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Entries in Organs (7)

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

Tuesday
Jun052012

Surgeon: Remove Kidneys for Transplant Before Donor's Death

Stockbyte/Thinkstock(NEW YORK) -- The severe shortage of viable organs for transplantation in the U.S. has led a transplant surgeon to propose harvesting kidneys from people who are not dead yet.

Dr. Paul Morrissey, an associate professor of surgery at Brown University's Alpert Medical School, wrote in The American Journal of Bioethics that the protocol known as donation after cardiac death -- meaning death as a result of irreversible damage to the cardiovascular system -- has increased the number of organs available for transplant, but has a number of limitations, including the need to wait until the heart stops.

Because of the waiting time, Morrissey said that about one-third of potential donors end up not being able to donate, and many organs turn out to not be viable as a result.

Instead, he argues in favor of procuring kidneys from patients with severe irreversible brain injury whose families consent to kidney removal before their cardiac and respiratory systems stop functioning.

"These individuals, maintained on mechanical ventilation, do not meet the criteria for brain death," he wrote. In these cases, the patient would be removed from life support and kidneys would be harvested while ensuring that the patient receives anesthesia and pain relief during the operation. After that, the patients would be kept comfortable until they have not had a pulse for five minutes, a threshold at which they are declared dead.

"Under this protocol, the donor is alive at the time of kidney recovery, but a determination has been made and confirmed by medical experts that death is imminent," he wrote.

Kidney removal, he stressed, would not cause the death of the donor, which is "instead caused foremost by the original catastrophic injury and secondarily by terminating mechanical ventilation."

In addition to providing more organs usable for transplant, Morrissey said this revised protocol would allow families to grieve in peace, since surgeons wouldn't need to rush the body into the operating room to remove organs. He said they could also take comfort in the knowledge that their loved one's death saved other lives.

A number of experts responded to Morrissey's proposal in commentaries published in the same journal. Some supported his arguments, while others expressed concern that it wouldn't be in the donor's best interests and could potentially violate medical ethics and the law.

Donald Marquis, a professor at the University of Kansas, wrote that Morrissey's argument has some validity.

Removing both kidneys, he said, "will not make the donor worse off than the donor would have been in the absence of the nephrectomy."

"Though not dead yet, they are 'as good as dead' from an ethical perspective," wrote Franklin Miller, a bioethicist at the National Institutes of Health, along with Dr. Robert Truog, a professor of medical ethics, anesthesiology and pediatrics at Harvard Medical School. "No harm or wrong is committed by procuring vital organs prior to stopping life support, provided that valid consent is obtained for donation."

But removing both kidneys from a living donor would not always be in a patient's best interests.

"There is no reason to believe that registering as an organ donor involves the willingness to undergo premortem double nephrectomy," argued bioethicists Maxwell Smith of the University of Toronto, David Rodriguez-Arias of the Spanish National Research Council and Ivan Ortega of Alcala de Henares University.

And Norman Cantor, a distinguished professor of law at Rutgers School of Law, wrote that removing both kidneys before death could be legally risky.

"An organ retrieval intervention poses some hazard of accelerating death, as by hemorrhage or cardiac arrest," he said. "Any medical action potentially accelerating death, even by a few minutes and even for a gravely debilitated patient, demands a legally recognized justification."

Removing one kidney, he said, could be legally defensible, but removing both "would almost certainly be deemed unlawful under the current legal framework."

Copyright 2012 ABC News Radio

Monday
May142012

Sarah Hyland’s Secret Struggle With Kidney Disease

JOE KLAMAR/AFP/Getty Images(LOS ANGELES) -- Haley Dunphy, the big sister on Modern Family, Dunphy appears carefree, spending hours on her cellphone and giving her parents a rough time on the show like any other teenager.

But Sarah Hyland, the 21-year-old actress who plays Haley on the show, has had anything but a carefree life.  Hyland’s been struggling with kidney disease since childhood, when she was diagnosed with abnormal kidney development at the age of nine.

“I would be in a lot of pain a lot of the time. If I didn’t get, like, 12 hours of sleep, It felt, like -- It felt, like, none at all,” said the Manhattan-born actress.

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A secret to the millions of Modern Family fans, Hyland would often sit down or text on her phone during a scene to hide her exhaustion.

“You know, if you’re sick, you still go to work.  And in between takes, you sit down, or you lay your head down or something,” she said.

As the pain got worse, the actress began looking for an organ donor to avoid spending her life on dialysis.  Luckily her father, actor Edward James Hyland, was a perfect match.

Last month, she underwent the transplant surgery and will recover this summer while the show takes a break from filming.

Actress Julie Bowen, who plays Claire Dunphy on the show, has been stopping by to help her clean.  Her real-life and on-screen boyfriend, Matt Prokop, has been helping her recover as well.

