are diseases disproportionately affecting lower-income Americans who predictably comprise a comparatively higher number of people getting new organs.
Ideally, everyone who can benefit from an organ transplant would receive one, especially a young patient like Ms. Sarkisyan. But with more patients than available organs, some form of allocation procedure involving administrative judgments is inevitable. In Ms. Sarkisyan's case, that judgment was made by CIGNA, in an advisory capacity to her father's employer, interpreting the terms of the employer's health-insurance contract. In the U.K. and other European systems -- and in the U.S. single-payer system favored by Mr. Edwards -- those judgments are made solely by a government agency. The available data suggests that the government allocation procedures do a somewhat worse job, as far as health outcomes are concerned, than private allocation procedures in the U.S.
As in all events, the inevitable trade-offs and ethical dilemmas cannot be wished away. Our system in the U.S. for allocating scarce resources remains imperfect. But taken as a whole, statistics show that organ access, our willingness to transplant the sickest patients, and our medical outcomes are among the best in the world. Probably superior to the single-payer systems that Mr. Edwards would have Americans emulate -- and certainly better than the facts that Mr. Edwards wants us to believe.
Dr. Gottlieb is a practicing physician and resident fellow at the American Enterprise Institute.
Pacific Palisades ~ Palisadian-Post
Pacific Palisades ~ Palisadian-Post
Palisades Expert Warns about Liver Disease
January 09, 2008
Sue Pascoe , Staff Writer
The liver is not the most glamorous of organs and is rarely mentioned in song or prose. Yet liver disease is on the rise among 40- to 60-year-olds in the United States, which means this overlooked body part deserves a spotlight.
The Centers for Disease Control estimate that one in every 55 people in Los Angeles County have hepatitis C, the most common blood-borne illness in America. Alarmingly, two-thirds of these people are not aware they have the disease.
'It is getting worse and worse,' said Pacific Palisades resident Dr. Sammy Saab, an internationally known liver expert. 'People often contract the virus when they are in high school and college, but it takes two to three decades before the disease becomes full-blown.'
In fact, 'some 80 percent of the people in the beginning stages of liver disease have no symptoms,' Saab said. 'It's like high blood pressure--a silent killer.'
Saab explained that people afflicted with hepatitis C today might have experimented with needles or drugs decades ago, and one or two times may have been enough for them to contract the virus. Other major risk factors include blood transfusions that were done before 1992 and having kidney dialysis.
The only way doctors can diagnose early-stage liver disease is through blood tests, but if the disease is detected early, it's treatable.
'If you catch liver disease at an early stage, you can halt it or even reverse it,' Saab said. There are injections and pills for hepatitis C.
Many people are not concerned about hepatitis C because they thought they were immunized. Unfortunately, existing immunizations are only for the other two hepatitis viruses: A and B.
Hepatitis A is most commonly transmitted by the fecal-oral route, such as contaminated food. It does not cause permanent liver damage, but can make you sick for as long as four to six weeks.
The vaccine for hepatitis A is most commonly recommended if you travel outside of the country to areas where there is a high prevalence of the disease.
Hepatitis B is spread through blood and sex and for the most part people recover, but in some it can linger on and cause chronic liver disease. A vaccination for B is recommended for adults at increased risk of infections and all infants.
According to Saab, the liver is soft and mushy like tofu, but if one has untreated hepatitis or alcoholism, the liver becomes diseased and tissue is replaced with scar tissue, which makes it hard, leading to cirrhosis.
If cirrhosis goes unchecked, varicose veins develop in the esophagus (called esophageal varices) and the disease can progress to cancer of the liver. Those cancer patients need to be screened every six months.
'If we can catch liver cancer early, we can cure someone,' Saab said. 'And anyone with liver cancer should be considered for a liver transplant.'
Doctors are able to do a blood test that predicts how long a patient with liver disease can live, which is called a M.E.L.D. score (Model for End-Stage Liver Disease), which ranges from 6 to 40; the latter reflects more serious disease. The M.E.L.D. score determines the order for receiving liver transplants.
'Half of all liver transplants today are a result of hepatitis C,' Saab said.
Fatty liver may replace hepatitis C as a major problem in the future and is a result of lifestyle choices, Saab said. Those patients usually are overweight and have diabetes and/or high cholesterol.
'A fast-food diet gets converted to fat in our livers,' said Saab, who noted the alarming fact that '20 percent of California kids are obese.'
Fatty liver takes the same route as hepatitis C: liver damage that results in scarring and eventually produces cirrhosis, which can cause cancer or liver failure.
Saab's advice for preventing fatty liver is, 'Eat healthy, avoid fatty and sweet foods, exercise, and limit alcohol intake to one or two drinks a day.'
Saab, an associate professor of medicine and surgery at UCLA, is traveling to China in February to talk about hepatitis B and C, and liver transplants. In May he'll be featured at a conference in Canada and in July he'll lecture on liver transplants in Paris.
He and his wife Peggy have four children: Kenny, 10, Clara 9, Elena 7 (all of whom attend Corpus Christi School), and Adelaide, 4.
Palisades Expert Warns about Liver Disease
January 09, 2008
Sue Pascoe , Staff Writer
The liver is not the most glamorous of organs and is rarely mentioned in song or prose. Yet liver disease is on the rise among 40- to 60-year-olds in the United States, which means this overlooked body part deserves a spotlight.
