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Entries in Transplant (33)

Sunday
Apr142013

Researchers Take First Step in Engineering Artificial Kidney

iStockPhoto/Thinkstock(NEW YORK) -- Researchers at Massachusetts General Hospital have engineered an artificial kidney that they believe holds promise for shortening organ transplant waiting lists.

According to BBC News, similar studies have created simpler body parts that have already been used in patients. However, the kidney is one of the most complex organs yet engineered.

Researchers hope to reach a point where they can take an old kidney, remove the existing cells, and then rebuild the structure of the kidney with cells from a transplant patient. The belief is that this process would avoid organ rejection and increase the number of organs available for transplant.

While the potential is huge, BBC News reports that engineered kidneys have a long way to go before they become a reality. In the research at Massachusetts General Hospital, the kidney's effectiveness was measured just 5 percent of a natural kidney when it was transplanted into a laboratory rat.

According to BBC News, researchers must still prove that the engineered organs can function over extended periods of time. However, engineered windpipes and bladders have already been successfully implanted.

Over 100,000 people in the United States alone are awaiting kidney transplants, while just 18,000 receive a new organ each year.

Copyright 2013 ABC News Radio

Friday
Jan042013

Quadruple Amputee Gets Two New Hands on Life

ABC News(NEW YORK) -- It's the simplest thing, the grasp of one hand in another.  But Lindsay Ess will never see it that way, because her hands once belonged to someone else.

Growing up in Texas and Virginia, Ess, 29, was always one of the pretty girls.  She went to college, did some modeling and started building a career in fashion, with an eye on producing fashion shows.

Then, she lost her hands and feet.

When she was 24 years old, Ess had just graduated from Virginia Commonwealth University's well-regarded fashion program when she developed a blockage in her small intestine from Crohn's Disease.  After having surgery to correct the problem, an infection took over and shut down her entire body.  To save her life, doctors put her in a medically-induced coma.  When she came out of the coma a month later, still in a haze, Ess said she knew something was wrong with her hands and feet.

"I would look down and I would see black, almost like a body that had decomposed," she said.

The infection had turned her extremities into dead tissue.  Still sedated, Ess said she didn't realize what that meant at first.

"There was a period of time where they didn't tell me that they had to amputate, but somebody from the staff said, 'Oh honey, you know what they are going to do to your hands, right?'  That's when I knew," she said.

After having her hands and feet amputated, Ess adapted.  She learned how to drink from a cup, brush her teeth and even text on her cellphone with her arms, which were amputated just below the elbow.

Despite her progress, Ess said she faced challenges being independent.  Her mother, Judith Aronson, basically moved back into her daughter's life to provide basic care, including bathing, dressing and feeding.  Having also lost her feet, Ess needed her mother to help put on her prosthetic legs.

Ess said she found that her prosthetic arms were a struggle.

"These prosthetics are s---," she said.  "I can't do anything with them.  I can't do anything behind my head.  They are heavy.  They are made for men.  They are claws, they are not feminine whatsoever."

For the next couple of years, Ess exercised diligently as part of the commitment she made to qualify for a hand transplant, which required her to be in shape.

Ess had to wait for a donor.  Dr. Scott Levin, her orthopedic surgeon at the University of Pennsylvania in Philadelphia, said it was preferable if Ess' donor hands were female, and had a size and skin color that matched hers.

Once one was found, two separate teams of surgeons, one dedicated to the left hand, the other to the right, worked for nearly 12 hours to perform an operation so cutting-edge that surgeons have only attempted it about 60 times in the past 15 years.

After the surgery, Ess was in a cocoon of bandages.  Levin said the initial signs for recovery were good.

"This is more than we could ever hope for," he said.  "Her blood pressure is good, all the parameters related to how to blood flow in and out of her new arms.  This is, if you will, a picture perfect course so far."

Less than a month after her surgery, Ess was out of the ICU and working on a therapy regime.  The skin color of her new hands and arms wasn't exactly the same as her upper arms.  They still looked like they belonged to someone else.

"The first couple of days I refused to look at them," Ess said.  "It was kind of like one of those scary movie moments.  I'm too scared to look because it's reality [but] I'm so grateful to have them that I just don't really think about it superficially."

Four months after her surgery, in January 2012, Ess' doctors said they continued to be amazed at her recovery.  They said they didn't expect her to have fine motion control for another 12 to 18 months, but her muscles were reacting well.  She could even pick up lightweight objects.

In February, Ess was allowed to go home for the first time since the surgery five months before.  Levin said the prognosis for both hands couldn't be better.  Even so, rejection was still a huge concern.

Tune into a special edition of ABC's Nightline, To Hold Again, Friday at 11:35 p.m. ET to find out what happens to Ess and how she moves forward.

