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Entries in Organ Transplant (11)

Wednesday
Dec192012

Woman Dies After Receiving Smoker's Lungs in Transplant

Jupiterimages/Thinkstock(NEW YORK) -- Jennifer Wederell, a 27-year-old British woman with cystic fibrosis, died of lung cancer after she received the lungs of a heavy smoker in an organ transplant.

According to BBC News, Wederell had been on the waiting list for a lung transplant for 18 months when in April 2011, she was told there was finally a match.  She received the transplant, apparently not knowing the donor had been a smoker.

In February 2012, a malignant mass was found in her lungs.  She died less than 16 months after the transplant.

Her father, Colin Grannell, said he believed his daughter had died a death meant for someone else.

"The shock immediately turned to anger insofar as all the risks were explained in the hour before her transplant," he told the BBC, "and not once was the fact smoker's lungs would be used mentioned."

Wederell's case raises difficult issues regarding organ transplants.  She was diagnosed with cystic fibrosis, a progressive and debilitating lung disease that affects more than 70,000 people worldwide, at the age of 2.  By her mid-20s, she relied on an oxygen tank 24 hours a day to survive.

Would she have been better off refusing the transplant, and hoping another set of organs became available that matched her blood type and came from a non-smoker?

"Probably not," said Dr. G. Alexander Patterson, surgical director of lung transplants at the Washington University and Barnes Jewish transplant center in St. Louis, one of the largest organ transplant programs in the nation.  "If she was critically ill and had poor chance of short-term survival, she was better off accepting the transplant."

Patterson said most hospitals, including those in the U.S., also transplant the lungs of smokers if they are of otherwise good quality.

"This is a necessity because there are far fewer donors than there are recipients and most patients who are on a waiting list would gladly accept a set of smoker's lungs in exchange for the ones they have, which usually have little chance of carrying them through to long-term survival," he said.

About 17,000 Americans receive a transplant each year, and more than 4,600 die waiting for one, according to United Network for Organ Sharing, the organization charged with allocating the nation's organs.  If surgeons do not accept less-than-perfect organs, Patterson said that the numbers might be much worse.

Harefield Hospital in London, where Wederell was treated, has since apologized to her family for not revealing all the information about her donor's medical history.  But Patterson said most transplant surgeons don't share such details with their patients unless they are asked directly.

Copyright 2012 ABC News Radio

Wednesday
Aug152012

Autism Transplant Denial Sparks Debate

Jupiterimages/Thinkstock(PHILADELPHIA) -- It was hard enough for Karen Corby to hear that her autistic son would need a heart transplant to survive, but it was even harder to take the news that doctors wouldn't give him one.

"I was numb at first," Corby, of Pottsville, Pa., told ABC News, remembering the phone call from Paul's cardiologist when she found out he wouldn't be placed on the transplant list. "Before she hung up, she told me to have a nice day."

Her son Paul, 23, has a left ventricle that didn't close after he was born, so his heart doesn't pump the right amount of blood. The Corbys found out in 2008, and were told it was time for a transplant in 2011.

The cardiologist at Penn Medicine told Corby that Paul was denied, "given his psychiatric issues, autism, the complexity of the process, multiple procedures and the unknown and unpredictable effect of steroids on behavior," according to the letter Corby released.

Paul's experience raises questions about how autism and other brain disorders should be factored into transplant decisions.

"It seems that they have looked at this person as a label rather than the unique qualities that this person has," Dr. Dan Coury, Autism Speaks' Medical Director for the Autism Treatment Network, told ABC News. Coury said he has not met Paul or reviewed his medical records, but he is aware of the rejection from a Philadelphia Inquirer story.

He said autism is one of many factors that should be considered in the transplant decision, but based on what he's read, he isn't sure why Paul was denied. He noted that Paul can carry on a conversation, has a good quality of life and has a social network to support him after the surgery.

Dr. David Cronin, an associate professor of transplant surgery at the Medical College of Wisconsin, told ABC News he does not know the case, but organ transplant denial tends to be easier for people to accept because of an anatomic problem, such as calcified blood vessels that would prevent the successful implantation of a new kidney.

