Anatomical Gifts: A Compassionate Alternative to a Traditional Funeral
Anatomical Gifts: A Compassionate Alternative to a Traditional Funeral
A full body donation is one of the most compassionate alternatives to a funeral. A full body donation is not the same as organ donation. Although organ donation is perhaps a better known alternative to a funeral, anatomical donations are a much greater gift to the future of humankind. By donating your body to science, you are helping give surgeons a learning opportunity which may lead to a more efficient technique or a new life-saving surgical procedure. Your full body donation makes cutting edge developments in the fields of cancer treatment, thoracic research and neurology studies possible.
Anatomical donations allow research institutions to discover new ways to fight serious diseases and disorders such as cancer, Alzheimer’s disease and multiple sclerosis. At LifeQuest, we also work closely with surgical teaching institutions. LifeQuest is affiliated with Innovations in Medical Education and Training (IMET), an organization of healthcare professionals committed to an ever-improving medical education standard. We carefully match anatomical gifts to the needs of accredited medical research institutions for the greatest benefit to research and education. A LifeQuest surgical technician accompanies the whole body donor at each stage of the journey. This commitment has made LifeQuest the program of choice for the leading research and teaching institutions in the nation.
Donating your body to science carries an unfair stigma. The process of making an anatomical gift is really not that much different than the preparations that a mortician makes for a standard funeral. Unlike a standard funeral, however, the donation process provides viable tissues and specimens for research and study. When LifeQuest receives notice of the death of a potential donor, we discuss the possibility of donation with the family and physician. With family and medical consent, we recover the anatomical gifts most needed by research facilities and surgical teaching institutions. The remains are then cremated and may be returned to the family if they so choose.
If you or a loved one is considering cremation as an alternative to a traditional funeral, please consider making an anatomical gift. LifeQuest provides a free cremation to those who make a full body donation to science. Making an anatomical gift is a final act of caring and leaves a legacy of hope for the future. Contact LifeQuest to request a donation packet and learn more about this procedure.
Promoting Organ Donations the Gift of Life
Saturday, January 26, 2008
Drug-free breakthrough in transplant patients - Los Angeles Times
Drug-free breakthrough in transplant patients - Los Angeles Times
Drug-free breakthrough in transplant patients
A procedure using bone marrow weans kidney recipients off anti-rejection medications which can produce side effects.
By Thomas H. Maugh II, Los Angeles Times Staff Writer
January 26, 2008
Massachusetts researchers have been able to wean four of five kidney transplant patients off anti-rejection drugs, a feat that could eventually lead to a sharp reduction in use of the expensive, side-effect-ridden medications.
By simultaneously giving recipients bone marrow from living donors, physicians were able to induce what is known as a state of tolerance, in which a recipient's immune system does not recognize the new organ as foreign.
The procedure was more remarkable in that the recipients were given kidneys that were not perfect tissue matches, making them more susceptible to rejection.
Based on experiments in monkeys, "there is reason to hope these patients will be off drugs for the rest of their lives," said Dr. David Sachs of Massachusetts General Hospital, lead author of the report in Thursday's New England Journal of Medicine.
The technique will not alleviate the shortage of donors, and patients who have already received transplants will not be able to stop taking medications, but the procedure could have a major effect on transplant recipients if it can be replicated in larger studies.
Anti-rejection drugs can cause a variety of problems, including excessive hair growth, bloating, tremors and kidney failure.
In the new procedure, developed in animals during a 30-year period, the team gave drugs and radiation to prospective recipients to weaken their immune systems and destroy T cells, the primary immune system component involved in tissue rejection.
A few days later, each patient received the transplant and an infusion of bone marrow from the donor. The patients initially received anti-rejection drugs but were successfully weaned off them after eight to 14 months.
The procedure was successful in the first two patients, one of whom has been drug-free for more than five years. The third patient, however, rejected the transplant and had to have a second. Examining the patient, the team observed a high level of another immune cell, called a B cell.
In the final two patients, the transplant team added antibodies against B cells. Both patients were weaned from drugs and have been drug-free two to three years.
Sachs plans to study the procedure in 15 to 20 other patients, and a team at Northwestern Memorial Hospital in Chicago is planning to study it in 20 patients.
thomas.maugh@latime
Drug-free breakthrough in transplant patients
A procedure using bone marrow weans kidney recipients off anti-rejection medications which can produce side effects.
By Thomas H. Maugh II, Los Angeles Times Staff Writer
January 26, 2008
Massachusetts researchers have been able to wean four of five kidney transplant patients off anti-rejection drugs, a feat that could eventually lead to a sharp reduction in use of the expensive, side-effect-ridden medications.
By simultaneously giving recipients bone marrow from living donors, physicians were able to induce what is known as a state of tolerance, in which a recipient's immune system does not recognize the new organ as foreign.
The procedure was more remarkable in that the recipients were given kidneys that were not perfect tissue matches, making them more susceptible to rejection.
Based on experiments in monkeys, "there is reason to hope these patients will be off drugs for the rest of their lives," said Dr. David Sachs of Massachusetts General Hospital, lead author of the report in Thursday's New England Journal of Medicine.
The technique will not alleviate the shortage of donors, and patients who have already received transplants will not be able to stop taking medications, but the procedure could have a major effect on transplant recipients if it can be replicated in larger studies.
Anti-rejection drugs can cause a variety of problems, including excessive hair growth, bloating, tremors and kidney failure.
In the new procedure, developed in animals during a 30-year period, the team gave drugs and radiation to prospective recipients to weaken their immune systems and destroy T cells, the primary immune system component involved in tissue rejection.
A few days later, each patient received the transplant and an infusion of bone marrow from the donor. The patients initially received anti-rejection drugs but were successfully weaned off them after eight to 14 months.
The procedure was successful in the first two patients, one of whom has been drug-free for more than five years. The third patient, however, rejected the transplant and had to have a second. Examining the patient, the team observed a high level of another immune cell, called a B cell.
In the final two patients, the transplant team added antibodies against B cells. Both patients were weaned from drugs and have been drug-free two to three years.
Sachs plans to study the procedure in 15 to 20 other patients, and a team at Northwestern Memorial Hospital in Chicago is planning to study it in 20 patients.
thomas.maugh@latime
Medical News: Kidney and Liver Transplant Rejection Purged by Chimerism - in Surgery, Transplantation from MedPage Today
Medical News: Kidney and Liver Transplant Rejection Purged by Chimerism - in Surgery, Transplantation from MedPage Today
Kidney and Liver Transplant Rejection Purged by Chimerism
By John Gever, Staff Writer, MedPage Today
Published: January 24, 2008
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine. Earn CME/CE credit
for reading medical news
BOSTON, Jan. 23 -- Six organ-transplant recipients have remained healthy for up to five years without anti-rejection drugs, said researchers in the U.S. and Australia whose strategy was chimerism.
In essence, the recipients' immune systems were re-engineered to treat the donor organs -- five kidneys and one liver -- as their own, according to three reports in the Jan. 24 issue of the New England Journal of Medicine.
All but one of the transplants involved HLA-mismatched donations. Action Points
--------------------------------------------------------------------------------
Explain that the studies found that anti-rejection drugs could be withdrawn successfully in some kidney and liver transplant patients.
Point out that most of the cases involved carefully selected patients not representative of most transplant candidates.
Point out the techniques remain experimental and need to be confirmed in larger numbers of patients.
The idea is to chimerize the organ donor's immune system with the recipient. A successfully chimerized immune system recognizes both the donor organ as well as the recipient's native tissues as self. Thus, there is no need for antirejection therapy and also no danger of graft-versus-host disease.
These are not the first human instances of allograft tolerance, as dozens of cases have been reported before. But the new results show how chimerism and tolerance might be applied to a broad population of transplant recipients.
David Sachs, M.D., at Massachusetts General Hospital, and colleagues reported that four of five kidney transplant patients have been stable for 2.0 to 5.3 years without antirejection therapy.
At Stanford in California, John Scandling, M.D., and colleagues said one patient had gone more than 28 months without antirejection drugs or signs of GvHD. The researchers have tried the same approach in six additional patients, three with less successful results and the other three only just recently.
And clinicians at the University of Sydney in Australia, led by Stephen I. Alexander, M.B., B.S., described a remarkable case of graft tolerance in a young liver transplant recipient.
Both U.S. groups sought to induce chimerism by infusing donor hematopoietic cells along with the organ transplant.
Dr. Sachs and colleagues certainly had the largest number of successes, even more noteworthy because the cases involved HLA-mismatched donors.
Prior to transplant, the recipients received a myeloablative regimen including cyclophosphamide, the MEDI507 anti-CD2 monoclonal antibody drug, cyclosporine A, and thymic irradiation. The last two patients also received rituximab (Rituxan) to deplete B cells.
The patients then received kidneys and intravenous infusions of bone marrow from parents or siblings mismatched by one HLA haplotype. Oral cyclosporine A at 8 to 12 mg daily began with transplant but was tapered and then discontinued over several months.
After transplant, both donor- and native-type leukocytes were found in the patients' blood. But by day 21, this mixed chimerism had disappeared, the researchers said.
In an interview, Dr. Sachs said this period of transient chimerism reflects a normal selection process in the thymus by which immune cells that target self-proteins are eliminated. In their study, as they hoped, not only anti-self reactions were eliminated, but anti-donor reactions as well.
In an accompanying editorial, Thomas Starzl, M.D., the University of Pittsburgh liver transplant pioneer, questioned the disappearance of chimerism in these patients. He pointed out that Dr. Sachs and colleagues had looked for recipient-lineage cells only in blood, not in other tissues.
Dr. Starzl said he believed that a few recipient cells continued to survive. The coexistence of donor and recipient immune cells is critical to successful tolerance, he said.
All the Boston patients showed capillary leak syndrome, a sign of rejection, and one patient developed acute humoral rejection with irreversible loss of renal function. The others were treated with corticosteroids and had cyclosporine withdrawn on schedule, with rejection symptoms eventually disappearing and kidney function remaining normal.
"Stable graft function after planned, complete withdrawal of immunosuppressive drugs is feasible in recipients of HLA-mismatched grafts," the Boston team wrote.
The Stanford team's approach was similar except that the recipient underwent no conditioning prior to the transplant day.
In an interview, Dr. Scandling said the lack of pre-transplant conditioning was important because it means the technique should be adaptable to cadaver transplants, making it more broadly applicable.
On the other hand, the group's cases have involved fully HLA-matched donations -- from a live brother in the successful case reported in the NEJM.
Dr. Scandling described the approach as just one step toward the ultimate goal. Success with HLA-matched donors will pave the way toward testing with mismatched donations, he suggested.
"We'll know more in about six months," he said, when the later patients included in the protocol can be evaluated.
Unlike the Boston group's result in which donor-lineage immune cells predominated after transplant, Dr. Scandling and colleagues found about equal division between donor- and recipient-type immune cells in their successful case.
For both groups, the results capped a long and carefully planned research program.
The Boston and Stanford teams had spent years testing different approaches, first in animals and then in selected human patients.
That's not what happened with Dr. Alexander's group in Australia. They were hoping to save a nine-year-old girl in a desperate crisis.
They had performed what was intended as a conventional liver transplant on the girl, using an HLA-mismatched, cadaver male donor organ and followed by standard immunosuppression.
Ten months later, the girl developed life-threatening hemolytic anemia. It apparently arose as her initially RhD-negative blood subgroup switched to the donor's RhD-positive subgroup. Antibodies to the resulting RhD-positive red blood cells were prompting the hemolytic crisis.
Lab studies suggested that although donor-type hematopoietic cells had largely taken over in her marrow, some residual B cells of the girl's own type persisted and were mounting the antibody attack.
Dr. Alexander and colleagues considered two options for saving the girl. One was to deplete all the girl's antibody-producing B cells with rituximab, including those of the donor's type as well as her own, which would leave her vulnerable to infection.
The other option was to withdraw immunosuppressant therapy altogether, allowing the donor-type hematopoietic cells to completely crowd out the girl's residual B cells. That would end the anti-RhD-positive immune attack.
They chose the second option and it succeeded. The hemolytic anemia resolved and, 17 months after the transplant, Dr. Alexander and colleagues determined that the girl had achieved complete hematopoietic chimerism. Her peripheral blood reflected the donor's HLA typing with repeat studies, although some donor-reactive T-cell populations remained five years after transplant.
Four years after immunosuppressive treatment ended, the researchers said the girl remains healthy, fully tolerant of the liver allograft without immunosuppressant therapy. There were no signs of graft-versus-host disease.
One side effect of her ordeal was that wiping out her original B cells also erased her immunity to mumps, measles, and rubella. Dr. Alexander and colleagues said that normal antibody responses to these pathogens were restored after a standard round of vaccinations.
The researchers said that other factors besides their decision to stop antirejection treatment could have contributed to the outcome. Both the initial period of immunosuppression and an active cytomegalovirus infection that appeared shortly after transplant may have played roles, they said.
In his editorial, Dr. Starzl suggested additional work is needed before tolerance can be induced routinely.
"Perhaps it will be possible to systematically achieve stable organ engraftment with very low dependence on -- or in some cases complete freedom from -- long-term treatment," Dr. Starzl wrote. "To do so will require just the right dose and timing of immunosuppressive therapy with or without the aid of adjunct hematopoietic stem cells."
The Boston group's work was supported by the Immune Tolerance Network, a collaborative clinical research project supported by the National Institute of Allergy and Infectious Diseases, the National Institute of Diabetes and Digestive and Kidney Diseases, and the Juvenile Diabetes Research Foundation.