Copyright 2013 ABC News Radio

Friday
Dec282012

Women Turn to Eyebrow Transplants to Improve Brow Fullness

John Slater/Digital Vision/Thinkstock(NEW YORK) -- When it comes to eyebrows, thin is no longer in.  But if you’ve been waxing and plucking for years, you may find that your eyebrow hair just won’t grow back.

Some people with that problem are turning to eyebrow transplants.

Take Pamela Penrose, for instance.  For 10 years, she watched as bald spots appeared in her eyebrows.  She was constantly filling them in with a pencil hoping for a better look.

“It’s a little embarrassing and it affects my self-esteem,” Penrose told ABC's Good Morning America.

Penrose turned to Dr. Sanusi Umar for an eyebrow transplant.  Doctors used to transplant head hairs, but Umar pioneered a way to harvest hair from a woman’s arms, legs or nape of the neck.

Hair from those areas “much more resembles the natural eyebrow,” Umar, of Derm Hair Clinic in Los Angeles and Redondo Beach, Calif., told GMA.

“It’s slow to grow, small in appearance and much more resembles the natural eyebrow,” he said.

It’s painstaking work.  Each hair is transplanted individually, and the entire procedure lasts about two-and-a-half hours.

GMA went back to visit Penrose three weeks after she had the transplant.

“My eyebrows look a lot larger and thicker and exactly what I wanted,” she said, adding: “I feel like a totally different person.  I feel much more confident.”

Eyebrow implants are not cheap -- they cost between $6,000 and $8,000, depending on how much hair needs to be replaced.  But there is another alternative that women can consider first: Rogaine.

Rogaine is the anti-balding medication used mostly by men, but there is a women’s version.  Dr. Doris Day, a dermatologist, said her patients have had good luck getting eyebrow hair to grow in fuller using it.

But be careful how you apply it.  If you get the treatment on other parts of your face, you could end up growing unwanted hair there.

Copyright 2012 ABC News Radio

Wednesday
Sep122012

Texas Woman to Receive Nation’s First Double Arm Transplant

Keith Brofsky/Thinkstock(BOSTON) -- Surgeons at Brigham and Women’s Hospital in Boston will perform the nation’s first double arm transplant on a Texas woman, the hospital announced Wednesday.

Katy Hayes, 44, a quadruple amputee and mother of three from Kingwood, Texas, has been approved for the transplant after undergoing rigorous evaluation.

In 2010, Hayes, a former massage therapist, developed a flesh-eating bacterial infection after giving birth to her third child. To keep her alive, doctors had to amputate her arms above the elbow, her legs above her knees, her uterus and her large intestines.

“I never thought about how much a gift your hands are,” Hayes said at a news conference Wednesday. “I have to be baby-sat, which is ridiculous.”

More than 48 patients worldwide have received hand and arm transplants. In 2009, the University of Pittsburgh Medical Center performed the nation’s first bilateral hand transplant.

An above-the-elbow arm transplant similar to Hayes’ proposed procedure has previously been performed in Munich, Germany, by Dr. Christoph Hoehnke.

The procedure will involve a team of 40 medical experts, doctors said at the news conference.

The transplant will connect skin, muscle, bones and blood vessels on both arms. While the surgery will repair the appearance of her arms, doctors are not sure whether full function of the arms will be restored.

Unlike internal organ transplants, hand and arm transplants not only depend on connecting the blood supply, but also on nerve regrowth for the arm to function normally, according to Dr. Vijay Gorantla, administrative medical director of the Pittsburgh Reconstructive Transplant Program at University of Pittsburgh Medical Center.

Nerves regrow about one millimeter a day, said Gorantla, who is not involved in Hayes’ transplant, but was on the earlier double-hand transplant team.

“The recipient nerves have to regrow in the donor shell,” said Gorantla, adding it could take years, if it happens at all. “At this point, there’s no technology to expedite that growth.”

“Theoretically, there’s a risk that these patients may not be functional or as functional as a distal hand transplant,” he said.

Research on hand and arm transplants has grown since the first transplant. Transplant patients often take multiple high-dose medications to prevent tissue rejection. Researchers at Johns Hopkins Medicine are researching ways to cut the number of high-dose drugs taken.

In a current study, Johns Hopkins researchers are treating patients with antibodies on the day of the transplant, followed by a bone marrow infusion after the transplant. Patients are then able to be treated with a single, lower-dose medication.

Doctors did not clarify Hayes’ post-transplant recovery plans, but said the process to recovery will be a long one.

“I want my life back,” said Hayes. “I want to hold my children. I want to hug my husband.”

Dr. Bohdan Pomahac, director of plastic surgery transplantation at Brigham and Women’s Hospital, the same pioneering surgeon who performed total face transplants to patients including Dallas Weins and Charla Nash, will be among Hayes’ surgical team.

Brigham and Women’s is working with the New England Organ Bank, a New England-based organ procurement organization, to find Hayes a donor.