"Those no's are more acceptable than if somebody says, for example, 'You don't have enough insurance coverage,' or 'You still have behavioral problems like substance abuse issues,'" he said. "It's not like a CT scan where you can put it up and say,' Look. We can't technically do it.'"

Denials come because organs are a scarce resource, with three to four times as many people who need transplants as there are organs available. As such, he said, doctors look for transplant candidates to have good expected outcomes. For example, a dying patient who has a one percent chance of survival with a new organ would not be a good candidate because that organ could have gone to someone who could have lived a full life with it, he said.

The patient has to be able to take care of the new organ or have a support group to ensure that the organ doesn't go to waste, which can be an issue with mental illness, addiction and even autism, he said.

Cronin, who has not met Paul, said someone with a mental disorder could need to be restrained during surgery or rip out life-saving tubes and wires during recovery.

"I have never since 1995 seen that decision made in a cavalier fashion," Cronin said. "These decisions are not made in isolation. They're not made easily…We know the outcome is if someone is denied a transplant."

Penn Medicine was unable to comment on Paul's specific case, but said it reviews a number of factors before putting a patient on the transplant list.

"Our criteria for listing an individual for transplant are regularly reviewed in comparison with national standards, but we always encourage patients to seek another opinion," the statement concludes.

Patients who are denied can seek evaluation for the national waiting list at another transplant center in the hopes that the new center has a different criterion for choosing transplant candidates. Once the patient is on the national list, the United Network for Organ Sharing, a non profit contracted by the federal government matches donor organs to recipients.

As of 7:54 a.m. Wednesday morning, there were 114,852 people on the national list, according to the UNOS website. From January to May of this year, 11,468 transplants were performed, it said.

For now, Corby is accepting signatures on her Change.org petition and has mailed Paul's records to the Mayo Clinic for review. She also plans to send his records to the University of Pittsburgh's hospital.

"We don't want to get too hopeful, but it's better than where we were before," she said.

Copyright 2012 ABC News Radio

Wednesday
Jun272012

With Each Operation, Artificial Hearts Show More Promise

Jupiterimages/Thinkstock(NEW YORK) -- Not long ago, patients diagnosed with heart failure would have faced a grim prognosis, as there would have been few options available to sustain them until a donor heart became available.  But that may be changing.

On June 21, physicians at Brigham and Women's Hospital in Boston announced that they had performed the first successful artificial heart transplant in New England for a patient who had advanced heart failure.

"It's a regional milestone," said Dr. Gregory Couper, surgical director of the heart transplant program at Brigham and Women's.  "This is the first implantation of an artificial heart in a patient needing a heart transplant in New England."

Although this is the first transplant in New England, other artificial heart transplants have already been performed around the United States and internationally.  In fact, artificial hearts are being manufactured by a few companies, one of which is testing their device at 30 sites across the country.

More than five million people in the United States currently have heart failure.  In heart failure, the heart muscles weaken such that the heart is unable to pump a sufficient amount of blood through the body.  If the heart failure is left untreated, then other organs, including the kidneys, begin to fail.

Physicians will first attempt to manage heart failure patients with medications that help get rid of excess fluid in the body while also controlling blood pressure.  For the 50,000 to 100,000 patients with advanced heart failure who cannot be treated with medications, a device known as the left ventricular assist device (LVAD) may be helpful.  LVADs are devices that replace the function of the failing heart, and artificially pump blood throughout the body's circulatory system.

But in some cases even LVADs may not be effective in helping heart function. That is where artificial hearts come into play. The artificial heart acts as a bridge therapy -- a temporary measure until a patient can get off the organ donor waiting list and receive a heart transplant.  

About 2,000 heart transplants are performed in the U.S. each year, although thousands more -- if enough donors were available -- could potentially benefit from them.

Copyright 2012 ABC News Radio

Monday
Jun252012

Lab-Grown 'Custom' Organs May Be Future of Medicine

Comstock/Thinkstock(NEW YORK) -- What if dying patients waiting for an organ transplant could receive a custom, lab-grown replacement rather than waiting for a donor organ?