The Centers for Disease Control estimate that one in every 55 people in Los Angeles County have hepatitis C, the most common blood-borne illness in America. Alarmingly, two-thirds of these people are not aware they have the disease.
'It is getting worse and worse,' said Pacific Palisades resident Dr. Sammy Saab, an internationally known liver expert. 'People often contract the virus when they are in high school and college, but it takes two to three decades before the disease becomes full-blown.'
In fact, 'some 80 percent of the people in the beginning stages of liver disease have no symptoms,' Saab said. 'It's like high blood pressure--a silent killer.'
Saab explained that people afflicted with hepatitis C today might have experimented with needles or drugs decades ago, and one or two times may have been enough for them to contract the virus. Other major risk factors include blood transfusions that were done before 1992 and having kidney dialysis.
The only way doctors can diagnose early-stage liver disease is through blood tests, but if the disease is detected early, it's treatable.
'If you catch liver disease at an early stage, you can halt it or even reverse it,' Saab said. There are injections and pills for hepatitis C.
Many people are not concerned about hepatitis C because they thought they were immunized. Unfortunately, existing immunizations are only for the other two hepatitis viruses: A and B.
Hepatitis A is most commonly transmitted by the fecal-oral route, such as contaminated food. It does not cause permanent liver damage, but can make you sick for as long as four to six weeks.
The vaccine for hepatitis A is most commonly recommended if you travel outside of the country to areas where there is a high prevalence of the disease.
Hepatitis B is spread through blood and sex and for the most part people recover, but in some it can linger on and cause chronic liver disease. A vaccination for B is recommended for adults at increased risk of infections and all infants.
According to Saab, the liver is soft and mushy like tofu, but if one has untreated hepatitis or alcoholism, the liver becomes diseased and tissue is replaced with scar tissue, which makes it hard, leading to cirrhosis.
If cirrhosis goes unchecked, varicose veins develop in the esophagus (called esophageal varices) and the disease can progress to cancer of the liver. Those cancer patients need to be screened every six months.
'If we can catch liver cancer early, we can cure someone,' Saab said. 'And anyone with liver cancer should be considered for a liver transplant.'
Doctors are able to do a blood test that predicts how long a patient with liver disease can live, which is called a M.E.L.D. score (Model for End-Stage Liver Disease), which ranges from 6 to 40; the latter reflects more serious disease. The M.E.L.D. score determines the order for receiving liver transplants.
'Half of all liver transplants today are a result of hepatitis C,' Saab said.
Fatty liver may replace hepatitis C as a major problem in the future and is a result of lifestyle choices, Saab said. Those patients usually are overweight and have diabetes and/or high cholesterol.
'A fast-food diet gets converted to fat in our livers,' said Saab, who noted the alarming fact that '20 percent of California kids are obese.'
Fatty liver takes the same route as hepatitis C: liver damage that results in scarring and eventually produces cirrhosis, which can cause cancer or liver failure.
Saab's advice for preventing fatty liver is, 'Eat healthy, avoid fatty and sweet foods, exercise, and limit alcohol intake to one or two drinks a day.'
Saab, an associate professor of medicine and surgery at UCLA, is traveling to China in February to talk about hepatitis B and C, and liver transplants. In May he'll be featured at a conference in Canada and in July he'll lecture on liver transplants in Paris.
He and his wife Peggy have four children: Kenny, 10, Clara 9, Elena 7 (all of whom attend Corpus Christi School), and Adelaide, 4.
Liberal.ca :: Media Releases
Liberal.ca :: Media Releases
Conservatives’ Ban of Organ Donations by Gay Men Done in Secret
January 10, 2008
OTTAWA – The Conservative government’s decision to secretly implement a policy that excludes gay men from donating organs is yet another example of the shady way that this government operates, said Liberal Health Critic Robert Thibault.
“The government claims it widely consulted a variety of groups about this change and there were no concerns expressed about it,” said Mr. Thibault. “And yet here we have the head of Canada’s largest organ transplant program and two of the biggest organizations representing the gay community saying that they knew nothing about it.
“Just who did the government consult? It is very frustrating for Canadians to have a federal government that continuously operates in secrecy, and makes false claims about developing public policy in partnership with Canadians,” he said.
It was only through the media that the public learned that Health Canada recently implemented new regulations to determine who can donate organs.
The new regulations exclude any man who has had a same-sex partner in the previous five years from donating tissue. Doctors have expressed concerns that such a ban could lead to an increase of deaths by shrinking an already dwindling pool of donors.
Dr. Gary Levy, head of Canada’s largest organ transplant program at Toronto University’s Health Network, told CBC that he was not informed of the change, or even that it was being considered.
He called the new regulations “too tight” and “too restrictive,” estimating that seven out of every 100 organ donors at his hospital every year will be rejected because of them. (CBC, Jan. 7, 2008)
Both PFLAG Canada and Egale Canada, two of the largest organizations representing the gay and lesbian community, have said they were not consulted during the drafting of this new regulation.
Egale Executive Director Helen Kennedy called it “discriminatory,” saying the government is “perpetrating stereotypes.” They have demanded that the government suspend the policy. (Egale Press Release, Jan. 8, 2008)
Mr. Thibault pointed out that high-risk sexual behaviour and not sexual orientation is what puts an individual at risk for contracting diseases. In fact, he added, the statistics show that women are becoming the fastest growing population to contract HIV and AIDS - not gay men.