The Stanford group's work was supported by the National Heart, Lung, and Blood Institute.
The Australian group was supported by the Juvenile Diabetes Research Foundation.
The Boston group reported no potential conflicts of interest.
Dr. Scandling reported receiving lecture fees from Astellas and research support from Astellas, Novartis, and Roche. Another co-author received research support from Astellas, Isotechnika, Pfizer, and Novartis.
The Australian researchers reported no potential conflicts of interest.
Dr. Starzl reported no potential conflicts of interest.
Primary source: New England Journal of Medicine
Source reference:
Kawai T, et al "HLA-mismatched renal transplantation without maintenance immunosuppression" N Engl J Med 2008; 358: 353-61.
Additional source: New England Journal of Medicine
Source reference:
Scandling J, et al "Tolerance and chimerism after renal and hematopoietic-cell transplantation" N Engl J Med 2008; 358: 362-68.
Additional source: New England Journal of Medicine
Source reference:
Starzl T, "Immunosuppressive therapy and tolerance of organ allografts" N Engl J Med 2008; 358: 407-10.
Related Article(s):
Low Early Immunosuppression Doses Better After Kidney Transplant
AASLD: Recipients of Liver Grafts for Acetaminophen Hepatotoxicity Do Better Than Expected
AASLD: Spare the Tacrolimus and Save the Kidneys
Additional Transplantation Coverage
Kidney and Liver Transplant Rejection Purged by Chimerism
By John Gever, Staff Writer, MedPage Today
Published: January 24, 2008
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine. Earn CME/CE credit
for reading medical news
BOSTON, Jan. 23 -- Six organ-transplant recipients have remained healthy for up to five years without anti-rejection drugs, said researchers in the U.S. and Australia whose strategy was chimerism.
In essence, the recipients' immune systems were re-engineered to treat the donor organs -- five kidneys and one liver -- as their own, according to three reports in the Jan. 24 issue of the New England Journal of Medicine.
All but one of the transplants involved HLA-mismatched donations. Action Points
--------------------------------------------------------------------------------
Explain that the studies found that anti-rejection drugs could be withdrawn successfully in some kidney and liver transplant patients.
Point out that most of the cases involved carefully selected patients not representative of most transplant candidates.
Point out the techniques remain experimental and need to be confirmed in larger numbers of patients.
The idea is to chimerize the organ donor's immune system with the recipient. A successfully chimerized immune system recognizes both the donor organ as well as the recipient's native tissues as self. Thus, there is no need for antirejection therapy and also no danger of graft-versus-host disease.
These are not the first human instances of allograft tolerance, as dozens of cases have been reported before. But the new results show how chimerism and tolerance might be applied to a broad population of transplant recipients.
David Sachs, M.D., at Massachusetts General Hospital, and colleagues reported that four of five kidney transplant patients have been stable for 2.0 to 5.3 years without antirejection therapy.
At Stanford in California, John Scandling, M.D., and colleagues said one patient had gone more than 28 months without antirejection drugs or signs of GvHD. The researchers have tried the same approach in six additional patients, three with less successful results and the other three only just recently.
And clinicians at the University of Sydney in Australia, led by Stephen I. Alexander, M.B., B.S., described a remarkable case of graft tolerance in a young liver transplant recipient.
Both U.S. groups sought to induce chimerism by infusing donor hematopoietic cells along with the organ transplant.
Dr. Sachs and colleagues certainly had the largest number of successes, even more noteworthy because the cases involved HLA-mismatched donors.
Prior to transplant, the recipients received a myeloablative regimen including cyclophosphamide, the MEDI507 anti-CD2 monoclonal antibody drug, cyclosporine A, and thymic irradiation. The last two patients also received rituximab (Rituxan) to deplete B cells.
The patients then received kidneys and intravenous infusions of bone marrow from parents or siblings mismatched by one HLA haplotype. Oral cyclosporine A at 8 to 12 mg daily began with transplant but was tapered and then discontinued over several months.
After transplant, both donor- and native-type leukocytes were found in the patients' blood. But by day 21, this mixed chimerism had disappeared, the researchers said.
In an interview, Dr. Sachs said this period of transient chimerism reflects a normal selection process in the thymus by which immune cells that target self-proteins are eliminated. In their study, as they hoped, not only anti-self reactions were eliminated, but anti-donor reactions as well.
In an accompanying editorial, Thomas Starzl, M.D., the University of Pittsburgh liver transplant pioneer, questioned the disappearance of chimerism in these patients. He pointed out that Dr. Sachs and colleagues had looked for recipient-lineage cells only in blood, not in other tissues.
Dr. Starzl said he believed that a few recipient cells continued to survive. The coexistence of donor and recipient immune cells is critical to successful tolerance, he said.
All the Boston patients showed capillary leak syndrome, a sign of rejection, and one patient developed acute humoral rejection with irreversible loss of renal function. The others were treated with corticosteroids and had cyclosporine withdrawn on schedule, with rejection symptoms eventually disappearing and kidney function remaining normal.
"Stable graft function after planned, complete withdrawal of immunosuppressive drugs is feasible in recipients of HLA-mismatched grafts," the Boston team wrote.
The Stanford team's approach was similar except that the recipient underwent no conditioning prior to the transplant day.
In an interview, Dr. Scandling said the lack of pre-transplant conditioning was important because it means the technique should be adaptable to cadaver transplants, making it more broadly applicable.
On the other hand, the group's cases have involved fully HLA-matched donations -- from a live brother in the successful case reported in the NEJM.
Dr. Scandling described the approach as just one step toward the ultimate goal. Success with HLA-matched donors will pave the way toward testing with mismatched donations, he suggested.
"We'll know more in about six months," he said, when the later patients included in the protocol can be evaluated.
Unlike the Boston group's result in which donor-lineage immune cells predominated after transplant, Dr. Scandling and colleagues found about equal division between donor- and recipient-type immune cells in their successful case.
For both groups, the results capped a long and carefully planned research program.
The Boston and Stanford teams had spent years testing different approaches, first in animals and then in selected human patients.
That's not what happened with Dr. Alexander's group in Australia. They were hoping to save a nine-year-old girl in a desperate crisis.
They had performed what was intended as a conventional liver transplant on the girl, using an HLA-mismatched, cadaver male donor organ and followed by standard immunosuppression.
Ten months later, the girl developed life-threatening hemolytic anemia. It apparently arose as her initially RhD-negative blood subgroup switched to the donor's RhD-positive subgroup. Antibodies to the resulting RhD-positive red blood cells were prompting the hemolytic crisis.
Lab studies suggested that although donor-type hematopoietic cells had largely taken over in her marrow, some residual B cells of the girl's own type persisted and were mounting the antibody attack.
Dr. Alexander and colleagues considered two options for saving the girl. One was to deplete all the girl's antibody-producing B cells with rituximab, including those of the donor's type as well as her own, which would leave her vulnerable to infection.
The other option was to withdraw immunosuppressant therapy altogether, allowing the donor-type hematopoietic cells to completely crowd out the girl's residual B cells. That would end the anti-RhD-positive immune attack.
They chose the second option and it succeeded. The hemolytic anemia resolved and, 17 months after the transplant, Dr. Alexander and colleagues determined that the girl had achieved complete hematopoietic chimerism. Her peripheral blood reflected the donor's HLA typing with repeat studies, although some donor-reactive T-cell populations remained five years after transplant.
Four years after immunosuppressive treatment ended, the researchers said the girl remains healthy, fully tolerant of the liver allograft without immunosuppressant therapy. There were no signs of graft-versus-host disease.
One side effect of her ordeal was that wiping out her original B cells also erased her immunity to mumps, measles, and rubella. Dr. Alexander and colleagues said that normal antibody responses to these pathogens were restored after a standard round of vaccinations.
The researchers said that other factors besides their decision to stop antirejection treatment could have contributed to the outcome. Both the initial period of immunosuppression and an active cytomegalovirus infection that appeared shortly after transplant may have played roles, they said.
In his editorial, Dr. Starzl suggested additional work is needed before tolerance can be induced routinely.
"Perhaps it will be possible to systematically achieve stable organ engraftment with very low dependence on -- or in some cases complete freedom from -- long-term treatment," Dr. Starzl wrote. "To do so will require just the right dose and timing of immunosuppressive therapy with or without the aid of adjunct hematopoietic stem cells."
The Boston group's work was supported by the Immune Tolerance Network, a collaborative clinical research project supported by the National Institute of Allergy and Infectious Diseases, the National Institute of Diabetes and Digestive and Kidney Diseases, and the Juvenile Diabetes Research Foundation.
The Stanford group's work was supported by the National Heart, Lung, and Blood Institute.
The Australian group was supported by the Juvenile Diabetes Research Foundation.
The Boston group reported no potential conflicts of interest.
Dr. Scandling reported receiving lecture fees from Astellas and research support from Astellas, Novartis, and Roche. Another co-author received research support from Astellas, Isotechnika, Pfizer, and Novartis.
The Australian researchers reported no potential conflicts of interest.
Dr. Starzl reported no potential conflicts of interest.
Primary source: New England Journal of Medicine
Source reference:
Kawai T, et al "HLA-mismatched renal transplantation without maintenance immunosuppression" N Engl J Med 2008; 358: 353-61.
Additional source: New England Journal of Medicine
Source reference:
Scandling J, et al "Tolerance and chimerism after renal and hematopoietic-cell transplantation" N Engl J Med 2008; 358: 362-68.
Additional source: New England Journal of Medicine
Source reference:
Starzl T, "Immunosuppressive therapy and tolerance of organ allografts" N Engl J Med 2008; 358: 407-10.
Related Article(s):
Low Early Immunosuppression Doses Better After Kidney Transplant
AASLD: Recipients of Liver Grafts for Acetaminophen Hepatotoxicity Do Better Than Expected
AASLD: Spare the Tacrolimus and Save the Kidneys
Additional Transplantation Coverage
Friday, January 25, 2008
Transplant Experience - Organ Transplant Rejection and its symptoms
Transplant Experience - Organ Transplant Rejection and its symptoms
Rejection & Its Symptoms
Your immune system is your body's defense against foreign invaders like bacteria or viruses. Unfortunately, your immune system cannot tell the difference between a harmful invader and your new organ.
Rejection happens when the body's immune system tries to get rid of a transplanted organ. Anti-rejection medicines (also called immunosuppressants) slow down your immune system to help keep this from happening. You will probably take more than one medicine to protect your organ, and each medicine works in a different way.
Even with all the right care and medicines, many transplant recipients still have at least one acute rejection episode. Acute rejections more likely to happen within the first year after the surgery; however, it's possible that rejection could happen years later.
Chronic rejection is when the body slowly and continually attacks the transplanted organ.
Occasionally, acute rejection can lead to chronic rejection. Therefore, you should be aware of the signs of acute rejection and seek treatment as soon as you experience any of them. It is important to remember, however, that rejection can occur without any symptoms. Sometimes rejection is only found when your transplant team gets the results of common follow-up tests. That is why it is so important for you to keep all of your doctor appointments.
Symptoms of Rejection
Rejection can be happening without you knowing and is often only found during your regular doctor visits. However, you should be aware of some of the following symptoms of rejection and call your transplant team right away if you experience any of them:
Fever over 100°F (38°C)
Flu-like symptoms such as chills, nausea, vomiting, diarrhea, tiredness, headache, dizziness, or body aches and pains
Pain or tenderness over your transplant site
Retaining fluids or having sudden weight gain
Shortness of breath
Sudden rise in blood pressure
Change in pulse rate
Kidney transplant recipients only:
Change in the color or smell of urine
A lower amount of urine
Liver transplant recipients only:
Yellow color to the skin or eyes
Light-colored or blackened stools
Change in the color or smell of urine
Rejection is an ongoing concern for transplant recipients. That is why it is extremely important that you take all of your medications, every day, exactly as prescribed. Click here for some tips that can help you remember to take your medications.
Rejection & Its Symptoms
Your immune system is your body's defense against foreign invaders like bacteria or viruses. Unfortunately, your immune system cannot tell the difference between a harmful invader and your new organ.
Rejection happens when the body's immune system tries to get rid of a transplanted organ. Anti-rejection medicines (also called immunosuppressants) slow down your immune system to help keep this from happening. You will probably take more than one medicine to protect your organ, and each medicine works in a different way.
Even with all the right care and medicines, many transplant recipients still have at least one acute rejection episode. Acute rejections more likely to happen within the first year after the surgery; however, it's possible that rejection could happen years later.
Chronic rejection is when the body slowly and continually attacks the transplanted organ.
Occasionally, acute rejection can lead to chronic rejection. Therefore, you should be aware of the signs of acute rejection and seek treatment as soon as you experience any of them. It is important to remember, however, that rejection can occur without any symptoms. Sometimes rejection is only found when your transplant team gets the results of common follow-up tests. That is why it is so important for you to keep all of your doctor appointments.
Symptoms of Rejection
Rejection can be happening without you knowing and is often only found during your regular doctor visits. However, you should be aware of some of the following symptoms of rejection and call your transplant team right away if you experience any of them:
Fever over 100°F (38°C)
Flu-like symptoms such as chills, nausea, vomiting, diarrhea, tiredness, headache, dizziness, or body aches and pains
Pain or tenderness over your transplant site
Retaining fluids or having sudden weight gain
Shortness of breath
Sudden rise in blood pressure
Change in pulse rate
Kidney transplant recipients only:
Change in the color or smell of urine
A lower amount of urine
Liver transplant recipients only:
Yellow color to the skin or eyes
Light-colored or blackened stools
Change in the color or smell of urine
Rejection is an ongoing concern for transplant recipients. That is why it is extremely important that you take all of your medications, every day, exactly as prescribed. Click here for some tips that can help you remember to take your medications.