To some, this may sound like science fiction -- and in many ways, it still is.  But the advances in the field of regenerative medicine that made headlines last week suggest such lab-grown organs may become a reality in the future.

One of these advances was Swedish scientists' creation of a custom vein that has carried blood from a little girl's intestines to her liver for a year and counting.  In another, a group in Japan successfully implanted lab-grown livers made from human cells into mice -- organs that metabolized drugs the way they would in a human.

And these developments may be just the tip of the iceberg.  From skin to blood vessels to solid organs, work is underway to offer more options for patients with faulty or damaged body parts.

Dr. Anthony Atala, director of the Wake Forest Institute for Regenerative Medicine in Winston-Salem, N.C., was part of the first group in the world to successfully implant a lab-grown organ into the human body.  Atala's interest in the field began when he was training to become a urologist and saw numerous children who had undergone bladder replacement surgery.  Many of them were experiencing leaks, and some even suffered ruptures of their new bladders.

"That's when I really thought, 'Why not try to grow these children new bladders from their own cells?'" Atala said.

Atala collected a small number of cells -- about the size of half a postage stamp -- from the original, inadequate bladders of children with spinal cord birth defects.  Each child's own cells were multiplied in the lab and then placed on a biodegradable scaffolding.  In seven weeks, the cells had grown to fill in the scaffold, creating a new bladder.  The procedure was first performed in 1998, and by 2006 they had seen long-term success of the organs.

"I still hear from some of them occasionally," Atala said.  "They are still walking around with their engineered bladders, and they are happy with them."

Since this first foray into growing organs, Atala has been one of the many doctors on the forefront of what some say could one day be a new paradigm in medicine -- growing spare parts from a patient's own cells.

Atala currently heads up more than 300 researchers in the Wake Forest University lab who are working on growing more than 30 different organs and body tissues.

In one trial for the U.S. Armed Forces, his team is collecting healthy skin cells from injured soldiers, processing them, and then spraying them onto battle wounds as a tailored treatment for healing.  For deeper wounds, they are in the process of developing an ink jet printer that scans a wound and creates a custom map of the defect.

"After the scan, the printer can go back and print multiple layers of cells right over the wound," Atala said.

The idea of using a patient's own cells rather than relying on those of a donor is important because it eliminates the need to find a "match."  For any transplant procedure there is a concern that tissues from a donor will be rejected by a recipient's body.

Even though doctors carefully analyze specimens under a microscope to find the most compatible individuals, and even despite the powerful drugs used to prevent the recipient's immune system from attacking the new body part, the risk of rejection still causes doctors to hold their breath in the days following a transplant.

Custom-made organs from a patient's own tissues would solve this problem, obviating the need for strong immune-suppressing medications that come with significant side effects.

The other potential benefit lies in availability.  Growing a replacement tissue or organ in the lab eliminates the dependence on waiting for a donor to die.  These parts cannot be grown overnight, but with people currently waiting months to years for donor organs, there might be a point at which the amount of time taken to grow a replacement is shorter than the wait for a donated one.

Copyright 2012 ABC News Radio

Wednesday
Apr252012

Teen Double Transplant Recipient Heads Home

Jupiterimages/Thinkstock(MILWAUKEE) -- A Chicago teenager is finally going home Wednesday after getting the transplant he needed to survive.

When Thomas Castillo was just 15-years-old, doctors told him that he had a 50 percent chance of living.  The Chicago native was suffering from congenital heart and liver failure, and while waiting for transplants had a stroke.  Transplant hopes were dwindling until a donor became available to provide Thomas with both a heart and a liver.

“[The doctor] smiled and he said ‘how would you like to go to surgery today?’  Are you kidding, wait are you serious, and I was so ecstatic I hugged him,” Linda Rebeles, Thomas’ Grandmother, told ABC News' Milwaukee affiliate WISN.

In February, Dr. James Tweddel led the heart transplant team at Milwaukee’s Children’s Hospital.

“The transplant was a coordinated effort.  A donor became available, whom we could obtain an excellent heart and liver and the operation took place over 17 hours,” said Dr. Tweddel.