“Why is this government putting unnecessary barriers in place that will stop doctors from using organs they otherwise would?” he said. “They are stopping donors from donating organs at a time when people are dying from lack of access to needed organs.
“This is simply more evidence of ideological discrimination. In addition to cuts to HIV/AIDS community programs, opposition to the INSITE safe injection site and the elimination of the Safer Tattooing Practices Initiative, we see once again that the Conservative government makes its decisions based on ideology rather than empirical fact.”
Mr. Thibault called on the government to allow donor agencies to continue the policy of screening based on individual behavioural risk, rather than a blanket policy of exclusion based on sexual orientation.
Conservatives’ Ban of Organ Donations by Gay Men Done in Secret
January 10, 2008
OTTAWA – The Conservative government’s decision to secretly implement a policy that excludes gay men from donating organs is yet another example of the shady way that this government operates, said Liberal Health Critic Robert Thibault.
“The government claims it widely consulted a variety of groups about this change and there were no concerns expressed about it,” said Mr. Thibault. “And yet here we have the head of Canada’s largest organ transplant program and two of the biggest organizations representing the gay community saying that they knew nothing about it.
“Just who did the government consult? It is very frustrating for Canadians to have a federal government that continuously operates in secrecy, and makes false claims about developing public policy in partnership with Canadians,” he said.
It was only through the media that the public learned that Health Canada recently implemented new regulations to determine who can donate organs.
The new regulations exclude any man who has had a same-sex partner in the previous five years from donating tissue. Doctors have expressed concerns that such a ban could lead to an increase of deaths by shrinking an already dwindling pool of donors.
Dr. Gary Levy, head of Canada’s largest organ transplant program at Toronto University’s Health Network, told CBC that he was not informed of the change, or even that it was being considered.
He called the new regulations “too tight” and “too restrictive,” estimating that seven out of every 100 organ donors at his hospital every year will be rejected because of them. (CBC, Jan. 7, 2008)
Both PFLAG Canada and Egale Canada, two of the largest organizations representing the gay and lesbian community, have said they were not consulted during the drafting of this new regulation.
Egale Executive Director Helen Kennedy called it “discriminatory,” saying the government is “perpetrating stereotypes.” They have demanded that the government suspend the policy. (Egale Press Release, Jan. 8, 2008)
Mr. Thibault pointed out that high-risk sexual behaviour and not sexual orientation is what puts an individual at risk for contracting diseases. In fact, he added, the statistics show that women are becoming the fastest growing population to contract HIV and AIDS - not gay men.
“Why is this government putting unnecessary barriers in place that will stop doctors from using organs they otherwise would?” he said. “They are stopping donors from donating organs at a time when people are dying from lack of access to needed organs.
“This is simply more evidence of ideological discrimination. In addition to cuts to HIV/AIDS community programs, opposition to the INSITE safe injection site and the elimination of the Safer Tattooing Practices Initiative, we see once again that the Conservative government makes its decisions based on ideology rather than empirical fact.”
Mr. Thibault called on the government to allow donor agencies to continue the policy of screening based on individual behavioural risk, rather than a blanket policy of exclusion based on sexual orientation.
Wednesday, January 9, 2008
Nova Scotia News - TheChronicleHerald.ca
Nova Scotia News - TheChronicleHerald.ca
Doctors say stricter organ donation rules could lead to deaths
By JOHN GILLIS Health Reporter
Wed. Jan 9 - 5:09 AM
Halifax doctors are worried a new blanket ban on organ donations from gay men could lead to deaths by shrinking an already small pool of donors.
Health Canada recently altered its regulations to exclude any man who has had sex with a man in the previous five years from donating tissue.
The move surprised and upset Dr. Mark Walsh, surgical director of liver and kidney transplantation at the Queen Elizabeth II Health Sciences Centre in Halifax.
"This stipulation is ridiculous," he said Tuesday. "We should be careful about telling people ‘Don’t bother even thinking about donation.’ That’s going to turn off a segment of the population, which is unfair to both donors and recipients."
One lost donor could lead to several deaths, he noted.
Dr. Walsh said he has a patient who needs a liver transplant within days to survive but he’s now in a position where he’d have to turn down an organ if it happened to come from a gay man, despite the hospital’s screening procedures.
He said each potential donor and recipient must be considered individually.
The QEII has always screened potential donors with medical histories, questionnaires (for surviving relatives) to detect high-risk behaviour and blood tests to detect viruses like HIV or hepatitis, said Dr. Stephen Beed, an intensive-care specialist and medical adviser to the provincial organ donation program.
He said the new regulation is overkill.
"We need to be careful that we don’t screen with too broad a brush," Dr. Beed said.
He said gay men as a group don’t necessarily pose any more risk as donors than heterosexuals.
"For somebody who is, for example, in a monogamous relationship and who has been practising safe sex, I would overall conclude that the risk there would be comparable to many other people," he said.
Dr. Beed said the screening system is not perfect and blood tests can produce false negative results but the possibility of infection transmission needs to be weighed against the potential life-saving benefit of transplantation.
"That small risk, as real as it is, may be acceptable to somebody who’s near death," he said.