Organ transplants | A successful mixture | Economist.com
Organ transplants | A successful mixture | Economist.com
Organ transplants
A successful mixture
Jan 24th 2008
From The Economist print edition
Transplanting immune-system stem cells along with kidneys stops rejection
WOE to the patient waiting for someone to offer up a spare organ for transplantation. Demand so far exceeds supply these days that in America alone around 17 people die every day while languishing in the queue. Nor do problems end there. Even the lucky ones, who do get their desired replacement part, face a lifetime on immunosuppressant drugs, to stop the alien tissue being rejected by their own immune systems.
David Sachs and Benedict Cosimi, of Harvard Medical School, have been working for some time to find a way around these problems. Their goal has been to trick the body into thinking that a foreign organ is really a native one, so that its immune system refrains from rejecting the foreigner. In this week's New England Journal of Medicine they report a small but promising study that, if confirmed on a grander scale, may deal with the issue once and for all and usher in a world in which immunosuppressant drugs are unnecessary and organs no longer need be matched to patients. That would make the lives of transplant patients easier and longer, and might also increase the useful supply of organs available for transplant.
Dr Sachs and Dr Cosimi tricked the body by transplanting a part of the donor's bone marrow along with the organ. Since the cells of the immune system are derived from stem cells in the bone marrow, these patients go on to develop what is known as chimeric immunity, which blends elements from the immune systems of both the donor and the recipient.
The process begins with the partial destruction of the recipient's own bone marrow using a drug called cyclophosphamide, followed by treatment with an antibody that depletes his supply of T cells, the part of the immune system that is most implicated in organ rejection. Once that is done, the organ (in this case a kidney) and the bone marrow are transplanted and the patient is confined for a fortnight in a sterile environment to protect him from infection while his new, mixed immune system boots up.
Dr Sachs and Dr Cosimi tried their new procedure on five people and it worked for four of them (though they did modify the process slightly after the third patient, by including antibodies against B cells, a second part of the immune system). On each occasion they transplanted a kidney that was, immunologically speaking, a poor match for the recipient. And in each of the four successful cases they were able take the patient off immunosuppressant drugs within 8-14 months, with no sign of rejection. All four of these patients are still alive; indeed, the first has now survived for more than five years. (The one failure later received a standard transplant, followed by a permanent regimen of immunosuppressant drugs, and is also still alive.)
Although the technique looks promising, it is a mystery why it should work. You would think that a chimeric immune system would be more active, not less, and would therefore attack the recipient's other organs, since they look foreign to the transplanted immune cells. Not so. Nor is it clear how the transplanted immune cells stop the existing ones from attacking the new organ. And, the immune system does not stay chimeric forever. Eventually, the original one predominates and the transplanted one vanishes (or, at least, becomes undetectable). Yet the transplant's protective effect persists with no sign, as yet, of diminishing—and there is every reason to believe, based on the results of experiments on monkeys, that it will not diminish in the future.
Four successes are not, of course, proof of a reliable technique. And even if the approach works for kidneys, it has yet to be tested for other organs. Neither does eliminating rejection increase the supply of organs for transplant, even though it means that fewer will be wasted. But Dr Sachs and Dr Cosimi have a suggestion here, too. They hope their discovery may allow organs to be transplanted from other species, such as pigs, and have filed a patent based on the idea.
Xenotransplantation, as this idea is known, really would increase the supply of organs, but it is a controversial idea. The “yuck” factor that cross-species transplants would probably provoke would surely fade if lives were saved. However, xenotransplantation brings the risk of transplanting animal viruses and thus creating new human diseases. It would be an irony if something intended to preserve lives ended up destroying them.
Organ transplants
A successful mixture
Jan 24th 2008
From The Economist print edition
Transplanting immune-system stem cells along with kidneys stops rejection
WOE to the patient waiting for someone to offer up a spare organ for transplantation. Demand so far exceeds supply these days that in America alone around 17 people die every day while languishing in the queue. Nor do problems end there. Even the lucky ones, who do get their desired replacement part, face a lifetime on immunosuppressant drugs, to stop the alien tissue being rejected by their own immune systems.
David Sachs and Benedict Cosimi, of Harvard Medical School, have been working for some time to find a way around these problems. Their goal has been to trick the body into thinking that a foreign organ is really a native one, so that its immune system refrains from rejecting the foreigner. In this week's New England Journal of Medicine they report a small but promising study that, if confirmed on a grander scale, may deal with the issue once and for all and usher in a world in which immunosuppressant drugs are unnecessary and organs no longer need be matched to patients. That would make the lives of transplant patients easier and longer, and might also increase the useful supply of organs available for transplant.
Dr Sachs and Dr Cosimi tricked the body by transplanting a part of the donor's bone marrow along with the organ. Since the cells of the immune system are derived from stem cells in the bone marrow, these patients go on to develop what is known as chimeric immunity, which blends elements from the immune systems of both the donor and the recipient.
The process begins with the partial destruction of the recipient's own bone marrow using a drug called cyclophosphamide, followed by treatment with an antibody that depletes his supply of T cells, the part of the immune system that is most implicated in organ rejection. Once that is done, the organ (in this case a kidney) and the bone marrow are transplanted and the patient is confined for a fortnight in a sterile environment to protect him from infection while his new, mixed immune system boots up.
Dr Sachs and Dr Cosimi tried their new procedure on five people and it worked for four of them (though they did modify the process slightly after the third patient, by including antibodies against B cells, a second part of the immune system). On each occasion they transplanted a kidney that was, immunologically speaking, a poor match for the recipient. And in each of the four successful cases they were able take the patient off immunosuppressant drugs within 8-14 months, with no sign of rejection. All four of these patients are still alive; indeed, the first has now survived for more than five years. (The one failure later received a standard transplant, followed by a permanent regimen of immunosuppressant drugs, and is also still alive.)
Although the technique looks promising, it is a mystery why it should work. You would think that a chimeric immune system would be more active, not less, and would therefore attack the recipient's other organs, since they look foreign to the transplanted immune cells. Not so. Nor is it clear how the transplanted immune cells stop the existing ones from attacking the new organ. And, the immune system does not stay chimeric forever. Eventually, the original one predominates and the transplanted one vanishes (or, at least, becomes undetectable). Yet the transplant's protective effect persists with no sign, as yet, of diminishing—and there is every reason to believe, based on the results of experiments on monkeys, that it will not diminish in the future.
Four successes are not, of course, proof of a reliable technique. And even if the approach works for kidneys, it has yet to be tested for other organs. Neither does eliminating rejection increase the supply of organs for transplant, even though it means that fewer will be wasted. But Dr Sachs and Dr Cosimi have a suggestion here, too. They hope their discovery may allow organs to be transplanted from other species, such as pigs, and have filed a patent based on the idea.
Xenotransplantation, as this idea is known, really would increase the supply of organs, but it is a controversial idea. The “yuck” factor that cross-species transplants would probably provoke would surely fade if lives were saved. However, xenotransplantation brings the risk of transplanting animal viruses and thus creating new human diseases. It would be an irony if something intended to preserve lives ended up destroying them.
Thursday, January 24, 2008
Marrow injections help kidney transplant success | Health | Reuters
Marrow injections help kidney transplant success | Health | Reuters
Marrow injections help kidney transplant success
Wed Jan 23, 2008 8:31pm
By Gene Emery
BOSTON (Reuters) - Injecting blood or bone marrow cells into people who have just received a donated kidney can reduce the need for drugs that suppress the immune system, researchers reported on Wednesday.
The stem cells in the blood and bone marrow helped trick the body into tolerating the transplants, two teams of researchers reported in the New England Journal of Medicine.
In one series of experiments, researchers at Massachusetts General Hospital and Harvard Medical School in Boston tested the technique on five volunteers who received a kidney from a relative. Four were eventually weaned off their anti-suppression drugs.
"While we need to study this approach in a larger group of patients before it is ready for broad clinical use, this is the first time that tolerance to a series of mismatched transplants has been intentionally and successfully induced," said Dr. David Sachs, who helped lead the study.
Doctors have long sought a permanent and reliable way to trick the body into thinking that a transplanted organ is not a foreign invader. The drugs currently in use can have onerous side effects, including cancer and kidney damage.
Bone marrow makes the body's immune system cells, and the donor's immune cells presumably took up residence in the transplant patient's body and helped create a welcoming reception for the kidney, the researchers said.
This technique has been tried before under different circumstances including on multiple myeloma patients.
The new study involved patients whose kidney failure was caused by other problems. Patients first had their bone marrow partially destroyed and then received a drug that kills off T cells -- immune cells that play a key role in rejecting transplanted organs
Marrow injections help kidney transplant success
Wed Jan 23, 2008 8:31pm
By Gene Emery
BOSTON (Reuters) - Injecting blood or bone marrow cells into people who have just received a donated kidney can reduce the need for drugs that suppress the immune system, researchers reported on Wednesday.
The stem cells in the blood and bone marrow helped trick the body into tolerating the transplants, two teams of researchers reported in the New England Journal of Medicine.
In one series of experiments, researchers at Massachusetts General Hospital and Harvard Medical School in Boston tested the technique on five volunteers who received a kidney from a relative. Four were eventually weaned off their anti-suppression drugs.
"While we need to study this approach in a larger group of patients before it is ready for broad clinical use, this is the first time that tolerance to a series of mismatched transplants has been intentionally and successfully induced," said Dr. David Sachs, who helped lead the study.
Doctors have long sought a permanent and reliable way to trick the body into thinking that a transplanted organ is not a foreign invader. The drugs currently in use can have onerous side effects, including cancer and kidney damage.
Bone marrow makes the body's immune system cells, and the donor's immune cells presumably took up residence in the transplant patient's body and helped create a welcoming reception for the kidney, the researchers said.
This technique has been tried before under different circumstances including on multiple myeloma patients.
The new study involved patients whose kidney failure was caused by other problems. Patients first had their bone marrow partially destroyed and then received a drug that kills off T cells -- immune cells that play a key role in rejecting transplanted organs
London Free Press - Ian Gillespie - Protesters on wrong track on this one
London Free Press - Ian Gillespie - Protesters on wrong track on this one
Protesters on wrong track on this one
By IAN GILLESPIE
There were about 30 young people, a bunch of signs and at least one bullhorn when protesters marched on a Health Canada office in London last week to squawk about the fact gay men aren't allowed to donate blood or organs.
It occurs to me that: a) this is what we get when people don't pay attention to their own recent history, and b) this is what we get when we raise kids in a culture of self-obsession that promotes and reveres individual rights above all else.
The protest was organized by a group called Students Against Queer Discrimination, and much of its pique was focused on question No. 18 on the form everyone fills out when they want to donate blood: "Male donors: Have you had sex with a man, even one time since 1977?"
The protesters believe this question discriminates against gay men. Local MP Irene Mathyssen apparently agrees, since she joined the protesters and asked, "Why on Earth would we ever allow homophobia?"
Here's a news flash for Mathyssen and those protesters: This isn't homophobia. It's life-and-death common sense.
It would appear Mathyssen and the protesters have never heard of a little something called the Krever inquiry, a 10-year criminal probe into Canada's worst preventable public health disaster.
The inquiry examined the sorry chain of events that led to what was widely referred to as the "tainted blood scandal." Officials estimate that during the 1980s, at least 2,000 Canadian recipients of blood and blood products contracted HIV, while another 20,000 recipients were infected with hepatitis C, a potentially debilitating liver disease.
As of 1997, it was estimated that about 3,000 people had died. But journalist Andre Picard, who wrote a book about the tragedy (The Gift of Death: Confronting Canada's Tainted Blood Tragedy), estimates about 5,000 more will ultimately die as a result of receiving bad blood.
The Krever inquiry concluded a number of things contributed to the tragedy, including a failure to screen out high-risk donors.
As a result, the Red Cross was stripped of its blood program and a new agency, the Canadian Blood Services, was formed to oversee the country's blood network.
In light of that nightmare, Canadian Blood Services has one over-riding priority: Ensure our blood supply is as safe as possible. And despite what Mathyssen and those callow protesters may think or say, that means paying attention to statistics.
"Scientific evidence says the highest-number of HIV-infected (people) are men who've had sex with another man," says Cindy Graham, regional communications manager, Southern Ontario, with Canadian Blood Services. "It's close to 40 per cent.
"The next highest comes from people who are intravenous drug users," she adds. "Then we're looking at people who have sex with those groups, and then there are people who come from African countries that are endemic for HIV."
All of those people, in any of those groups, are prohibited from giving blood. Likewise, new Health Canada regulations restrict organ transplants from sexually active gay men and intravenous drug users.
It's true that all blood donations are tested. But Graham says those tests aren't always foolproof.
"There's a window period (when tests can't detect the virus), particularly for HIV," she says. "There are lots of pathogens that we test for."
There are 29 questions on the donor form. They include: "At any time since 1977, have you taken money or drugs for sex?" And, "Have you ever taken illegal drugs or illegal steroids with a needle even one time?"
Does that first question discriminate against prostitutes? Does the second one discriminate against drug addicts?
Yes, they do. And for good reason -- because people who engage in those types of behaviour are more likely to carry infected blood.
Picard, who writes frequently about health-care rights, says it's wrong to make sweeping generalizations about gay men, since many are involved in long-term, monogamous relationships.