Thomas’ surgery was the first-ever double transplant done on a child under 17 in Wisconsin.  Leaving the hospital sporting his new Packer’s jersey, Thomas said he’d like to return the favor by becoming a heart transplant surgeon himself one day.

As for his family, they say none of this would be possible without organ donations.

Copyright 2012 ABC News Radio

Thursday
Mar082012

Girl's Life Saved by Multiple Organ Transplant

Jackson Health System(MIAMI) -- Few people survive much past childhood with Wolcott-Rallison syndrome, a rare genetic condition characterized by insulin-dependent diabetes that typically appears shortly after birth, and organ failure that usually leads to early death.

But Angela Bushi, a 6-year-old from Jacksonville, Fla., who's living with Wolcott-Rallison is on the way to beating the once-insurmountable odds, thanks to the first-ever multiple organ transplant she underwent on Dec. 29.

The little dark-haired girl, whose family emigrated from Albania seven years ago, underwent a liver, kidney and pancreas transplant at Holtz Children's Hospital in Miami. It was the first time doctors there had transplanted all these organs at once in a child, and the first time multiple transplant had been used to treat Wolcott-Rallison syndrome.

"Based on the syndrome, we knew that she would always be at increased risk for liver failure and renal failure, and her pancreas had already suffered some injury due to diabetes," said Dr. Olaf Bodamer, director of the pediatric genetics program at Holtz Children's Hospital. "By replacing the liver, it could reduce the risk to zero for her to have future episodes of liver failure. It functions normally and does not carry the genetic defect."

It's already been a lifetime of health struggles for the young girl. She developed diabetes when she was a year old, and a few years later, in September 2011, she showed the first signs of liver failure. Her 18-month-old sister had died from liver failure a few months before.

After an autopsy, the family learned she also had Wolcott-Rallison syndrome.

While devastating for the family, the girls' mother Valbona Bushi said, the youngest daughter's death clued her in to what was wrong with Angela.

"She had the same symptoms as my other child who died, so we knew," Bushi said.

Doctors spent months trying to solve Angela's medical mystery, and finally found the answer when research uncovered Wolcott-Rallison syndrome. Testing later confirmed doctors' suspicions.

In the months since the surgery, Angela's doctors said she's progressing well.

"All the organs are functioning normally, and she has not needed any insulin," said Dr. Andreas Tzakis, one of Angela's transplant surgeons. "We are cautiously optimistic that she can grow to be an old person with her existing organs."

Doctors removed Angela's damaged liver, but left her other organs, transplanting the healthy organs on top.

"We remodeled the abdomen," Tzakis explained. "The other organs will stay, because if we had to remove them, it would have made the operation bigger.

The only remnants of surgery that Angela has right now are a yellow feeding tube and a distended belly that resulted from having two sets of organs.

"She's back to normal like before. She's a normal kid," said Bushi.

But not everything about her life is normal. She has to be careful when playing with other children and avoid playmates who could be sick, since her immune system is compromised.

That also means she can't go to school, even though she'd recently started kindergarten. The news didn't make Angela very happy. "Yes," she exclaimed when one of her doctors asked if she misses going to school.

Doctors plan to monitor Angela's organ function carefully, and while they are optimistic so far, they caution that there are no guarantees.

"We are taking it one day, one week and one month at a time," said Tzakis. "This is uncharted territory, so we don't really know exactly how to react. We have prepared for as much as we can."

After years of struggling with her children's serious medical conditions, Bushi is grateful that her oldest daughter has a good chance of surviving the illness that killed her youngest.

"The doctors are amazing. It's an amazing transplant. You can tell when you see her now."

Copyright 2012 ABC News Radio

Wednesday
Feb012012

Maine Girl Gets Rare Six-Organ Transplant

Keith Brofsky/Thinkstock(BOSTON) -- A 9-year-old girl from Maine is heading home, three months after receiving a six-organ transplant at Children’s Hospital Boston.

Alannah Shevenell of Hollis, Maine, got a new esophagus, liver, stomach, spleen, pancreas and small intestine after losing her own to a myofibroblastic tumor.

“We needed to remove all the organs because the tumor had grown to basically encircle the blood supply,” said Dr. Heung Bae Kim, director of the hospital’s Pediatric Transplant Center.