A similar Health Canada regulation prevents any man who has had sex with a man since 1977 from ever donating blood. That restriction has been labelled discriminatory by gay advocacy groups like EGALE Canada and the Canadian Federation of Students.
Other people who cannot donate organs under the regulations include prison inmates and those who have spent more than 72 straight hours in custody in the preceding year, people with recent tattoos or piercings, people who have had sex for money or drugs within five years and people who have used non-medical intravenous drugs in the preceding five years.
A Health Canada spokeswoman responded to media calls with an e-mail.
Carole Saindon wrote that the regulations are based on risk and not lifestyle and that a man who has had sex with another man within five years is a high risk for transmitting infectious disease.
She noted that a gay man who had been abstinent for five years would not be excluded but a straight man who had had even one sexual encounter with a man in that period would be.
Ms. Saindon said the new regulations stem from a 1999 House of Commons committee recommendation for national standards on cells, tissues and organs intended for transplantation.
She said no group raised concerns about the changes throughout an extensive consultation process and all organ transplant programs across Canada have registered to say they are meeting the new standards.
( jgillis@herald.ca)
Doctors say stricter organ donation rules could lead to deaths
By JOHN GILLIS Health Reporter
Wed. Jan 9 - 5:09 AM
Halifax doctors are worried a new blanket ban on organ donations from gay men could lead to deaths by shrinking an already small pool of donors.
Health Canada recently altered its regulations to exclude any man who has had sex with a man in the previous five years from donating tissue.
The move surprised and upset Dr. Mark Walsh, surgical director of liver and kidney transplantation at the Queen Elizabeth II Health Sciences Centre in Halifax.
"This stipulation is ridiculous," he said Tuesday. "We should be careful about telling people ‘Don’t bother even thinking about donation.’ That’s going to turn off a segment of the population, which is unfair to both donors and recipients."
One lost donor could lead to several deaths, he noted.
Dr. Walsh said he has a patient who needs a liver transplant within days to survive but he’s now in a position where he’d have to turn down an organ if it happened to come from a gay man, despite the hospital’s screening procedures.
He said each potential donor and recipient must be considered individually.
The QEII has always screened potential donors with medical histories, questionnaires (for surviving relatives) to detect high-risk behaviour and blood tests to detect viruses like HIV or hepatitis, said Dr. Stephen Beed, an intensive-care specialist and medical adviser to the provincial organ donation program.
He said the new regulation is overkill.
"We need to be careful that we don’t screen with too broad a brush," Dr. Beed said.
He said gay men as a group don’t necessarily pose any more risk as donors than heterosexuals.
"For somebody who is, for example, in a monogamous relationship and who has been practising safe sex, I would overall conclude that the risk there would be comparable to many other people," he said.
Dr. Beed said the screening system is not perfect and blood tests can produce false negative results but the possibility of infection transmission needs to be weighed against the potential life-saving benefit of transplantation.
"That small risk, as real as it is, may be acceptable to somebody who’s near death," he said.
A similar Health Canada regulation prevents any man who has had sex with a man since 1977 from ever donating blood. That restriction has been labelled discriminatory by gay advocacy groups like EGALE Canada and the Canadian Federation of Students.
Other people who cannot donate organs under the regulations include prison inmates and those who have spent more than 72 straight hours in custody in the preceding year, people with recent tattoos or piercings, people who have had sex for money or drugs within five years and people who have used non-medical intravenous drugs in the preceding five years.
A Health Canada spokeswoman responded to media calls with an e-mail.
Carole Saindon wrote that the regulations are based on risk and not lifestyle and that a man who has had sex with another man within five years is a high risk for transmitting infectious disease.
She noted that a gay man who had been abstinent for five years would not be excluded but a straight man who had had even one sexual encounter with a man in that period would be.
Ms. Saindon said the new regulations stem from a 1999 House of Commons committee recommendation for national standards on cells, tissues and organs intended for transplantation.
She said no group raised concerns about the changes throughout an extensive consultation process and all organ transplant programs across Canada have registered to say they are meeting the new standards.
( jgillis@herald.ca)
Rural Patients Less Likely To Receive Organ Transplants
Rural Patients Less Likely To Receive Organ Transplants
ScienceDaily (Jan. 9, 2008) — Patients in small towns and isolated rural areas have lower organ transplant rates and are less likely to be wait-listed than patients in urban areas, according to a new study.
Organ transplantation offers the best, and often only hope for long-term survival for patients with end-stage heart, liver, and kidney disease. However, despite federal regulation and national efforts to ensure equal access to the limited pool of donated organs, previous research has demonstrated the presence of significant barriers to access to transplantation services for racial minorities, women, and patients with low socioeconomic status or poor insurance, according to background information in the article. Rural residents represent another group that may have impaired access to transplant services. Nearly 14 percent of the U.S. population lives outside major urban areas.
David A. Axelrod, M.D., M.B.A., of Dartmouth Medical School, Lebanon, N.H., and colleagues assessed the impact of rural residence on waiting list registration for heart, liver, and kidney transplant and rates of transplantation among wait-listed candidates. A total of 174,630 patients who were wait-listed and who underwent heart, liver, or kidney transplantation between 1999 and 2004 were included in the study.
The researchers found significant disparities in access to organ transplantation between rural and urban populations.