But still, he says the restrictions are justified.
"The bottom line for me is that giving blood is not a right," says Picard. "It's a privilege, and it has to be exercised carefully."
Maybe some day those protesters will outgrow their selfish solipsism and figure that out.
Email: igillespie@lfpress.com
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globeandmail.com: Smitherman blasts donor rules for gays
globeandmail.com: Smitherman blasts donor rules for gays
Smitherman blasts donor rules for gays
Homosexuals being ghettoized, he says
CAROLINE ALPHONSO
From Thursday's Globe and Mail
January 24, 2008 at 4:35 AM EST
Canada's only openly gay provincial health minister yesterday criticized Health Canada for "ghettoizing communities," arguing that regulations making it difficult for homosexuals to become organ donors should be eased.
Ontario Health Minister George Smitherman's comments set off a firestorm in Ottawa, with the federal government accusing him of not portraying the reality of the situation.
Following the failings highlighted in Canada's tainted-blood tragedy that left thousands infected with HIV and hepatitis C, Health Canada put in place a series of checks and balances aimed at ensuring all recipients of organ donations were fully aware of the risks involved. This includes telling would-be recipients that if they want to accept an organ from a sexually active gay man, there is a higher risk.
"Surely in this day and age our doctors ... are sophisticated enough to judge the risks posed by a prospective donor without resorting to ghettoizing communities," Mr. Smitherman said in an e-mail exchange yesterday.
"Our drive is to increase donations and save the lives of people languishing on lists. That is my job in part. Why would a regulation be written that ropes off prospective donors?"
But a spokeswoman for federal Health Minister Tony Clement quickly responded, saying the regulation doesn't ban organ donations by sexually active men or other groups considered high-risk. There are exemptions in the policy to allow doctors to conduct transplants even if the donor is in a risk category.
"Health Canada regulations do not prevent gay men from donating organs. The regulations are very clear that the final decision always rests with the recipient patient and the transplant doctor," Laryssa Waler said yesterday.
"These regulations do not constitute a change in policy. They are formalizing a practice that has been ongoing for many years in Canada that has to do with risk assessment. As Minister of Health for Ontario, George Smitherman is well aware of this," she added.
Currently, any organ to be donated is subject to tests and screening. But Health Canada says some groups pose a higher risk. That includes men who have had sex with another man even once in the past five years, those with a recent tattoo or piercing and people who have recently been in jail.
Doctors will test these organs for diseases including HIV and hepatitis, as well as speak with the donor's family or friends to assess their behaviour, before a potential recipient authorizes the use of the organs.
Ken Donohue, a spokesman for the British Columbia Transplant Society, said that because of the long waiting list for life-saving transplants, the province will not exclude anyone from being an organ donor.
"It's not that we say, 'You fall into this category, you cannot be a donor.' We say, 'Okay, in the regulations, Health Canada has said these behaviours are high-risk. Fair enough. But let's assess the person before simply waving them out of the door,' " Mr. Donohue said.
He added: "The regulations essentially put into place certain behaviours which may lead to [being in a] high-risk category. And we need to be extra vigilant in ensuring that organs are safe for transplant. But at the same time, B.C. Transplant has always assessed each potential donor on a case-by-case basis."
Smitherman blasts donor rules for gays
Homosexuals being ghettoized, he says
CAROLINE ALPHONSO
From Thursday's Globe and Mail
January 24, 2008 at 4:35 AM EST
Canada's only openly gay provincial health minister yesterday criticized Health Canada for "ghettoizing communities," arguing that regulations making it difficult for homosexuals to become organ donors should be eased.
Ontario Health Minister George Smitherman's comments set off a firestorm in Ottawa, with the federal government accusing him of not portraying the reality of the situation.
Following the failings highlighted in Canada's tainted-blood tragedy that left thousands infected with HIV and hepatitis C, Health Canada put in place a series of checks and balances aimed at ensuring all recipients of organ donations were fully aware of the risks involved. This includes telling would-be recipients that if they want to accept an organ from a sexually active gay man, there is a higher risk.
"Surely in this day and age our doctors ... are sophisticated enough to judge the risks posed by a prospective donor without resorting to ghettoizing communities," Mr. Smitherman said in an e-mail exchange yesterday.
"Our drive is to increase donations and save the lives of people languishing on lists. That is my job in part. Why would a regulation be written that ropes off prospective donors?"
But a spokeswoman for federal Health Minister Tony Clement quickly responded, saying the regulation doesn't ban organ donations by sexually active men or other groups considered high-risk. There are exemptions in the policy to allow doctors to conduct transplants even if the donor is in a risk category.
"Health Canada regulations do not prevent gay men from donating organs. The regulations are very clear that the final decision always rests with the recipient patient and the transplant doctor," Laryssa Waler said yesterday.
"These regulations do not constitute a change in policy. They are formalizing a practice that has been ongoing for many years in Canada that has to do with risk assessment. As Minister of Health for Ontario, George Smitherman is well aware of this," she added.
Currently, any organ to be donated is subject to tests and screening. But Health Canada says some groups pose a higher risk. That includes men who have had sex with another man even once in the past five years, those with a recent tattoo or piercing and people who have recently been in jail.
Doctors will test these organs for diseases including HIV and hepatitis, as well as speak with the donor's family or friends to assess their behaviour, before a potential recipient authorizes the use of the organs.
Ken Donohue, a spokesman for the British Columbia Transplant Society, said that because of the long waiting list for life-saving transplants, the province will not exclude anyone from being an organ donor.
"It's not that we say, 'You fall into this category, you cannot be a donor.' We say, 'Okay, in the regulations, Health Canada has said these behaviours are high-risk. Fair enough. But let's assess the person before simply waving them out of the door,' " Mr. Donohue said.
He added: "The regulations essentially put into place certain behaviours which may lead to [being in a] high-risk category. And we need to be extra vigilant in ensuring that organs are safe for transplant. But at the same time, B.C. Transplant has always assessed each potential donor on a case-by-case basis."
Pantagraph.com | News | Organ-donor list grows to 3.2 million
Pantagraph.com | News | Organ-donor list grows to 3.2 million
Organ-donor list grows to 3.2 million
By Kartikay Mehrotra
Kartikay.Mehrotra@lee.net
SPRINGFIELD — More than 3 million people have signed up for Illinois’ 2-year-old organ and tissue donor registry.
Since the new list was created in 2006, prohibiting survivors from changing the deceased’s donor wishes, more than half of the 6 million registrants cut out from the donor program are back.
“Promoting the importance of organ and tissue donation remains a top priority of my office,” Secretary of State Jesse White said. “It is estimated the new registry saves 100 more lives annually. One single donor can save or enhance the quality of life for 25 people.”
After the new registry was implemented Jan. 1, 2006, family members of the deceased were no longer allowed to interfere with the donor process, according to Illinois statute.
Previously, the final decision remained with the person’s family.
Because of the change in the law, donors who registered before Jan.1, 2006, need to re-register with the secretary of state’s office to guarantee that their wishes to donate are fulfilled.
Before Jan. 1, 2006, about 20 percent of donor families would say no to donating their deceased relative’s organs.
For the next four years, any donor will be crosschecked on both lists. If a donor appears on the previous list but not the new, first-person consent list, their
families will be consulted before any harvesting takes place, said David Bosch, spokesman for Gift of Hope, which executes organ donation.
During its second year at work, 59 of the 268 organ donors were registered with the first-person consent registry, Bosch said.
Tissue donations were similarly proportioned: 206 of the 10,330 tissue donors came from the registry in 2007.
“This program proves that people are very caring and giving,” Bosch said. “Getting over 3 million people to register in two years is an accomplishment.”
Although 3.2 million people have signed up for the new registry, nearly 4,500 people are still waiting for organs in Illinois.
To sign up for the first-person organ/tissue registry, call the Organ and Tissue Donor Program Office at (800) 210-2106 or visit www.lifegoeson.com.
Organ-donor list grows to 3.2 million
By Kartikay Mehrotra
Kartikay.Mehrotra@lee.net
SPRINGFIELD — More than 3 million people have signed up for Illinois’ 2-year-old organ and tissue donor registry.
Since the new list was created in 2006, prohibiting survivors from changing the deceased’s donor wishes, more than half of the 6 million registrants cut out from the donor program are back.
“Promoting the importance of organ and tissue donation remains a top priority of my office,” Secretary of State Jesse White said. “It is estimated the new registry saves 100 more lives annually. One single donor can save or enhance the quality of life for 25 people.”
After the new registry was implemented Jan. 1, 2006, family members of the deceased were no longer allowed to interfere with the donor process, according to Illinois statute.
Previously, the final decision remained with the person’s family.
Because of the change in the law, donors who registered before Jan.1, 2006, need to re-register with the secretary of state’s office to guarantee that their wishes to donate are fulfilled.
Before Jan. 1, 2006, about 20 percent of donor families would say no to donating their deceased relative’s organs.
For the next four years, any donor will be crosschecked on both lists. If a donor appears on the previous list but not the new, first-person consent list, their
families will be consulted before any harvesting takes place, said David Bosch, spokesman for Gift of Hope, which executes organ donation.
During its second year at work, 59 of the 268 organ donors were registered with the first-person consent registry, Bosch said.
Tissue donations were similarly proportioned: 206 of the 10,330 tissue donors came from the registry in 2007.
“This program proves that people are very caring and giving,” Bosch said. “Getting over 3 million people to register in two years is an accomplishment.”
Although 3.2 million people have signed up for the new registry, nearly 4,500 people are still waiting for organs in Illinois.
To sign up for the first-person organ/tissue registry, call the Organ and Tissue Donor Program Office at (800) 210-2106 or visit www.lifegoeson.com.
US scientists develop transplant without anti-rejection drugs - ABC News (Australian Broadcasting Corporation)
US scientists develop transplant without anti-rejection drugs - ABC News (Australian Broadcasting Corporation)
US scientists develop transplant without anti-rejection drugs
Posted 8 hours 46 minutes ago
Scientists in the United States say they have developed a new transplant technique in which patients do not need to take drugs to enable their bodies to accept new organs.
They say they have successfully transplanted kidneys into five patients, four of whom were able to stop taking the anti-rejection drugs.
One of the biggest problems facing people who receive organ transplants is the fact that they have to take immmuno-suppressant drugs for the rest of their lives.
While the drugs prevent rejection of the organ, they leave the patients vulnerable to a wide range of infections that often prove fatal.
The scientists say the key to the breakthrough is that doctors transplanted some of the donor's bone marrow as well as the kidney.
They first killed off mature immune cells in the recipient.
They then transplanted the kidney and the bone marrow.
When the recipient's immune system recovered, it treated the foreign organ as part of itself.
-BBC
US scientists develop transplant without anti-rejection drugs
Posted 8 hours 46 minutes ago
Scientists in the United States say they have developed a new transplant technique in which patients do not need to take drugs to enable their bodies to accept new organs.
They say they have successfully transplanted kidneys into five patients, four of whom were able to stop taking the anti-rejection drugs.
One of the biggest problems facing people who receive organ transplants is the fact that they have to take immmuno-suppressant drugs for the rest of their lives.
While the drugs prevent rejection of the organ, they leave the patients vulnerable to a wide range of infections that often prove fatal.
The scientists say the key to the breakthrough is that doctors transplanted some of the donor's bone marrow as well as the kidney.
They first killed off mature immune cells in the recipient.
They then transplanted the kidney and the bone marrow.
When the recipient's immune system recovered, it treated the foreign organ as part of itself.
-BBC
Experimental Procedure Induces Tolerance To Mismatched Kidney Transplants
Experimental Procedure Induces Tolerance To Mismatched Kidney Transplants
Experimental Procedure Induces Tolerance To Mismatched Kidney Transplants
ScienceDaily (Jan. 24, 2008) — Four of five patients participating in a trial of an experimental protocol designed to induce immune tolerance to HLA-mismatched kidney transplants have been able to discontinue immunosuppressive drugs. A mismatch of HLA (human leukocyte antigen) proteins is the most difficult immunological barrier to transplantation.
"We are very encouraged by our initial success in inducing tolerance across the HLA barrier, something that has been a major goal of transplant immunology for years," says David H. Sachs, MD, director of the MGH Transplantation Biology Research Center, the study's senior author.* "While we need to study this approach in a larger group of patients before it is ready for broad clinical use, this is the first time that tolerance to a series of mismatched transplants has been intentionally and successfully induced."
For more than three decades, Sachs and his colleagues have been pursuing ways to induce tolerance, tricking the immune system into regarding a donor organ as "self." Over the years the team has developed an approach in which the organ recipient receives bone marrow from the donor along with the needed organ to produce a state called mixed chimerism, an immune system that blends elements of both the donor and recipient.
In 1998 the team first used this approach in a woman whose kidney failure had been caused by the bone marrow cancer multiple myeloma, which can be treated with marrow transplantation. That patient received both marrow and a kidney from her HLA-matched sister and was able to discontinue immunosuppressive drugs about two months later. More than nine years later she remains healthy, and since then six more patients with myeloma-induced kidney failure have successfully become tolerant to HLA-matched transplants through this process
The current study enrolled five patients whose kidney failure resulted from non-cancerous conditions and who did not have an HLA-matched living donor. The study protocol begins with therapy designed to partially destroy the recipient's bone marrow and treatment with an antibody that reduces the level of T cells, the immune system component primarily involved in organ rejection. After receiving the transplanted kidney and bone marrow, patients stay in a relatively sterile environment for about two weeks, allowing the bone marrow to regenerate and produce new immune cells that are tolerant of the donor organ.