Hyland offers hope and advice for those struggling with kidney disease: “Know that you’re not alone.  Even though it may seem like it a lot of the time.  And that if you ask, ‘Why me?’  Well, why not you?  You know?  It makes you the person that you are today.”

Hyland is a youth ambassador for the Lopez Foundation, where she helps to promote community awareness for organ and kidney donation.

Copyright 2012 ABC News Radio

Thursday
Apr262012

One Kidney, Three Bodies: After Failed Transplant, Kidney Gives New Life 

Keith Brofsky/Thinkstock(CHICAGO) -- In a medical first, a transplanted kidney rejected by one patient was successfully transplanted into another patient, according to doctors at Northwestern Memorial Hospital in Chicago.

Twelve years ago, Ray Fearing, 27, of Arlington Heights, Ill., was diagnosed with focal segmental glomerulosclerosis (FSGS), a rare disease characterized by the buildup of scar tissue on the kidney. Most often found in young adults, the disease prevents harmful chemicals in the blood from filtering through the kidney.

When his disease worsened in April 2011, he was placed on the kidney transplant waiting list. His wait would not be long, just two months, after his younger sister, Cera, 21, stepped up right away to try to save her big brother.

"Before I even asked her she was ready to volunteer" her kidney, Ray Fearing said.

"It was very exciting," he said. "I'd been looking forward to it for a long time."

During routine kidney transplants, the new organ that is placed in the recipient rarely shows signs of recurring disease. But in patients with FSGS, there is a 50-percent chance that the transplanted kidney will also develop the disease.

Fearing was on the wrong side of those odds. Within two weeks of the transplant, surgeons removed his new kidney.

"I was making all these plans for the future because I would have a new kidney," said Fearing. "I was distraught and very wounded by the whole experience."

But instead of discarding the kidney -- which is routine in the event of a failed transplant -- Northwestern Memorial Hospital surgeons, with Cera Fearing's consent, decided to give the kidney another chance.

For the first time, doctors successfully re-implanted the so-called damaged kidney in another patient. Once the kidney was removed from Ray Fearing, it began to show signs of recovery from damage caused by its short-lived exposure to FSGS.

Within a few weeks, the kidney restored itself and was fully functioning in the new recipient, 67-year-old surgeon and father of five, Erwin Gomez.

"We proved for the first time that the disease is reversible in an organ once it's taken out of the body," said Dr. Lorenzo Collon, a transplant nephrologist and medical director of the kidney transplant program Northwestern Memorial Hospital in Chicago.

This procedure challenges the idea that surgeons can only attempt to transplant an organ once, said Collon, whose findings were published in the New England Journal of Medicine.

"Instead of removing the organ and throwing it away, if you have a good surgical background to reconstruct the vessels, you can put the kidney in someone else and it can work," said Collon.

More than 92,000 Americans are on the waiting list for a kidney transplant, and nearly 3,000 new patients are added to the list each month, according to the National Kidney Foundation. In 2011, nearly 17,000 Americans underwent a kidney transplant.

Although transplants take place when a match is found between a donor and recipient, in some cases -- as in Fearing's -- there's still a chance the transplant may not be successful, Collon said. But recycling the transplanted kidney will give more recipients a shot within an already-limited donor pool, he said.

"It will increase the donor pool, which needs to be increased anyhow," said Collon.

Fearing was put back on dialysis and will have to wait at least a year before another transplant attempt can be made.

"I'm excited to be a part of this, even though it didn't work for me," said Fearing.

The road ahead for Fearing is complicated by the fact that the chance of his disease damaging another new kidney is even higher than 50 percent, Still, Fearing says he remains optimistic.

"I'm convinced that I should be hopeful," he said.

Copyright 2012 ABC News Radio

Tuesday
Dec062011

More than One Sexual Partner? You May Be an ‘Elevated Risk’ Donor

iStockphoto/Thinkstock(ATLANTA) -- Proposed guidelines that would label organ donors who have had more than one sexual partner in the last 12 months as risky are for the benefit of patients receiving the organs and would not halt or ban donations, a Centers for Disease Control and Prevention official said Tuesday.

The proposed guidelines, however, remained controversial in the transplant community.

“What we are trying to do is make sure patients are informed about the risks the organ might have so they can make the best decision about whether the transplant is right for them,” Dr. Matthew J. Kuehnert, director of the CDC’s office of Blood, Organ and Other Tissue Safety, told ABC News.

Under the new guidelines, which have not been adopted and are in the public comments stage, living and deceased donors who had more than one sexual partner in the past 12 months would be considered “elevated risk” donors because of the increased likelihood they could have HIV, hepatitis B and hepatitis C, even if they did not show any risk factors.