"This study demonstrates that patients living in small towns and isolated rural regions were eight percent to 15 percent less likely to be wait-listed and ten percent to 20 percent less likely to undergo heart, liver, and kidney transplantation than patients in urban environments," the authors write.
They suggest these discrepancies may be related to differences in the burden of disease in rural environments or reduced access to entering the waiting list. And they warn that the increasing concentration of transplant services in high-volume urban centers may lead to increased access barriers for rural patients.
"Further assessment of the disease burden facing rural residents and the barriers in access to specialty care services is needed to ensure equitable access to life-saving organ transplants," the researchers conclude.
Journal reference: JAMA. 2008;299(2):202-208.
Adapted from materials provided by JAMA and Archives Journals.
ScienceDaily (Jan. 9, 2008) — Patients in small towns and isolated rural areas have lower organ transplant rates and are less likely to be wait-listed than patients in urban areas, according to a new study.
Organ transplantation offers the best, and often only hope for long-term survival for patients with end-stage heart, liver, and kidney disease. However, despite federal regulation and national efforts to ensure equal access to the limited pool of donated organs, previous research has demonstrated the presence of significant barriers to access to transplantation services for racial minorities, women, and patients with low socioeconomic status or poor insurance, according to background information in the article. Rural residents represent another group that may have impaired access to transplant services. Nearly 14 percent of the U.S. population lives outside major urban areas.
David A. Axelrod, M.D., M.B.A., of Dartmouth Medical School, Lebanon, N.H., and colleagues assessed the impact of rural residence on waiting list registration for heart, liver, and kidney transplant and rates of transplantation among wait-listed candidates. A total of 174,630 patients who were wait-listed and who underwent heart, liver, or kidney transplantation between 1999 and 2004 were included in the study.
The researchers found significant disparities in access to organ transplantation between rural and urban populations.
"This study demonstrates that patients living in small towns and isolated rural regions were eight percent to 15 percent less likely to be wait-listed and ten percent to 20 percent less likely to undergo heart, liver, and kidney transplantation than patients in urban environments," the authors write.
They suggest these discrepancies may be related to differences in the burden of disease in rural environments or reduced access to entering the waiting list. And they warn that the increasing concentration of transplant services in high-volume urban centers may lead to increased access barriers for rural patients.
"Further assessment of the disease burden facing rural residents and the barriers in access to specialty care services is needed to ensure equitable access to life-saving organ transplants," the researchers conclude.
Journal reference: JAMA. 2008;299(2):202-208.
Adapted from materials provided by JAMA and Archives Journals.
Medical Breakthrough For Organ Transplants And Cardiovascular Diseases
Medical Breakthrough For Organ Transplants And Cardiovascular Diseases
ScienceDaily (Jan. 8, 2008) — When a blood vessel clogs up, a localized deficiency of oxygen results, causing the surrounding tissue to die. However, working with mice, VIB scientists connected to the Katholieke Universiteit Leuven have been able to prevent muscular tissue with severe hypoxia from dying. The muscles seem to 'adapt' to the lack of oxygen - a metabolic tour de force that animals also use when hibernating, but that has remained a mystery until now.
For the medical world, this discovery signifies an important step forward in limiting damage after a heart attack, for example, or for better preservation of organs awaiting transplants.
No life without oxygen - but oxygen can also be harmful
Oxygen is necessary to life. Humans and animals use oxygen to convert fats and sugars into the energy that keeps all life processes running and maintains the body's temperature. At the same time, oxygen can also be harmful when it is converted into toxic oxygen particles that cause serious damage to tissues and organs.
What about a little less?
Some animals can survive in places with little oxygen. Birds at high altitudes, for example, or animals that live underground or that can dive under water for a long time. Hibernating animals turn their bodily processes down low and live with a reduced amount of oxygen.
We can detect changes in the amount of oxygen with certain sensors. These oxygen meters are essential in adapting the body's metabolism during the changeover from an oxygen-rich to an oxygen-deficient environment.
ScienceDaily (Jan. 8, 2008) — When a blood vessel clogs up, a localized deficiency of oxygen results, causing the surrounding tissue to die. However, working with mice, VIB scientists connected to the Katholieke Universiteit Leuven have been able to prevent muscular tissue with severe hypoxia from dying. The muscles seem to 'adapt' to the lack of oxygen - a metabolic tour de force that animals also use when hibernating, but that has remained a mystery until now.
For the medical world, this discovery signifies an important step forward in limiting damage after a heart attack, for example, or for better preservation of organs awaiting transplants.
No life without oxygen - but oxygen can also be harmful
Oxygen is necessary to life. Humans and animals use oxygen to convert fats and sugars into the energy that keeps all life processes running and maintains the body's temperature. At the same time, oxygen can also be harmful when it is converted into toxic oxygen particles that cause serious damage to tissues and organs.
What about a little less?
Some animals can survive in places with little oxygen. Birds at high altitudes, for example, or animals that live underground or that can dive under water for a long time. Hibernating animals turn their bodily processes down low and live with a reduced amount of oxygen.
We can detect changes in the amount of oxygen with certain sensors. These oxygen meters are essential in adapting the body's metabolism during the changeover from an oxygen-rich to an oxygen-deficient environment.