The first two patients in the trial were successfully weaned from immunosuppressive drugs in the months following their transplant, but the third patient developed early rejection and eventual failure of the donor kidney. Since the antidonor immune response of that patient -- who subsequently received a successful second transplant with conventional immunosuppression -- was primarily caused by the immune system's B cells, the study protocol was adjusted to include an additional antibody targeting B cells. The fourth and fifth patients, both of whom received the revised protocol, were able to discontinue immunosuppressives 8 and 10 months after their tranplants. All four of the successfully transplanted patients continue to have normal kidney function from two to more than five years later.
As seen in previous animal studies and in some of the myeloma patients receiving matched transplants, the chimeric state -- the presence in bone marrow of immune cells from both recipient and donor -- was temporary, even though tolerance to donor tissue continues. Sachs and his colleagues are continuing to investigate this phenomenon, which they believe may involve some factor provided by the donor organ. "We have shown in monkeys that the kidney itself is required to maintain this state that we call peripheral tolerance, although we still don't fully understand the mechanism," he explains.
*The report of the study conducted at Massachusetts General Hospital (MGH) appears in the January 24 New England Journal of Medicine.
The study was supported by grants from the Immune Tolerance Network; the National Institute of Allergy and Infectious Diseases; the National Institute of Diabetes, Digestive and Kidney Diseases; and the Juvenile Diabetes Research Foundation. Additional co-authors of the NEJM report are Susan Saidman, PhD, Juanita Shaffer, Frederic Preffer, PhD, Jay Fishman, MD, Bimalangshu Dey, MD, Dicken Ko, MD, Martin Hertl, MD, Nelson Goes, MD, Waichi Wong, MD, Winfrid Williams, and Robert Colvin, MD, of the MGH; and Manikkam Suthanthiram, MD, Ruchuang Ding, MD, and Vijay Sharma, PhD, Weill Medical College of Columbia University.
Adapted from materials provided by Massachusetts General Hospital.
Experimental Procedure Induces Tolerance To Mismatched Kidney Transplants
ScienceDaily (Jan. 24, 2008) — Four of five patients participating in a trial of an experimental protocol designed to induce immune tolerance to HLA-mismatched kidney transplants have been able to discontinue immunosuppressive drugs. A mismatch of HLA (human leukocyte antigen) proteins is the most difficult immunological barrier to transplantation.
"We are very encouraged by our initial success in inducing tolerance across the HLA barrier, something that has been a major goal of transplant immunology for years," says David H. Sachs, MD, director of the MGH Transplantation Biology Research Center, the study's senior author.* "While we need to study this approach in a larger group of patients before it is ready for broad clinical use, this is the first time that tolerance to a series of mismatched transplants has been intentionally and successfully induced."
For more than three decades, Sachs and his colleagues have been pursuing ways to induce tolerance, tricking the immune system into regarding a donor organ as "self." Over the years the team has developed an approach in which the organ recipient receives bone marrow from the donor along with the needed organ to produce a state called mixed chimerism, an immune system that blends elements of both the donor and recipient.
In 1998 the team first used this approach in a woman whose kidney failure had been caused by the bone marrow cancer multiple myeloma, which can be treated with marrow transplantation. That patient received both marrow and a kidney from her HLA-matched sister and was able to discontinue immunosuppressive drugs about two months later. More than nine years later she remains healthy, and since then six more patients with myeloma-induced kidney failure have successfully become tolerant to HLA-matched transplants through this process
The current study enrolled five patients whose kidney failure resulted from non-cancerous conditions and who did not have an HLA-matched living donor. The study protocol begins with therapy designed to partially destroy the recipient's bone marrow and treatment with an antibody that reduces the level of T cells, the immune system component primarily involved in organ rejection. After receiving the transplanted kidney and bone marrow, patients stay in a relatively sterile environment for about two weeks, allowing the bone marrow to regenerate and produce new immune cells that are tolerant of the donor organ.
The first two patients in the trial were successfully weaned from immunosuppressive drugs in the months following their transplant, but the third patient developed early rejection and eventual failure of the donor kidney. Since the antidonor immune response of that patient -- who subsequently received a successful second transplant with conventional immunosuppression -- was primarily caused by the immune system's B cells, the study protocol was adjusted to include an additional antibody targeting B cells. The fourth and fifth patients, both of whom received the revised protocol, were able to discontinue immunosuppressives 8 and 10 months after their tranplants. All four of the successfully transplanted patients continue to have normal kidney function from two to more than five years later.
As seen in previous animal studies and in some of the myeloma patients receiving matched transplants, the chimeric state -- the presence in bone marrow of immune cells from both recipient and donor -- was temporary, even though tolerance to donor tissue continues. Sachs and his colleagues are continuing to investigate this phenomenon, which they believe may involve some factor provided by the donor organ. "We have shown in monkeys that the kidney itself is required to maintain this state that we call peripheral tolerance, although we still don't fully understand the mechanism," he explains.
*The report of the study conducted at Massachusetts General Hospital (MGH) appears in the January 24 New England Journal of Medicine.
The study was supported by grants from the Immune Tolerance Network; the National Institute of Allergy and Infectious Diseases; the National Institute of Diabetes, Digestive and Kidney Diseases; and the Juvenile Diabetes Research Foundation. Additional co-authors of the NEJM report are Susan Saidman, PhD, Juanita Shaffer, Frederic Preffer, PhD, Jay Fishman, MD, Bimalangshu Dey, MD, Dicken Ko, MD, Martin Hertl, MD, Nelson Goes, MD, Waichi Wong, MD, Winfrid Williams, and Robert Colvin, MD, of the MGH; and Manikkam Suthanthiram, MD, Ruchuang Ding, MD, and Vijay Sharma, PhD, Weill Medical College of Columbia University.
Adapted from materials provided by Massachusetts General Hospital.
PM - Liver transplant patient hailed a 'medical miracle'
PM - Liver transplant patient hailed a 'medical miracle'
Liver transplant patient hailed a 'medical miracle'
PM - Thursday, 24 January , 2008 18:10:00
Reporter: Paula Kruger
ASHLEY HALL: Doctors in Sydney may have stumbled across the holy grail of transplant surgery.
A young liver transplant patient has taken on the immune system of her donor, allowing her to stop taking potentially toxic anti-rejection drugs.
The doctors aren't exactly sure how it happened, but they do see potential benefits for other transplant patients, as well as for sufferers of auto-immune diseases like multiple sclerosis and type-one diabetes.
Paula Kruger reports.
PAULA KRUGER: Demi Brennan is a very grateful 15-year-old.
DEMI BRENNAN: I'm probably the most grateful person because that has saved my life, that gave me a chance to fulfil my life.
PAULA KRUGER: But the Sydney teenager isn't just blessed with the donated liver that saved her life six years ago, she is being hailed as a medical miracle.
Organ transplants have been saving lives around the world for 50 years but patients have had to take toxic anti-rejection drugs - known as immunosuppressant drugs - for the rest of their lives.
Demi Brennan doesn't. Instead her immune system changed to that of the organ donor.
It was a development that surprised Dr Michael Stormon, a paediatric hepatologist who treated Ms Brennan at Sydney's Westmead Hospital.
MICHAEL STORMON: Oh, we were stunned, because we'd never come across this before, we… there was no precedent for this having happened at any other time, so we were sort of flying by the seat of our pants to a certain degree trying to sort this out.
PAULA KRUGER: When Demi Brennan was nine years old she caught a virus that caused her liver to fail.
She was given an urgent transplant but became very ill nine months after the operation.
She suffered a process called haemolysis - her red blood cells were breaking down.
It was at that point that doctors discovered her blood type and bone marrow had changed to that of the organ donor.
But the young patient was still gravely ill.
MICHAEL STORMON: We certainly struggled with this for months and months because of the haemolytic process, she required multiple blood transfusions, we discovered that most but not all of her immune system was also that of the donor.
But at the same time she was producing some antibodies herself and you know, we as I said, struggled for several months. She spent that time in hospital. We put her on large doses of immunosuppression to try and stop that process.
And it was then that we decided, you know, one of our other options was actually to stop all her immunosuppression in the hope that she would become, her immune system would become completely that of the donor. And in fact that's what happened.
PAULA KRUGER: The patient is now a normal healthy 15-year-old.
But after taking on someone else's immune system she had to be re-vaccinated against the measles and mumps because the donor had never been vaccinated against the diseases.
Demi Brennan's case is being seen a medical breakthrough, and there are potential benefits for not only transplant surgery but a range of auto-immune diseases too, if the results can be replicated.
But her doctors still aren't sure why it happened.
MICHAEL STORMON: I think it's a combination of factors and I guess that's the million-dollar question because, if we could replicate this then that would be a fantastic achievement, but it's probable that there was a sort of sequence of events that in some way resulted in this occurring.
PAULA KRUGER: Dr Michael Stormon has co-authored an article on Demi Brennan's remarkable recovery in the New England Medical Journal.
The latest issue also reports on a similar situation in the United States.
Researchers from Stanford University in California treated a patient with radiation and a drug that destroyed his T-cells before transplanting a kidney from the patient's brother.
Along with the transplant was a blood infusion that had been enriched for blood-producing stem cells.
Two years after the procedure the patient still has his brother's immune cells in his system and there are no signs of organ rejection even though he has stopped taking immunosuppressant drugs.
The researchers are continuing their study and say that if all goes well with other patients the technique could be generally available within ten years.
ASHLEY HALL: Paula Kruger reporting.
Liver transplant patient hailed a 'medical miracle'
PM - Thursday, 24 January , 2008 18:10:00
Reporter: Paula Kruger
ASHLEY HALL: Doctors in Sydney may have stumbled across the holy grail of transplant surgery.
A young liver transplant patient has taken on the immune system of her donor, allowing her to stop taking potentially toxic anti-rejection drugs.
The doctors aren't exactly sure how it happened, but they do see potential benefits for other transplant patients, as well as for sufferers of auto-immune diseases like multiple sclerosis and type-one diabetes.
Paula Kruger reports.
PAULA KRUGER: Demi Brennan is a very grateful 15-year-old.
DEMI BRENNAN: I'm probably the most grateful person because that has saved my life, that gave me a chance to fulfil my life.
PAULA KRUGER: But the Sydney teenager isn't just blessed with the donated liver that saved her life six years ago, she is being hailed as a medical miracle.
Organ transplants have been saving lives around the world for 50 years but patients have had to take toxic anti-rejection drugs - known as immunosuppressant drugs - for the rest of their lives.
Demi Brennan doesn't. Instead her immune system changed to that of the organ donor.
It was a development that surprised Dr Michael Stormon, a paediatric hepatologist who treated Ms Brennan at Sydney's Westmead Hospital.
MICHAEL STORMON: Oh, we were stunned, because we'd never come across this before, we… there was no precedent for this having happened at any other time, so we were sort of flying by the seat of our pants to a certain degree trying to sort this out.
PAULA KRUGER: When Demi Brennan was nine years old she caught a virus that caused her liver to fail.
She was given an urgent transplant but became very ill nine months after the operation.
She suffered a process called haemolysis - her red blood cells were breaking down.
It was at that point that doctors discovered her blood type and bone marrow had changed to that of the organ donor.
But the young patient was still gravely ill.
MICHAEL STORMON: We certainly struggled with this for months and months because of the haemolytic process, she required multiple blood transfusions, we discovered that most but not all of her immune system was also that of the donor.
But at the same time she was producing some antibodies herself and you know, we as I said, struggled for several months. She spent that time in hospital. We put her on large doses of immunosuppression to try and stop that process.
And it was then that we decided, you know, one of our other options was actually to stop all her immunosuppression in the hope that she would become, her immune system would become completely that of the donor. And in fact that's what happened.
PAULA KRUGER: The patient is now a normal healthy 15-year-old.
But after taking on someone else's immune system she had to be re-vaccinated against the measles and mumps because the donor had never been vaccinated against the diseases.
Demi Brennan's case is being seen a medical breakthrough, and there are potential benefits for not only transplant surgery but a range of auto-immune diseases too, if the results can be replicated.
But her doctors still aren't sure why it happened.
MICHAEL STORMON: I think it's a combination of factors and I guess that's the million-dollar question because, if we could replicate this then that would be a fantastic achievement, but it's probable that there was a sort of sequence of events that in some way resulted in this occurring.
PAULA KRUGER: Dr Michael Stormon has co-authored an article on Demi Brennan's remarkable recovery in the New England Medical Journal.
The latest issue also reports on a similar situation in the United States.
Researchers from Stanford University in California treated a patient with radiation and a drug that destroyed his T-cells before transplanting a kidney from the patient's brother.
Along with the transplant was a blood infusion that had been enriched for blood-producing stem cells.
Two years after the procedure the patient still has his brother's immune cells in his system and there are no signs of organ rejection even though he has stopped taking immunosuppressant drugs.
The researchers are continuing their study and say that if all goes well with other patients the technique could be generally available within ten years.
ASHLEY HALL: Paula Kruger reporting.
Ontario health minister blasts Health Canada directive on gay organ donation - Yahoo! Canada News
Ontario health minister blasts Health Canada directive on gay organ donation - Yahoo! Canada News
Ontario health minister blasts Health Canada directive on gay organ donation
Module body
Wed Jan 23, 5:51 PM
By Keith Leslie, The Canadian Press
TORONTO - George Smitherman, the country's only gay health minister, went on the attack Wednesday against an "offensive" Health Canada advisory penned by "wonky bureaucrats" that seeks to exclude homosexual men from becoming organ donors.