Chemotherapy didn’t work, and smaller surgeries were no match for the sprawling tumor. Shevenell couldn’t eat because the tumor was squeezing her esophagus. The multi-organ transplant was her last hope, but she had to wait a year for a suitable donor.

“Especially for children, finding a donor who has organs in good shape and the right size is a real challenge,” said Kim. But on October 27, Shevenell’s family got the call: They found a donor, and her transplant would be the next day.

Kim led a team of surgeons, nurses and anesthesiologists through the grueling 14-and-a-half-hour procedure, which he called “the most extensive” transplant procedure he’s ever done.

The team transplanted the new organs as a package and waited for them to take over.

“We were so happy,” Kim said of the result. “It was technically very successful. The organs looked good.”

Because Shevenell’s tumor made it impossible for her to eat, she got used to being fed through a feeding tube into her stomach.

“It had been so long that she lost her appetite,” said Kim. “But on the weekend she started eating again. And yesterday she had some cake.”

Although Shevenell is heading home, she’ll need frequent checkups throughout her life.

“There is a risk that she’ll need another transplant down the road. And if there were any tumor cells left behind, there is a risk it could come back,” said Kim.

Shevenell will also need to take anti-rejection drugs for the rest of her life.

Copyright 2012 ABC News Radio

Friday
Oct282011

New York Man Pleads Guilty to Organ Trafficking

Jupiterimages/Thinkstock(NEW YORK) -- A Brooklyn, N.Y., man admitted in court Thursday that he purchased human kidneys from live Israeli donors that were ultimately transplanted into three New Jersey residents.

Levy Izhak Rosenbaum, 60, earned $410,000 from the three black-market sales and was conspiring to broker another deal when he was caught, federal prosecutors said in a statement. He received another $10,000 as down payment for that transaction.

Rosenbaum’s attorneys, Ronald Kleinberg and Richard Finkel, issued a statement saying their client’s motivation was to save the lives of people who would have died without the transplants because more than 90,000 Americans are on transplant waiting lists.

“The transplants were successful and the donors and recipients are now leading full and healthy lives,” the attorneys said.  “In fact, because of the transplants and for the first time in many years, the recipients are no longer burdened by the medical and substantial health dangers associated with dialysis and kidney failure.”

But New Jersey U.S. Attorney Paul Fishman called Rosenbaum’s actions “an affront to human dignity” and said these black-market organ sales offer an unfair, life-saving advantage to people who can afford to buy organs.

Rosenbaum, an Israeli citizen, admitted the sales took place between 2006 and 2009.  He was ultimately caught in a sting involving the FBI and a woman who told Rosenbaum her uncle needed a kidney transplant. According to prosecutors, Rosenbaum told the woman he knew the organ sales were illegal, but he had been in the business a long time. They agreed on a price of $150,000, part of which he said was to pay individuals for their part in finding a donor.

He faces three counts related to the kidney brokering and another count of conspiracy.  He could spend up to 20 years in prison and have to pay a stiff fine. He will also pay back the $420,000 he earned and is under house arrest until he is sentenced in February.

Prosecutors did not name the hospitals where the transplants took place, but as for whether the institutions should hold any accountability, Dr. Linda Chen, surgical director of the Live Donor Kidney Program at the University of Miami’s Miller School of Medicine, said it is difficult to determine whether individuals are being honest about where organs come from.

Chen also said that because waiting lists for kidneys across the country are so long -- it is about two-and-a-half years in Florida and seven to nine years in New York -- it makes sense that there is such a profitable black market out there.

“But this is a big blow for the transplant community,” she said. ”We need to get the right message out there about the fact that it’s a highly regulated process governed by the United Network for Organ Sharing and the Organ Procurement and Transplantation Network.”

Chen also said there could be safety issues involved with internationally acquired organs.

“It’s always a safety issue,” she said. ”How long can a kidney remain in a box while it’s transported? There could be issues with prolonging preservation time.”

Copyright 2011 ABC News Radio

Tuesday
Sep202011

Controversial Changes to Organ Sharing Rules On the Way?