TheStar.com | News | Most gays ruled out as organ donors
TheStar.com | News | Most gays ruled out as organ donors
Jan 09, 2008 04:30 AM
Joseph Hall
Health Reporter
A Health Canada regulation that bans most gay men from donating organs is scientifically unjustified, virtually unenforceable and could worsen critical transplant shortages, a prominent Toronto AIDS doctor says.
The regulation, which took effect in December and closely resembles blood-donor guidelines, prohibits organ donations from sexually active gay men, intravenous drug users and hepatitis victims.
Both strictures are unfair to thousands of conscientious gays, says Dr. Philip Berger, head of family and community medicine at St. Michael's Hospital.
"What about a gay monogamous couple, (Health Canada) is not going to let them donate? It's ridiculous," says Berger. "It's been known for 20 years that the risk factor is not in being gay (but) in risky sexual behaviour."
Heath Canada officials did not respond to numerous requests for interviews yesterday.
Berger says "it's what the individual does in their sexual lives, whether gay or straight, (that) puts them at risk."
"To exclude bona fide donors because they've had sex with another man ... would exclude a lot of people who are no risk at all. Zero risk."
Berger says the "unreasonable" restriction is bound to reduce the supply of transplant organs at a time when the need is growing more urgent.
But Dr. Gary Levy, head of Canada's largest organ transplant program, says the new regulation simply formalizes precautions in use across Canada for at least 10 years.
The precautions were based largely on blood donor criteria that exclude sexually active gays, says Levy, head of the transplant program at the University Health Network.
Still, Levy says, Health Canada's formalizing of the criteria was bound to cause "some anger and hostility" among many homosexuals.
And he agrees with Berger that the restrictions likely go too far in excluding all sexually active gay men.
"I personally believe someone who has been in a monogamous relationship for 30 years, regardless of the gender of their partner, is a safe situation," Levy says.
Levy says transplant physicians will likely urge Health Canada to reconsider the ban to put the emphasis on high-risk behaviour, whether promiscuous sex or illicit needle use.
In the end, however, Levy says transplant surgeons will continue to make the final decision on which organs are suitable for use.
He says many organs from known gay men have been used in his program after physicians determined from retrieval agencies that the donor's sexual behaviour did not carry a significant HIV risk.
Under the new regulation, however, surgeons will have to sign a form stating they authorized the use of an organ that would normally be excluded.
In the vast majority of organ donation cases, sexual history is assessed through interviews with relatives of the deceased. Even if a donor card has been signed, the family or the courts must give permission for harvesting in Ontario, Levy says.
But Berger says the Health Canada regulation is fundamentally flawed because the organ harvesting system depends entirely on the goodwill and honesty of donors or their families.
He adds that current HIV screening tests can confirm the infection-free status of donated organs rapidly and with virtual certainty.
The only risk would come from donors in the "so-called window period when they've been recently infected," Berger says, calling that an "infinitesimal" worry.
However, Levy says HIV can incubate for 20 days or more before becoming detectable.
Jan 09, 2008 04:30 AM
Joseph Hall
Health Reporter
A Health Canada regulation that bans most gay men from donating organs is scientifically unjustified, virtually unenforceable and could worsen critical transplant shortages, a prominent Toronto AIDS doctor says.
The regulation, which took effect in December and closely resembles blood-donor guidelines, prohibits organ donations from sexually active gay men, intravenous drug users and hepatitis victims.
Both strictures are unfair to thousands of conscientious gays, says Dr. Philip Berger, head of family and community medicine at St. Michael's Hospital.
"What about a gay monogamous couple, (Health Canada) is not going to let them donate? It's ridiculous," says Berger. "It's been known for 20 years that the risk factor is not in being gay (but) in risky sexual behaviour."
Heath Canada officials did not respond to numerous requests for interviews yesterday.
Berger says "it's what the individual does in their sexual lives, whether gay or straight, (that) puts them at risk."
"To exclude bona fide donors because they've had sex with another man ... would exclude a lot of people who are no risk at all. Zero risk."
Berger says the "unreasonable" restriction is bound to reduce the supply of transplant organs at a time when the need is growing more urgent.
But Dr. Gary Levy, head of Canada's largest organ transplant program, says the new regulation simply formalizes precautions in use across Canada for at least 10 years.
The precautions were based largely on blood donor criteria that exclude sexually active gays, says Levy, head of the transplant program at the University Health Network.
Still, Levy says, Health Canada's formalizing of the criteria was bound to cause "some anger and hostility" among many homosexuals.
And he agrees with Berger that the restrictions likely go too far in excluding all sexually active gay men.
"I personally believe someone who has been in a monogamous relationship for 30 years, regardless of the gender of their partner, is a safe situation," Levy says.
Levy says transplant physicians will likely urge Health Canada to reconsider the ban to put the emphasis on high-risk behaviour, whether promiscuous sex or illicit needle use.
In the end, however, Levy says transplant surgeons will continue to make the final decision on which organs are suitable for use.
He says many organs from known gay men have been used in his program after physicians determined from retrieval agencies that the donor's sexual behaviour did not carry a significant HIV risk.
Under the new regulation, however, surgeons will have to sign a form stating they authorized the use of an organ that would normally be excluded.
In the vast majority of organ donation cases, sexual history is assessed through interviews with relatives of the deceased. Even if a donor card has been signed, the family or the courts must give permission for harvesting in Ontario, Levy says.