The directive, which agency officials defended as a reiteration of existing policies that was drafted with the help of medical professionals and the provinces, caught many health professionals off guard when it was issued with little fanfare last month.
"To have these wonky bureaucrats up in Ottawa write that kind of nonsense, based on some long-standing bias within their department, ignoring the front-line people that actually do this stuff, that was the part that was most offensive," Smitherman said in an interview.
Over the course of five years as a member of the Ontario cabinet, Smitherman has lobbied aggressively - along with the Trillium Gift of Life Network, the province's organ and tissue donor agency - to raise the profile of organ donation in the province.
Not only has he signed every organ donor card he's ever received, he said, but he still carries all of them around in his wallet because he believes so strongly in the principles and the importance of organ donation.
"The Trillium Gift of Life network will work aggressively in the gay community to let them know that opportunities are still available (to donate organs)," he said.
"We're going to work hard to reach out to the community and make sure they know opportunities are not lost, notwithstanding the impressions created by Health Canada."
Federal Health Minister Tony Clement's office wasted little time Wednesday defending the Health Canada directive, which was drafted with input from professionals and scientists from all over Canada, including Smitherman's own ministry.
"These regulations do not constitute a change in policy. They are formalizing a practice that has been ongoing for many years in Canada that has to do with risk assessment," Clement's press secretary, Laryssa Waler, said in an e-mail.
"As minister of health for Ontario, George Smitherman is well aware of this."
But Smitherman said it would be wrong to prevent sexually active gay men like himself from proceeding to the rigorous screening process that already exists for potential organ donors, which he said has built-in failsafe mechanisms to assess any possible health risks.
"I think it was a bit silly, really, and very insensitive, the way that they make these blanket determinations about risk on the basis alone of my sexual orientation," he said.
"So because I'm a gay man, they make it seem like we're not sophisticated enough to ask the next range of questions to really determine what the risk is. That was the stupid part about it."
Trillium chief executive Dr. Frank Markel said he's confident there was no intent on the part of the health professionals who helped draft the Health Canada directive to slight or otherwise offend the gay community.
"I've personally learned from what's happened (and) I think our organization has learned," Markel said in an interview.
"We will be reaching out to the gay community in a variety of ways to . . . make clear they're welcome as potential donors and that we will treat them in a non-discriminatory way."
Ontario doesn't exclude anyone from being an organ donor because of the long waiting list for a life-saving transplant, he added.
"We need every donor we can get," Markel said. "We have 1,650 people on the waiting list, so we would not deny anybody the chance to be a donor if their organ can be used."
Ontario health minister blasts Health Canada directive on gay organ donation
Module body
Wed Jan 23, 5:51 PM
By Keith Leslie, The Canadian Press
TORONTO - George Smitherman, the country's only gay health minister, went on the attack Wednesday against an "offensive" Health Canada advisory penned by "wonky bureaucrats" that seeks to exclude homosexual men from becoming organ donors.
The directive, which agency officials defended as a reiteration of existing policies that was drafted with the help of medical professionals and the provinces, caught many health professionals off guard when it was issued with little fanfare last month.
"To have these wonky bureaucrats up in Ottawa write that kind of nonsense, based on some long-standing bias within their department, ignoring the front-line people that actually do this stuff, that was the part that was most offensive," Smitherman said in an interview.
Over the course of five years as a member of the Ontario cabinet, Smitherman has lobbied aggressively - along with the Trillium Gift of Life Network, the province's organ and tissue donor agency - to raise the profile of organ donation in the province.
Not only has he signed every organ donor card he's ever received, he said, but he still carries all of them around in his wallet because he believes so strongly in the principles and the importance of organ donation.
"The Trillium Gift of Life network will work aggressively in the gay community to let them know that opportunities are still available (to donate organs)," he said.
"We're going to work hard to reach out to the community and make sure they know opportunities are not lost, notwithstanding the impressions created by Health Canada."
Federal Health Minister Tony Clement's office wasted little time Wednesday defending the Health Canada directive, which was drafted with input from professionals and scientists from all over Canada, including Smitherman's own ministry.
"These regulations do not constitute a change in policy. They are formalizing a practice that has been ongoing for many years in Canada that has to do with risk assessment," Clement's press secretary, Laryssa Waler, said in an e-mail.
"As minister of health for Ontario, George Smitherman is well aware of this."
But Smitherman said it would be wrong to prevent sexually active gay men like himself from proceeding to the rigorous screening process that already exists for potential organ donors, which he said has built-in failsafe mechanisms to assess any possible health risks.
"I think it was a bit silly, really, and very insensitive, the way that they make these blanket determinations about risk on the basis alone of my sexual orientation," he said.
"So because I'm a gay man, they make it seem like we're not sophisticated enough to ask the next range of questions to really determine what the risk is. That was the stupid part about it."
Trillium chief executive Dr. Frank Markel said he's confident there was no intent on the part of the health professionals who helped draft the Health Canada directive to slight or otherwise offend the gay community.
"I've personally learned from what's happened (and) I think our organization has learned," Markel said in an interview.
"We will be reaching out to the gay community in a variety of ways to . . . make clear they're welcome as potential donors and that we will treat them in a non-discriminatory way."
Ontario doesn't exclude anyone from being an organ donor because of the long waiting list for a life-saving transplant, he added.
"We need every donor we can get," Markel said. "We have 1,650 people on the waiting list, so we would not deny anybody the chance to be a donor if their organ can be used."
Wednesday, January 23, 2008
Where Are The Donors? -- Courant.com
Where Are The Donors? -- Courant.com
Where Are The Donors?
January 23, 2008
It took equal measures of courage and love for Corey Gray to do what he did. Mr. Gray, 29, donated half of his liver to his uncle Daniel Gray, 59, whose own liver was failing due to a large tumor. The operation, performed a week ago at Yale-New Haven Hospital by a team led by Dr. Sukru Emre, was the state's first liver transplant from a living donor.
As The Courant's Hilary Waldman reported, the operation can be very risky for the donor; two have died in the past decade. Corey Gray's acceptance of the risk to save his uncle's life is a gesture of heroic proportion.
Yet a question we must ask is why he had to do it.
Doctors began a limited use of transplants from living donors because there are not enough livers from deceased people. According to the government website OrganDonor.gov, the national waiting list as of Jan. 11 for an organ transplant was 97,938. About 7,000 people, including almost 2,000 on the liver transplant list, die every year while waiting for a lifesaving organ. The wait for a kidney, depending on blood type, is up to four years. More than half of those on the list will die before receiving a transplant. Meanwhile, countless usable organs are buried or cremated every day.
Why? Why don't more people offer their organs and tissues for transplant?
We can say with reasonable certainty that they won't be needed on the other side of the River Styx. Donation doesn't cost anything. It doesn't negate an open casket viewing. Hospitals do not hasten the deaths of donors. All mainline religions endorse the practice. In short, there is no reason not to give these gifts of life.
It can be done by going to a Department of Motor Vehicles office when getting or renewing your driver's license, or by going to the department's website, www.ct.gov/dmv. Scroll down, click on the pink heart and follow the instructions. Get that little heart on your license.
We also like the idea, from a nonprofit called LifeSharers (lifesharers.org), of putting registered organ donors at the top of the transplant list. In other words, if a registered donor finds herself in need of a transplant, she goes to the top of the waiting list. Fair is fair.
As inspiring as Corey Gray's act was, our world would be better if he hadn't had to do it.
Where Are The Donors?
January 23, 2008
It took equal measures of courage and love for Corey Gray to do what he did. Mr. Gray, 29, donated half of his liver to his uncle Daniel Gray, 59, whose own liver was failing due to a large tumor. The operation, performed a week ago at Yale-New Haven Hospital by a team led by Dr. Sukru Emre, was the state's first liver transplant from a living donor.
As The Courant's Hilary Waldman reported, the operation can be very risky for the donor; two have died in the past decade. Corey Gray's acceptance of the risk to save his uncle's life is a gesture of heroic proportion.
Yet a question we must ask is why he had to do it.
Doctors began a limited use of transplants from living donors because there are not enough livers from deceased people. According to the government website OrganDonor.gov, the national waiting list as of Jan. 11 for an organ transplant was 97,938. About 7,000 people, including almost 2,000 on the liver transplant list, die every year while waiting for a lifesaving organ. The wait for a kidney, depending on blood type, is up to four years. More than half of those on the list will die before receiving a transplant. Meanwhile, countless usable organs are buried or cremated every day.
Why? Why don't more people offer their organs and tissues for transplant?
We can say with reasonable certainty that they won't be needed on the other side of the River Styx. Donation doesn't cost anything. It doesn't negate an open casket viewing. Hospitals do not hasten the deaths of donors. All mainline religions endorse the practice. In short, there is no reason not to give these gifts of life.
It can be done by going to a Department of Motor Vehicles office when getting or renewing your driver's license, or by going to the department's website, www.ct.gov/dmv. Scroll down, click on the pink heart and follow the instructions. Get that little heart on your license.
We also like the idea, from a nonprofit called LifeSharers (lifesharers.org), of putting registered organ donors at the top of the transplant list. In other words, if a registered donor finds herself in need of a transplant, she goes to the top of the waiting list. Fair is fair.
As inspiring as Corey Gray's act was, our world would be better if he hadn't had to do it.
TheStar.com | News | Man seeks payment for transplant denied here
TheStar.com | News | Man seeks payment for transplant denied here
Man seeks payment for transplant denied here
Jan 21, 2008 08:44 PM
Isabel Teotonio
Staff Reporter
Each time Adolfo Flora finds himself in court, he's overwhelmed by the memories of when he was forced to accept death or fight to live.
First came the diagnosis of liver cancer in 1999. Next, came the refusal for a transplant in Ontario. Finally, there was the $450,000 he spent in England on a life-saving procedure he couldn't get at home - a decision that sparked a legal battle with the Ontario Health Insurance Plan.
"We've been through this so many times," said the 58-year-old retired Toronto high school teacher Monday, while fighting back tears and being comforted by his wife at Osgoode Hall, where his case was heard in the Ontario Court of Appeal.
"This was the most difficult time (in our lives) and every time we're in court everything comes back as if it was yesterday - the hopelessness and the negative situation."
On Monday, his lawyer, Mark Freiman, argued before a panel of three judges seeking to overturn an Ontario Divisional Court ruling that found Flora's Charter rights were not violated when OHIP refused to reimburse him for the overseas treatment.
"If the right to life means anything. . . . It means the right to have access," Freiman told Justices Eleanore Cronk, Robert Sharpe and Eileen Gillese.
When a government monopolizes health care, rations services, denies treatment and then "seals off the exits," that is a violation of a person's Charter rights, said Freiman, a former deputy attorney general of Ontario and an expert on the Charter.
"With that monopoly comes a responsibility to protect the right to life and security of the people of Ontario, who have no reasonable alternative for health care," he later said outside the courtroom.
Counsel for OHIP argued Flora's Charter rights were not violated because the government never deprived him of the right to seek treatment.
"There was nothing that the government did to deprive Mr. Flora of his ability to obtain treatment - the treatment decision was made by Ontario doctors," said Janet Minor, adding it was "made in accordance with Ontario standards." The judges heard arguments form both camps Monday and reserved their decision. Often, the Court of Appeal is the last stop for litigants, but they can seek to have their cases heard in the Supreme Court of Canada.
Flora's unusual tale dates back to 1973, when a vein was nicked during a routine surgery, which resulted in heavy bleeding and the need for a blood transfusion. He was given tainted blood and contracted hepatitis C, which led to the diagnosis of liver cancer in November 1999.
Given the scarcity of organs and the advanced stage of his cancer, specialists in Ontario said his chances for survival were slim if he underwent a full transplant from a dead donor.
At the time, living-relative liver transplants from adult to adult, in which part of a living donor's liver is transplanted, hadn't been done in Canada. Even though one of the Ontario specialists was looking for a candidate for such a procedure, the risk to the donor in Flora's case was deemed to be too great.
As a result, the Toronto man explored other avenues. He and his physician sought OHIP reimbursement for treatment in England. They were denied because it would have involved a procedure, chemoembolization, that was considered experimental in Ontario and not part of the insured services.
Nonetheless, in February 2000, Flora went to Cromwell Hospital in London, England, where he received a transplant from a living donor - his brother.
When he returned home, the Health Services Appeal and Review Board upheld OHIP's decision.
On Monday, a tired-looking Flora said one of the greatest lessons learned during this odyssey has been the need to fight for one's own health.
"People need to advocate for themselves," said Flora who today is free of both cancer and hepatitis C. "And they shouldn't be afraid to look for solutions."
Man seeks payment for transplant denied here
Jan 21, 2008 08:44 PM
Isabel Teotonio
Staff Reporter
Each time Adolfo Flora finds himself in court, he's overwhelmed by the memories of when he was forced to accept death or fight to live.
First came the diagnosis of liver cancer in 1999. Next, came the refusal for a transplant in Ontario. Finally, there was the $450,000 he spent in England on a life-saving procedure he couldn't get at home - a decision that sparked a legal battle with the Ontario Health Insurance Plan.
"We've been through this so many times," said the 58-year-old retired Toronto high school teacher Monday, while fighting back tears and being comforted by his wife at Osgoode Hall, where his case was heard in the Ontario Court of Appeal.
"This was the most difficult time (in our lives) and every time we're in court everything comes back as if it was yesterday - the hopelessness and the negative situation."