Digital Vision/Thinkstock(RICHMOND, Va.) -- Significant changes to organ sharing protocol could be on the way.

Under new rules that are being considered, surgeons retrieving organs for transplants after the donor’s heart stops beating would no longer have to wait at least two minutes to make sure the heart doesn’t spontaneously start beating again.

The rules were proposed by the United Network for Organ Sharing, a Richmond nonprofit organization that coordinates organ donation under contract with the federal government.

The same organization is also trying to eliminate a ban that many consider to be a much needed protective measure for patients in controversial cases who would be potential donors. This refers to the present ban on even considering anyone as an organ donor before doctors and family members have independently decided to stop trying to save them.

The proposed changes are part of the first major overhaul of the 2007 guidelines for a specific type of “donation after cardiac death” (DCD).

While proponents for the change argue that they would strengthen the transplant system, critics say that the change would increase the risk that donors would be treated like “tissue banks” rather than sick people fighting for their right to live or die peacefully.

What DCD involves is surgeons having the ability to take organs within minutes of forms of life support having been cut off from hospitalized patients who still may have some brain activity. The protocol had been the norm for organ donors before the neurological criteria “brain death” became the standard in the 1970s.

Doctors have started to increasingly revisit DCD as the number of people needing transplants rose and it has become a growing source of organs as a result.

Around 6,000 Americans die each year while waiting for donated organs.

Copyright 2011 ABC News Radio

Monday
Aug152011

Kidney Donation from Deceased Marine Saves a Fellow Marine's Life

Sgt. Jacob Chadwick (left) received a lifesaving kidney from Lt. Patrick Wayland (right), who died after going into cardiac arrest. ABC News(SAN DIEGO) -- A year after Sgt. Jacob Chadwick, 23, was deployed to Iraq with Regimental Combat Team 1, he returned to his home in San Marcos, California only to suffer blinding, week-long headaches: the first sign of his failing kidneys.

Last Sunday, Chadwick underwent a four-and-a-half hour kidney transplant that saved his life.  His kidney donor was a fellow Marine, 24-year-old Lt. Patrick Wayland from Midland, Texas, who went into cardiac arrest on Aug. 1 at Pensacola Naval Air Station in Florida.

On Friday, while the Waylands were attending their son's funeral services, Chadwick was visiting the UC San Diego Medical Center to check on his measured recovery.

The Chadwick family said that they would like the Waylands eventually to make contact.
 
"What they did was pretty great.  A piece of their son is keeping me alive," Chadwick said.  "Eventually, I think they should [get to know the person] who their son's kidney went to."

Nearly 90,000 Americans are on a waiting list for a kidney transplant, according to data from the Organ Procurement and Transplantation Network.  As of December 2010, 36 U.S. service members had donated 141 organs to gravely ill patients in the previous five years, according to a news article in the military publication Stars and Stripes.

For the last eight months, Chadwick endured dialysis treatments for three and a half hours every day for his condition, rapidly progressive glomerulonephritis, in which his immune system attacked his kidneys, slowly scarring them beyond repair.

The Chadwicks were desperately searching for a kidney donor whose blood type would match Jacob's rare Type O.  They contacted Operation Gratitude, with which Victoria had volunteered, sending packages to soldiers during her husband's deployment.  The organization promptly sent out a newsletter about Chadwick's need, and word quickly spread via Facebook and Twitter.

Some 1,400 miles away, in the heart of Texas, the community of Midland poured onto the streets on Thursday for the return of 2nd Lt. Wayland, who went into cardiac arrest while swimming in flight gear during training.

Chadwick said a doctor working with the Wayland family had searched the internet to find their ideal donor recipient.  They found Jacob, as well as four other recipients for Wayland's organs.

"[Wayland] was a registered donor but [the family] wanted to find people who they thought were deserving," Chadwick said.

Late Aug. 6, after it was decided where Wayland's organs would go, he was removed from life support.  That same morning, the Chadwicks received a phone call from the hospital: They had found a potential match.

Chadwick underwent the kidney transplant the next day.

Copyright 2011 ABC News Radio







ABC News Radio