But Berger says the Health Canada regulation is fundamentally flawed because the organ harvesting system depends entirely on the goodwill and honesty of donors or their families.
He adds that current HIV screening tests can confirm the infection-free status of donated organs rapidly and with virtual certainty.
The only risk would come from donors in the "so-called window period when they've been recently infected," Berger says, calling that an "infinitesimal" worry.
However, Levy says HIV can incubate for 20 days or more before becoming detectable.
Tuesday, January 8, 2008
Sunday, January 6, 2008
London Free Press - Bill Brady - E-mails can be treasures, AAMOF
London Free Press - Bill Brady - E-mails can be treasures, AAMOF
In the five days since the big ball fell, I have received a score of e-mails, some of which I was happy to get, others . . . well, let's face it, most of these cyber messages are irrelevant, silly or downright inappropriate.
I ask rhetorically, how did we communicate before this often-intrusive device was available? We wrote letters.
Some time ago when I had a job, I dictated them. Then when that changed I typed my own and learned to rely on spell check -- so much so that now I am an abysmal speller.
E-mail has made many of us slaves to the Internet. AOL and Mr. Rogers thrive as we send and receive. I check my incoming far too often only to be sorry I did if the content is unimportant or, worse, unfriendly.
The Free Press puts my e-mail address at the end of this column and that is done so readers can respond. I like the ones that begin, "Thank you for writing about . . ." or "I loved this morning's column, so insightful (funny, droll, timely), I think you should be in the paper every day." I made that last one up in case Paul Berton reads my stuff occasionally.
Conversely I am brought back to earth by, "Your column in today's Free Press was both inaccurate and badly . . ." Then the UWO English department wades in to articulately scold me for grammar gaffes. They get testy about both punctuation and prepositions.
Then there are the personal e-mails that I treasure. My extraordinary 22-year-old grandson Matt, bright and articulate, e-mails me often, but has the gift of terseness. A recent response to a question I asked was the epitome of brevity. He replied, "Yes."
His younger brother Mark, who sends the occasional message in lower case and filled with code for me to decipher, allows that I am "pretty good at this stuff for an older guy." I now know that BTW translates to "by the way" and ROFL means "rolling on the floor laughing." Just when I think I have it figured out, he hits me with AAMOF -- "as a matter of fact."
I am delighted when my longtime friend Peter John Garland e-mails. He was as witty as ever when the other day, he reported on a conversation with a former colleague.
"I met Jim Knowles at Sobey's (in the produce dept. -- onion area) and he informed me of your imminent departure to Florida. We agreed that life was like an onion, many layers and once peeled away you just have: a messy counter top unless you are making a nice soup with some sherry and melted Swiss and Parmesan atop the round of bread.
"He has a short attention span like me. I hope I-75 was kind to you and remembered to ask for apple juice at the 'Welcome to Florida' place and freak out the elderly volunteer.
"Here's also hoping you had a nice Christmas filled with all the (quoting saccharine cards now, mostly) 'bright and joyous seasonal holiday warmth of dear family, cherished friends' and blah, blah, blah. . . ."
Dr. Andy Kertesz saved the postage and relieved us of reading a long Christmas letter with this year-end e-mail: "Dear Friends, For those of you who like annual reports you might reply in kind, for those who do not, send this to cybergarbage."
My friend Ian Brooks, a former Londoner now living in Auckland, New Zealand, is a writer of great e-mails and we like to hear about his remarkable dad Fred, who is also from London and now retired in Australia: "We had a great time having him with us (at Christmas) . . . he really is amazing for someone who is nearly 93."
Then wonderful news from Joe Rapai who a few weeks ago received a live-saving liver transplant: "I have attached a recent picture so that you can visualize the great work of Dr. Bill Wall's team. Of course he had reasonably good subject matter to work with."
HNYTFRMS -- I'm sure you've figured that out but just in case, "Happy New Year and thanks for reading my stuff."
Bill Brady is secretary of the Blackburn Group Inc. His column appears Thursdays.
Father of Belleville girl takes comfort knowing she gives to others, even in death
Father of Belleville girl takes comfort knowing she gives to others, even in death
Father of Belleville girl takes comfort knowing she gives to others, even in death
Organ donation: LifeGoesOn.com
By CHERYL WITTENAUER
Associated Press Writer
ST. LOUIS -- When 9-year-old Jazmyne Davis of Belleville died in September from a massive asthma attack, her parents didn't hesitate to donate their child's organs.
"Before she did her own homework, she helped other kids. She was giving. It felt right," said Clarence Davis, who takes comfort knowing his "baby" continued to give to others, even in death.
Davis and other families of organ donors and recipients told their stories Friday at St. Louis Children's Hospital to stress the critical need for organ donation.
They included former Dallas Cowboys star Everson Walls, who donated a kidney to his friend, former teammate Ron Springs, last year.
On Friday, Walls teamed up with Rep. William Lacy Clay, D-Mo., who introduced a bill in September that would develop, expand and improve state organ and tissue donor registries and improve information sharing between them.
Clay's bill would provide grants to states' organ donor registries and study the feasibility of a database to track the health of people who have donated organs.
The Everson Walls and Ron Springs Gift For Life Act of 2007 also would establish a clearinghouse for states on organ donation.