On Monday, his lawyer, Mark Freiman, argued before a panel of three judges seeking to overturn an Ontario Divisional Court ruling that found Flora's Charter rights were not violated when OHIP refused to reimburse him for the overseas treatment.
"If the right to life means anything. . . . It means the right to have access," Freiman told Justices Eleanore Cronk, Robert Sharpe and Eileen Gillese.
When a government monopolizes health care, rations services, denies treatment and then "seals off the exits," that is a violation of a person's Charter rights, said Freiman, a former deputy attorney general of Ontario and an expert on the Charter.
"With that monopoly comes a responsibility to protect the right to life and security of the people of Ontario, who have no reasonable alternative for health care," he later said outside the courtroom.
Counsel for OHIP argued Flora's Charter rights were not violated because the government never deprived him of the right to seek treatment.
"There was nothing that the government did to deprive Mr. Flora of his ability to obtain treatment - the treatment decision was made by Ontario doctors," said Janet Minor, adding it was "made in accordance with Ontario standards." The judges heard arguments form both camps Monday and reserved their decision. Often, the Court of Appeal is the last stop for litigants, but they can seek to have their cases heard in the Supreme Court of Canada.
Flora's unusual tale dates back to 1973, when a vein was nicked during a routine surgery, which resulted in heavy bleeding and the need for a blood transfusion. He was given tainted blood and contracted hepatitis C, which led to the diagnosis of liver cancer in November 1999.
Given the scarcity of organs and the advanced stage of his cancer, specialists in Ontario said his chances for survival were slim if he underwent a full transplant from a dead donor.
At the time, living-relative liver transplants from adult to adult, in which part of a living donor's liver is transplanted, hadn't been done in Canada. Even though one of the Ontario specialists was looking for a candidate for such a procedure, the risk to the donor in Flora's case was deemed to be too great.
As a result, the Toronto man explored other avenues. He and his physician sought OHIP reimbursement for treatment in England. They were denied because it would have involved a procedure, chemoembolization, that was considered experimental in Ontario and not part of the insured services.
Nonetheless, in February 2000, Flora went to Cromwell Hospital in London, England, where he received a transplant from a living donor - his brother.
When he returned home, the Health Services Appeal and Review Board upheld OHIP's decision.
On Monday, a tired-looking Flora said one of the greatest lessons learned during this odyssey has been the need to fight for one's own health.
"People need to advocate for themselves," said Flora who today is free of both cancer and hepatitis C. "And they shouldn't be afraid to look for solutions."
Bill Would Stop Hospitals From Requiring Insurance For Transplants - Health News Story - WMUR Manchester
Bill Would Stop Hospitals From Requiring Insurance For Transplants - Health News Story - WMUR Manchester
Bill Would Stop Hospitals From Requiring Insurance For Transplants
Couple Says Son Died When He Wasn't Placed On Transplant List
CONCORD, N.H. -- One year ago, Nick Currier, 21, died after he was unable to get a liver transplant. His parents said a Boston hospital refused to put him on the transplant list because he lacked insurance, and they're turning to state lawmakers in an attempt to prevent that from happening again.
Health officials said each hospital sets its own criteria for placing patients on the organ recipient list, and the criteria are sometimes financial. Currier's family said he was turned away from a hospital because he didn't have insurance, and they found out too late that another hospital a few miles away would have listed him.
"They said, 'Nick, you need a liver to survive' -- and you could see the tears coming through his eyes -- 'but you have no insurance,'" said his father, Roland Currier.
A new bill would prohibit hospitals from requiring insurance coverage for organ donations and transplants.
"I think it is essential that uninsured people have the ability to access the same organ donor registry lists as people who can afford to pay," said Sen. Joseph Kenney, a sponsor of the bill.
Nick Currier was working two jobs, taking college classes and planned on a career as a plumber when he became sick. No New Hampshire hospitals do liver transplants, so he was transferred to a Massachusetts facility that his parents said they were assured was the best.
"Every solitary day they pounded us on insurance," Roland Currier said. "They told us they couldn't put him on the list without insurance."
Nothing in federal law mandates how a patient should be ranked on transplant lists, and Medicare and Medicaid cover kidney transplants but not liver transplants, health officials said.
But some said the bill may provide as comprehensive a fix as it seems because the state can only oversee its own hospitals.
"This bill only applies to hospitals licensed in New Hampshire," said Gina Barkus of Dartmouth Hitchcock Medical Center. "It doesn't follow New Hampshire patients out of state."
The law would not have helped the Curriers, but they said it's a start, and they hope other states will follow suit.
"It's been a tough year, and every day, we have to live with the loss of our son -- all because of insurance," Roland Currier said.
Supporters said they hope New Hampshire will pioneer standardized regulations across the country for organ donations regardless of insurance.
Although Dartmouth-Hitchcock doesn't perform liver transplants, it is the only hospital in the state that does other organ transplants. Officials there said the hospital adds people to waiting lists regardless of ability to pay.
Copyright 2008 by WMUR. All rights reserved. This material may not be published, broadcast, rewritten or redistributed
KWTX - iWitness
KWTX - iWitness
Organ Donations Up in 2007 Save Email Print
Austin
Reporter: Michelle Segovia
Email Address: MSegovia@txorgansharing.org
A 119 Central and South Texans gave the Gift of Life in 2007 when their family members so generously agreed to donate their loved ones’ organs.
Sixty-six percent of people living in Central and South Texas consented to donation, resulting in life-saving transplants for nearly 400 people.
Texas Organ Sharing Alliance (TOSA) is the Organ Procurement Organization for the 56 counties in Central and South Texas which includes San Antonio, Laredo, Austin, Waco, San Angelo and the Rio Grande Valley.
TOSA educates the public about the importance of organ donation and consents families for donation when their loved one has the potential to be an organ donor.
“The increase in donors is the result of a number of factors,” explained Patrick Giordano, Chief Executive Officer of TOSA. “Many hospitals have done a tremendous job of notifying us of potential donors. This allows us to send one of our staff members to the hospital in a timely manner to be able to talk with the family, answer their questions, and offer them the opportunity to donate.
However, the real heroes are the families who decided to donate while going through a very difficult time in their lives,” Giordano said. “We believe that more families are consenting to donation because the public is becoming more aware of the benefits of donation and, as a result, are more supportive of it,” he said.
Of those families consenting to donation, more than 38 percent were family initiated discussions. In other words, the family asked about organ donation for their loved one before anyone from TOSA approached them.
Even with increasing consent rates, the number of people on the waiting list continues to grow. Nationally, more than 98,900 people are awaiting a life-saving transplant. 7,400 of them live right here in Texas. If you’d like to be an organ donor, talk to your family today and indicate your wishes at www.donatelifetexas.org
Organ Donations Up in 2007 Save Email Print
Austin
Reporter: Michelle Segovia
Email Address: MSegovia@txorgansharing.org
A 119 Central and South Texans gave the Gift of Life in 2007 when their family members so generously agreed to donate their loved ones’ organs.
Sixty-six percent of people living in Central and South Texas consented to donation, resulting in life-saving transplants for nearly 400 people.
Texas Organ Sharing Alliance (TOSA) is the Organ Procurement Organization for the 56 counties in Central and South Texas which includes San Antonio, Laredo, Austin, Waco, San Angelo and the Rio Grande Valley.
TOSA educates the public about the importance of organ donation and consents families for donation when their loved one has the potential to be an organ donor.
“The increase in donors is the result of a number of factors,” explained Patrick Giordano, Chief Executive Officer of TOSA. “Many hospitals have done a tremendous job of notifying us of potential donors. This allows us to send one of our staff members to the hospital in a timely manner to be able to talk with the family, answer their questions, and offer them the opportunity to donate.
However, the real heroes are the families who decided to donate while going through a very difficult time in their lives,” Giordano said. “We believe that more families are consenting to donation because the public is becoming more aware of the benefits of donation and, as a result, are more supportive of it,” he said.
Of those families consenting to donation, more than 38 percent were family initiated discussions. In other words, the family asked about organ donation for their loved one before anyone from TOSA approached them.
Even with increasing consent rates, the number of people on the waiting list continues to grow. Nationally, more than 98,900 people are awaiting a life-saving transplant. 7,400 of them live right here in Texas. If you’d like to be an organ donor, talk to your family today and indicate your wishes at www.donatelifetexas.org
Tuesday, January 22, 2008
'So grateful': Lives changed after receiving organs - USATODAY.com
'So grateful': Lives changed after receiving organs - USATODAY.com
Firefighter Bill Jensen was burned over 70% of his body and received donated skin in various colors. He talks about how he realizes "everything I took for granted."
By Daniel Horgan for USA TODAY
Bill Jensen and the rest of the firefighters on Engine 24 were making progress when a strong wind suddenly blew the fire up out of the canyon in Malibu, Calif., that October day in 1996.
There was no time to run as a wall of flame engulfed them. When the inferno passed, Jensen staggered to his feet. His clothing had disintegrated and his skin was hanging off of him. More than 70% of his body had second- and third-degree burns.
He surprised doctors by surviving, but recovery was slow and painful. Exposed areas were covered with donated skin.
Forty surgeries and 11 years later, Jensen is grateful to the people of all colors who donated parts of their bodies.
"I have skin on my back that's brown, skin that's yellow. It was supposed to be temporary, but it took," Jensen, now 63, said recently from his home in Burbank, Calif.
He says the fire made him realize the importance of life "and everything I took for granted."
He makes regular appearances at burn centers, his charred jacket and helmet from the fire in tow. He also has made appearances with transplant activist Reg Green. Green explains what donor families experience; Jensen talks about what it's like for those who receive the donations.
"We talk to them, counsel them," he says. "No doctor out there can explain it like another burn survivor. We show them there's life after burn."
His daughter's heart beats in his chest
Chet Szuber had been on the waiting list for a new heart for four years. He could barely get up a flight of stairs. A predawn phone call in 1994 brought him and his wife, Jeanne, grim news: Their daughter, Patti, had been gravely injured in a car crash in Tennessee.
The Berkley, Mich., couple and other relatives gathered at the hospital in Knoxville to wait and hope. Szuber remembered that Patti once told him she had signed a donor card. The family soon received news that their precious Patti — 22 years old and just starting out as a nurse — was gone.
A transplant coordinator told Szuber he could have his daughter's heart. He refused, saying it would be a constant reminder of his loss.
But he reconsidered. His family needed him; they urged him to accept the heart. Now that heart beats inside Szuber, a revitalized man. The transplant is believed to be the only child-parent heart donation in the world.
Szuber, who is now 73, is happy to think of his daughter every day. "She's still part of the family."
He now has the stamina to run a Christmas tree farm, go hunting and enjoy winters in Florida. He also speaks in public on behalf of organ donation.
"She didn't just help me," he says of his daughter. "She gave two blind ladies vision, two other people her kidneys, I got her heart and another her liver."
The liver donation proved a lifesaver, Szuber says. The day Patti died, a 15-year-old girl in Arkansas had a liver transplant, and it was rejected. Her outlook was bleak. She received Patti's liver and went on to graduate from high school and get married.
"When we met her, the girl's mother grabbed my wife, and she wouldn't let go, she was so grateful," Szuber says. "She just hung on and hung on."
Twins Anabel and Isabel Stenzel were born with cystic fibrosis, a disease that attacks the lungs and the digestive system.
The disease made their family's daily life a torment. As they grew older, their parents had to lay the girls on pillows and paddle their chests for as long as five hours a day to loosen the thick mucus blocking their lungs. The girls hacked continuously and had difficulty even walking.
They spent their childhoods in and out of hospitals with lung infections. At age 24, Anabel had only 30% of normal lung function and was put on oxygen.
Then in June 2000, her pager went off. A set of lungs was waiting for her. The operation was a success, and Anabel went on to climb the famed Half Dome peak in Yosemite National Park in California carrying a heavy backpack.
Isabel had a harder time of it, and in February 2004, her loved ones gathered at the hospital preparing for the worst as she faded in and out of consciousness. But a new set of healthy lungs became available just in time. She now swims laps, hikes and does cross-country skiing.
Both twins now live in the San Francisco Bay Area and recently published a book about their triumph over cystic fibrosis. In a twist, Anabel's body later rejected her lungs; luckily, she received a new donated set of lungs in July.
"I'm busy and enjoying life again," Ana said recently after returning from a trek in the Santa Cruz mountains. "To be able to hike again is a miracle." Isabel, for her part, was excited to be on the DonateLife float in the New Year's Day Tournament of Roses Parade in Pasadena, Calif.
Firefighter Bill Jensen was burned over 70% of his body and received donated skin in various colors. He talks about how he realizes "everything I took for granted."
By Daniel Horgan for USA TODAY
Bill Jensen and the rest of the firefighters on Engine 24 were making progress when a strong wind suddenly blew the fire up out of the canyon in Malibu, Calif., that October day in 1996.
There was no time to run as a wall of flame engulfed them. When the inferno passed, Jensen staggered to his feet. His clothing had disintegrated and his skin was hanging off of him. More than 70% of his body had second- and third-degree burns.
He surprised doctors by surviving, but recovery was slow and painful. Exposed areas were covered with donated skin.
Forty surgeries and 11 years later, Jensen is grateful to the people of all colors who donated parts of their bodies.
"I have skin on my back that's brown, skin that's yellow. It was supposed to be temporary, but it took," Jensen, now 63, said recently from his home in Burbank, Calif.
He says the fire made him realize the importance of life "and everything I took for granted."