Organ transplant doctors said they are concerned the proposed guidelines will lead to more deaths of the 112,000 people who are currently on the transplant waiting list because they will eat up valuable time and money conducting tests on organs for HIV, and Hepatitis A and C, even though the tests aren’t 100-percent accurate.

“If you game the system to prevent any possible transmission of an infectious disease, you will simply wind up with an increase of deaths,” said Dr. David Cronin, who is an associate professor of surgery at the Medical College of Wisconsin and director of liver transplantation at Froedtert Hospital.

The American Society of Transplant Surgeons agreed with Cronin and issued a letter criticizing the new guidelines, decrying the lack of a collaborative process behind the scenes, which caused several of its members to withdraw from an advisory panel.

“[The guidelines have] a real potential to mislead the public regarding the risks of disease transmission through solid organ transplantation,” said the letter, which was directed to CDC Director Thomas Frieden. “These guidelines, if finalized in their current form, are likely to have significant consequences for the transplant community.”

Kuehnert said he “would be concerned about any factor that would deter a donor,” but added that there is education that needs to be done for donors and recipients. If implemented, these guidelines would be just that -- markers to guide the transplant process, and they wouldn’t be policy, he said.

He stressed that certain medical information from donors would be kept anonymous from recipients of their gifts.

“There is no exclusion of organs in any case, unless the organ tests positive for HIV,” which is a federal law, he said.

As of now, there are no specifics regarding how donors would be questioned about their sexual histories, Kuehner said, but it’s an area that Cronin finds deeply concerning.

More than 28,000 organ transplants take place each year, according to data from the Organ Procurement and Transplantation Network.

The public comment period regarding the proposed guidelines ends Dec. 23.

Copyright 2011 ABC News Radio

Wednesday
Nov232011

Parents Donate Child's Organs After Accidental Death

Keith Brofsky/Thinkstock(ASHEVILLE, N.C.) -- Skateboarding was one of young Niyale Johnson's beloved hobbies.  That's exactly what the middle-schooler was doing two weeks ago with a couple of friends in her Asheville, N.C., home when her father heard a terrible scream.

Niyale fell through a plate of glass.  She was cut but conscious, and her father took her to the hospital.

Her parents didn't panic, because she seemed fine.  But suddenly, her mother told ABC News affiliate WLOS-TV, things went very wrong.

A piece of glass pierced one of her heart valves and got stuck in her spine.  She never regained consciousness after surgery, and after 11 days, her parents took her off life support and decided to donate their dead daughter's organs.

"You make decisions on what they should eat, and just -- what they should wear, and you go from that to should I donate my child's organs," Niyale's father, Demetrius McGee, told WLOS.

But their daughter loved to help people, and it was in that spirit that Niyale's parents made their decision.

"That's what she would have wanted, because she's a helper.  That's what she always does.  She helped everybody," McGee said.

According to the United Network for Organ Sharing, there are more than 110,00 people nationwide waiting for organ transplants who could benefit from the family's generosity.  The American Academy of Pediatrics said in a 2010 study that 2 to 3 percent of those individuals on transplant waiting lists are children younger than 17.

Niyale's parents hope that their tragedy can bring joy to others who need it.

"I just feel like if another child out there can be saved, or adult or anything, that's the best thing that we can possibly do," McGee told WLOS.

Copyright 2011 ABC News Radio

Friday
Mar042011

TED2011: Scientists Create Organ 'Copies' in Just Seven Hours

Hemera Technologies/Thinkstock(LONG BEACH, Calif.) -- Welcome to TED, where the world's great minds come to dream the impossible and show that it's happening. This week in Long Beach, Calif., the room gasped at the sight of something that could revolutionize medicine: organs created, in effect, as Xerox copies.

Dr. Anthony Atala, the director of the Wake Forest Institute for Regenerative Medicine, has spent 30 years studying the ability to grow and regenerate human tissue. Stepping onto the TED2011 stage Thursday for his 18-minute talk, he put out his hand and said, "And here it is, you can actually see the human kidney, as it was printed earlier today."

In just seven hours, Wake Forest scientists created a functioning human kidney, using cells regenerated from a sample of the patient's living cells. A machine separated out the cells that specialized into kidney cells, which then were grown in a lab and layered on top of one another until they were sculpted into a kidney.

The scientists call it "printing."

Dr. Atala was just one of the 50 or so speakers to present their great ideas over the four-day conference.

Five years ago, TED, a nonprofit organization devoted to "ideas worth spreading," started taking some of these great lectures and putting them online for free. No speaker is ever allowed to go more than 18 minutes -- just 18 minutes to share the next great idea.

Chris Anderson, the curator of the TED conference, said the time limit is "long enough to say something serious, but short enough not to lose your audience."

Microsoft founder Bill Gates, who spoke at TED this week, said "by forcing that speaker to boil it down, to capture the essence ... it's inspirational, it's educational."







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