Clay says the bill would elevate tissue and organ donation to a national health care priority at a time when 97,000 patients are waiting for organs.
Last year, 6,000 people in the U.S. died while awaiting transplants. Clay's staff said Sen. Carl Levin, D-Mich., will sponsor a companion bill in the Senate.
St. Louis Children's Hospital last year performed 94 organ transplants, its most ever, but 100 children are still on the waiting list.
"The issue is the availability of organs," hospital president Lee Fetter said. "This is a critically important bill."
Clay encouraged prospective organ donors to sign a registry.
That takes some of the pressure off grieving family members to make that decision, said Dr. Stuart Sweet, who heads the Pediatric Lung Transplant Program at Children's Hospital.
He said it takes less than five minutes to register online to be a Missouri organ donor.
George McCoy of St. Louis learned the hard way how important it is to register as an organ donor. His 20-year-old daughter, Britney, needs a heart.
"You don't think about it until you need it," he said.
Father of Belleville girl takes comfort knowing she gives to others, even in death
Organ donation: LifeGoesOn.com
By CHERYL WITTENAUER
Associated Press Writer
ST. LOUIS -- When 9-year-old Jazmyne Davis of Belleville died in September from a massive asthma attack, her parents didn't hesitate to donate their child's organs.
"Before she did her own homework, she helped other kids. She was giving. It felt right," said Clarence Davis, who takes comfort knowing his "baby" continued to give to others, even in death.
Davis and other families of organ donors and recipients told their stories Friday at St. Louis Children's Hospital to stress the critical need for organ donation.
They included former Dallas Cowboys star Everson Walls, who donated a kidney to his friend, former teammate Ron Springs, last year.
On Friday, Walls teamed up with Rep. William Lacy Clay, D-Mo., who introduced a bill in September that would develop, expand and improve state organ and tissue donor registries and improve information sharing between them.
Clay's bill would provide grants to states' organ donor registries and study the feasibility of a database to track the health of people who have donated organs.
The Everson Walls and Ron Springs Gift For Life Act of 2007 also would establish a clearinghouse for states on organ donation.
Clay says the bill would elevate tissue and organ donation to a national health care priority at a time when 97,000 patients are waiting for organs.
Last year, 6,000 people in the U.S. died while awaiting transplants. Clay's staff said Sen. Carl Levin, D-Mich., will sponsor a companion bill in the Senate.
St. Louis Children's Hospital last year performed 94 organ transplants, its most ever, but 100 children are still on the waiting list.
"The issue is the availability of organs," hospital president Lee Fetter said. "This is a critically important bill."
Clay encouraged prospective organ donors to sign a registry.
That takes some of the pressure off grieving family members to make that decision, said Dr. Stuart Sweet, who heads the Pediatric Lung Transplant Program at Children's Hospital.
He said it takes less than five minutes to register online to be a Missouri organ donor.
George McCoy of St. Louis learned the hard way how important it is to register as an organ donor. His 20-year-old daughter, Britney, needs a heart.
"You don't think about it until you need it," he said.
LA Daily News - Insurer denial revives argument over health care access
LA Daily News - Insurer denial revives argument over health care access
Insurer denial revives argument over health care access
By Susan Abram, Staff Writer
Article Last Updated: 01/06/2008 12:11:05 AM PST
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The case of Nataline Sarkisyan of Northridge - who died last month after her insurer denied, then agreed to, a liver transplant hours before her death - continues to highlight the national controversy about insurance and medical care and what, if anything, can be changed.
While overall complaints against some California insurance companies about everything from access to care to other services have declined in the past two years, complaints about more specific procedures - like Nataline's - have increased, according to a Daily News review of state data.
And patients asking for independent medical reviews - the official process of seeking a second opinion - have jumped 13percent in that time, according to the data.
It remains to be seen what kind of impact those complaints will have on the system, but Nataline's death has reignited a heated public debate about the effectiveness of the nation's health care insurance process.
"Just a few weeks ago in America, Nataline Sarkisyan, a 17-year-old girl, ... needed a liver transplant, and (her) insurance company decided they wouldn't pay for her liver transplant operation," Democratic presidential candidate John Edwards said last week after placing second in the Iowa Caucus.
Insurer denial revives argument over health care access
By Susan Abram, Staff Writer
Article Last Updated: 01/06/2008 12:11:05 AM PST
.
The case of Nataline Sarkisyan of Northridge - who died last month after her insurer denied, then agreed to, a liver transplant hours before her death - continues to highlight the national controversy about insurance and medical care and what, if anything, can be changed.
While overall complaints against some California insurance companies about everything from access to care to other services have declined in the past two years, complaints about more specific procedures - like Nataline's - have increased, according to a Daily News review of state data.
And patients asking for independent medical reviews - the official process of seeking a second opinion - have jumped 13percent in that time, according to the data.
It remains to be seen what kind of impact those complaints will have on the system, but Nataline's death has reignited a heated public debate about the effectiveness of the nation's health care insurance process.
"Just a few weeks ago in America, Nataline Sarkisyan, a 17-year-old girl, ... needed a liver transplant, and (her) insurance company decided they wouldn't pay for her liver transplant operation," Democratic presidential candidate John Edwards said last week after placing second in the Iowa Caucus.
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