He makes regular appearances at burn centers, his charred jacket and helmet from the fire in tow. He also has made appearances with transplant activist Reg Green. Green explains what donor families experience; Jensen talks about what it's like for those who receive the donations.
"We talk to them, counsel them," he says. "No doctor out there can explain it like another burn survivor. We show them there's life after burn."
His daughter's heart beats in his chest
Chet Szuber had been on the waiting list for a new heart for four years. He could barely get up a flight of stairs. A predawn phone call in 1994 brought him and his wife, Jeanne, grim news: Their daughter, Patti, had been gravely injured in a car crash in Tennessee.
The Berkley, Mich., couple and other relatives gathered at the hospital in Knoxville to wait and hope. Szuber remembered that Patti once told him she had signed a donor card. The family soon received news that their precious Patti — 22 years old and just starting out as a nurse — was gone.
A transplant coordinator told Szuber he could have his daughter's heart. He refused, saying it would be a constant reminder of his loss.
But he reconsidered. His family needed him; they urged him to accept the heart. Now that heart beats inside Szuber, a revitalized man. The transplant is believed to be the only child-parent heart donation in the world.
Szuber, who is now 73, is happy to think of his daughter every day. "She's still part of the family."
He now has the stamina to run a Christmas tree farm, go hunting and enjoy winters in Florida. He also speaks in public on behalf of organ donation.
"She didn't just help me," he says of his daughter. "She gave two blind ladies vision, two other people her kidneys, I got her heart and another her liver."
The liver donation proved a lifesaver, Szuber says. The day Patti died, a 15-year-old girl in Arkansas had a liver transplant, and it was rejected. Her outlook was bleak. She received Patti's liver and went on to graduate from high school and get married.
"When we met her, the girl's mother grabbed my wife, and she wouldn't let go, she was so grateful," Szuber says. "She just hung on and hung on."
Twins Anabel and Isabel Stenzel were born with cystic fibrosis, a disease that attacks the lungs and the digestive system.
The disease made their family's daily life a torment. As they grew older, their parents had to lay the girls on pillows and paddle their chests for as long as five hours a day to loosen the thick mucus blocking their lungs. The girls hacked continuously and had difficulty even walking.
They spent their childhoods in and out of hospitals with lung infections. At age 24, Anabel had only 30% of normal lung function and was put on oxygen.
Then in June 2000, her pager went off. A set of lungs was waiting for her. The operation was a success, and Anabel went on to climb the famed Half Dome peak in Yosemite National Park in California carrying a heavy backpack.
Isabel had a harder time of it, and in February 2004, her loved ones gathered at the hospital preparing for the worst as she faded in and out of consciousness. But a new set of healthy lungs became available just in time. She now swims laps, hikes and does cross-country skiing.
Both twins now live in the San Francisco Bay Area and recently published a book about their triumph over cystic fibrosis. In a twist, Anabel's body later rejected her lungs; luckily, she received a new donated set of lungs in July.
"I'm busy and enjoying life again," Ana said recently after returning from a trek in the Santa Cruz mountains. "To be able to hike again is a miracle." Isabel, for her part, was excited to be on the DonateLife float in the New Year's Day Tournament of Roses Parade in Pasadena, Calif.
Health Canada clarifies organ donation policy - Yahoo! Canada News
Health Canada clarifies organ donation policy - Yahoo! Canada News
SASKATCHEWAN (CBC) - Health Canada has clarified its latest policy on organ donations from sexually active gay men, injection drug users and other groups it considers high risk, saying that it does not ban the use of organs from these groups. Rather, the federal agency says, their organs are "excluded" from consideration for transplant unless a potential recipient authorizes their use.
"This requirement is related to the risk of the activity and not a person's lifestyle or sexual orientation," said Carole Saindon, a spokesperson for Health Canada, in a statement e-mailed to CBCNews.ca. "The organs can still be used provided the recipient is aware of the risk and gives consent."
She said the regulations on organ donation are based on risk factors for the transmission of infectious disease. One of these risk factors pertains to a man who has had sex with another man within the past five years. Donors are also excluded if they have had a recent tattoo or piercing, are an inmate of a correctional facility, or have hemophilia and have received blood products.
"Everyone can be considered for organ donation in Canada," Saindon wrote. "If a donor falls into any of the high risk categories, it is then a decision between the recipient and his or her physician as to whether a donation from a high risk donor is appropriate to the situation."
Federal regulations require that before an organ donor organization can distribute a higher-risk organ to a transplant establishment, that establishment has to obtain the patient's informed consent, Saindon said.
The informed consent document must be obtained before the transplant takes place. In some cases a recipient can consent in advance, while on a waiting list, to accept a higher-risk organ if one becomes available, Saindon said.
She added that there are other conditions in the regulations to protect patients who receive higher-risk organs. One such condition is that a high-risk organ can only be considered for transplant if an organ that meets all of the standard requirements is not immediately available. Another provision requires that a transplant medical practitioner authorize the distribution of the higher-risk organ to a patient based on their clinical judgment that the organ is safe to use.
Saindon said Health Canada's latest policy is "formalizing a practice that has been ongoing for many years in Canada" in the organ transplant community, adding in her e-mail that "similar exclusions are applicable to blood donors."
Under the formalized policy, for example:
- A gay man who had practised abstinence for five years prior to organ donation would be considered an acceptable donor.
- A heterosexual man who has had a single sexual encounter with a male within the past five years would not be considered an acceptable donor.
Health Canada wants to ascertain that the organs it uses are safe, Saindon said. "The safety of the cells, tissues and organs intended for transplantation is paramount." She said the regulations are based on "safety concerns and not lifestyle choices."
SASKATCHEWAN (CBC) - Health Canada has clarified its latest policy on organ donations from sexually active gay men, injection drug users and other groups it considers high risk, saying that it does not ban the use of organs from these groups. Rather, the federal agency says, their organs are "excluded" from consideration for transplant unless a potential recipient authorizes their use.
"This requirement is related to the risk of the activity and not a person's lifestyle or sexual orientation," said Carole Saindon, a spokesperson for Health Canada, in a statement e-mailed to CBCNews.ca. "The organs can still be used provided the recipient is aware of the risk and gives consent."
She said the regulations on organ donation are based on risk factors for the transmission of infectious disease. One of these risk factors pertains to a man who has had sex with another man within the past five years. Donors are also excluded if they have had a recent tattoo or piercing, are an inmate of a correctional facility, or have hemophilia and have received blood products.
"Everyone can be considered for organ donation in Canada," Saindon wrote. "If a donor falls into any of the high risk categories, it is then a decision between the recipient and his or her physician as to whether a donation from a high risk donor is appropriate to the situation."
Federal regulations require that before an organ donor organization can distribute a higher-risk organ to a transplant establishment, that establishment has to obtain the patient's informed consent, Saindon said.
The informed consent document must be obtained before the transplant takes place. In some cases a recipient can consent in advance, while on a waiting list, to accept a higher-risk organ if one becomes available, Saindon said.
She added that there are other conditions in the regulations to protect patients who receive higher-risk organs. One such condition is that a high-risk organ can only be considered for transplant if an organ that meets all of the standard requirements is not immediately available. Another provision requires that a transplant medical practitioner authorize the distribution of the higher-risk organ to a patient based on their clinical judgment that the organ is safe to use.
Saindon said Health Canada's latest policy is "formalizing a practice that has been ongoing for many years in Canada" in the organ transplant community, adding in her e-mail that "similar exclusions are applicable to blood donors."
Under the formalized policy, for example:
- A gay man who had practised abstinence for five years prior to organ donation would be considered an acceptable donor.
- A heterosexual man who has had a single sexual encounter with a male within the past five years would not be considered an acceptable donor.
Health Canada wants to ascertain that the organs it uses are safe, Saindon said. "The safety of the cells, tissues and organs intended for transplantation is paramount." She said the regulations are based on "safety concerns and not lifestyle choices."
Beaumont liver plan OK'd
Beaumont liver plan OK'd
Tuesday, January 22, 2008
Beaumont liver plan OK'd
Royal Oak hospital is third in state to have a transplant program, and hopes to do procedures by late spring.
Sofia Kosmetatos / The Detroit News
Beaumont Hospital, Royal Oak has received state approval to develop a new liver transplant program, the third in the state.
The program will offer traditional and live-donor liver transplantation services, the hospital said Monday. Traditional surgeries are done with organs from deceased people, while live-donor surgeries transplant a portion of a living donor's liver to an individual in need of a transplant.
Beaumont conducted a national search for a transplant surgeon, the results of which will be announced soon, said Dr. Charles Shanley, senior vice president and chairman of the department of surgery. The hospital will work on training staff for the more complicated surgeries in the coming months, and could begin performing transplants by late spring.
In Michigan, nearly 400 residents are waiting for a liver transplant, and Beaumont's program will help shrink that waiting list, Shanley said. "There is clearly a need."
Liver transplants are the second most common transplant procedure performed in the United States, next to kidney transplants, according to Beaumont. Nationally, 16,562 people are on waiting lists to receive a liver transplant, according to the United Network for Organ Sharing.
"As Beaumont succeeds, all Michigan residents will benefit, just like with all our transplant centers" Gift of Life Michigan spokesman Tim Makinen said.
Liver transplants are expected to increase 15 percent in southeast Michigan by 2010, Shanley said, citing data from the Michigan Health and Hospital Association, because of the prevalence of diseases affecting the liver and kidneys.
The surgery, including recovery of the organ and first year care, costs an estimated $352,000, according to Gift of Life Michigan.
Henry Ford Hospital and the University of Michigan's University Hospital are the other two hospitals offering a liver transplant program in the state. Founded in 1985, U-M's program was the first in Michigan. It performed 71 transplants in 2007. Henry Ford's program, begun in 1989, performed 117 liver transplants last year.
Beaumont conservatively projects it will perform at least 12 transplants in the program's first year, and 37 to 40 in its second year.
Beaumont Royal Oak already has a kidney transplant center, which has been operating more than 20 years. The addition of the liver transplant program is part of Beaumont's strategic plan to become one of the top academic health centers in the United States, Shanley said, and should help attract additional researchers and doctors.
"This will be a boon regionally for us to have that kind of talent pool in association with the new medical school," he said, noting Beaumont Hospitals and Oakland University's partnership to open a privately funded medical school by fall 2010.
There are 127 liver transplant programs in the country, according to Gift of Life Michigan, a federally designated organ and tissue recovery organization that serves as the intermediary between donors, doctors and hospitals. Almost all transplants (96 percent) are done with organs from deceased donors. Beaumont said it hopes its focus on live donors will benefit patients who are waiting for a transplant but, because they are not deemed ill enough, may not be able to receive a liver under the current allocation system.
You can reach Sofia Kosmetatos at (313) 222-2401 or skosmetatos@detnews.com
Tuesday, January 22, 2008
Beaumont liver plan OK'd
Royal Oak hospital is third in state to have a transplant program, and hopes to do procedures by late spring.
Sofia Kosmetatos / The Detroit News
Beaumont Hospital, Royal Oak has received state approval to develop a new liver transplant program, the third in the state.
The program will offer traditional and live-donor liver transplantation services, the hospital said Monday. Traditional surgeries are done with organs from deceased people, while live-donor surgeries transplant a portion of a living donor's liver to an individual in need of a transplant.
Beaumont conducted a national search for a transplant surgeon, the results of which will be announced soon, said Dr. Charles Shanley, senior vice president and chairman of the department of surgery. The hospital will work on training staff for the more complicated surgeries in the coming months, and could begin performing transplants by late spring.
In Michigan, nearly 400 residents are waiting for a liver transplant, and Beaumont's program will help shrink that waiting list, Shanley said. "There is clearly a need."
Liver transplants are the second most common transplant procedure performed in the United States, next to kidney transplants, according to Beaumont. Nationally, 16,562 people are on waiting lists to receive a liver transplant, according to the United Network for Organ Sharing.
"As Beaumont succeeds, all Michigan residents will benefit, just like with all our transplant centers" Gift of Life Michigan spokesman Tim Makinen said.
Liver transplants are expected to increase 15 percent in southeast Michigan by 2010, Shanley said, citing data from the Michigan Health and Hospital Association, because of the prevalence of diseases affecting the liver and kidneys.
The surgery, including recovery of the organ and first year care, costs an estimated $352,000, according to Gift of Life Michigan.
Henry Ford Hospital and the University of Michigan's University Hospital are the other two hospitals offering a liver transplant program in the state. Founded in 1985, U-M's program was the first in Michigan. It performed 71 transplants in 2007. Henry Ford's program, begun in 1989, performed 117 liver transplants last year.
Beaumont conservatively projects it will perform at least 12 transplants in the program's first year, and 37 to 40 in its second year.
Beaumont Royal Oak already has a kidney transplant center, which has been operating more than 20 years. The addition of the liver transplant program is part of Beaumont's strategic plan to become one of the top academic health centers in the United States, Shanley said, and should help attract additional researchers and doctors.
"This will be a boon regionally for us to have that kind of talent pool in association with the new medical school," he said, noting Beaumont Hospitals and Oakland University's partnership to open a privately funded medical school by fall 2010.
There are 127 liver transplant programs in the country, according to Gift of Life Michigan, a federally designated organ and tissue recovery organization that serves as the intermediary between donors, doctors and hospitals. Almost all transplants (96 percent) are done with organs from deceased donors. Beaumont said it hopes its focus on live donors will benefit patients who are waiting for a transplant but, because they are not deemed ill enough, may not be able to receive a liver under the current allocation system.
You can reach Sofia Kosmetatos at (313) 222-2401 or skosmetatos@detnews.com
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