Copyright 2012 ABC News Radio

Thursday
Jun142012

Doctors Transplant Vein Grown from Patient's Own Cells

Comstock/Thinkstock(NEW YORK) -- Scientists in Sweden are reporting a medical first: a vein grown in a lab for a 10-year-old girl using her body's own cells.

Doctors are hailing the step as a milestone in tissue engineering, a field in which doctors grow windpipes, bladders, lungs and other organs to replace faulty ones while avoiding the dangerous, lifelong complications of organ transplants.

While a handful of doctors around the world have had success growing blood vessels and other organs and transplanting them into patients, doctors said this is the first time a vein has been lab-grown and successfully transplanted using cells and parts taken entirely from the human body.

"To many of us working in this field, it is a validation of what we believe will be a revolution in medicine," said Dr. Adam Katz, director of plastic surgery research at the University of Florida.

Suchitra Sumitran-Holgersson, one of the authors of a report on the transplant published Wednesday in the Lancet journal, said the experimental procedure could someday bring promise to patients needing new blood vessels for dialysis or coronary bypasses.

Sumitran-Holersson and her colleagues grew the vein for a 10-year-old girl who had a blockage in the vein connecting her intestines and spleen with her liver. The rare condition can cause life-threatening bleeding, delayed development and even death. The patients often need a graft of a vein to replace the blocked one.

In this new approach, doctors took about 3.5 inches of a vein from the groin of a 30-year-old deceased donor and, in the lab, scraped away all of the donor's cells, leaving just the protein scaffolding of the vein. Doctors then took cells from the bone marrow of the 10-year-old girl and seeded the vein scaffolding with them. Then, for two weeks, they waited for the cells to grow.

The result was a blood vessel engineered entirely from human tissue. When surgeons took the vein and used it to replace the faulty vein leading to the girl's liver, normal blood flow was restored almost immediately, the researchers said.

The vessel had to be repaired after nine months when hardened scar tissue in the girl's body put too much pressure on the transplanted vessel.

A year after the transplant, the girl has grown nearly 2.5 inches, gained 11 pounds and has even taken up light gymnastics. So far, her body also shows no signs that it will reject the vein. But doctors will have to make sure that the vein and the liver stay healthy.

"When we met her last week, she was somersaulting and talking away," Sumitran-Holgersson said. "So far, she is doing very well."

Even though the results are exciting, doctors remain cautious about their implications for patients who need vein grafts for more common conditions, such as dialysis or coronary bypasses. The process of harvesting a donor's vein and covering it with the girl's own cells was nearly as complicated and costly as the process for an organ transplant.

"The organization and resources required for this process are significant and would severely limit the applicability of the treatment strategy to large groups of patients," said Dr. William Marston, chief of vascular surgery at University of North Carolina Hospitals.

Some cardiovascular surgeons said many patients having coronary bypasses have no shortage of their own arteries and veins that can be used in those surgeries. And many patients can't wait for treatment while doctors grow a vein for them.

Also, the fact that the graft needed repair after a year is a concern.

"A uniform conduit such as a perfectly sized and available bioengineered vein would be of great utility, but it needs to last closer to a lifetime, not a year," said Dr. John Calhoon, a professor of head and thoracic surgery at the University of Texas Health Science Center.

Sumitran-Holgersson said more work will need to be done to work out the kinks in the process and to test it in other patients. But she remains optimistic about scientists' ability to create personalized blood vessels and other organs, reducing the need for a lifetime of drugs and surgeries.

"This is a very exciting technique and one that can greatly improve a patient's quality of life after transplantation," she said. "I think we're going to see quite a bit of this in the future."

Copyright 2012 ABC News Radio

Friday
Jun082012

Man Cured of AIDS: ‘I Feel Good’

Bananastock/Thinkstock(NEW YORK) -- The fact that Timothy Brown is a reasonably healthy 46-year-old is no small thing.  Only a few years ago, he had AIDS.

“I feel good,” Brown told ABC News.  “I haven’t had any major illnesses, just occasional colds like normal people.”

Brown is the only person in the world to be cured of AIDS, the result of a transplant of blood stem cells he received to treat leukemia.

“My case is the proof in concept that HIV can be cured,” he said.

Brown got lucky.  The blood stem cells he received came from a donor with a special genetic mutation that made him resistant to HIV.  The genetic mutation occurs in less than 1 percent of Caucasians, and far less frequently in people of other races.  Before Brown got his transplant in 2007, doctors tested nearly 70 donors for this genetic mutation before they found one who was a match.

But doctors hope that a similar solution could help other people with HIV: umbilical cord blood transplants.

Dr. Lawrence Petz, medical director of StemCyte, an umbilical cord blood bank, said although Brown was cured by his transplant, the process was complicated because the blood stem cells came from an adult donor.

“When you do that you have to have a very close match between donor and recipient,” Petz said.  “With umbilical cord blood, we don’t need such a close match.  It’s far easier to find donor matches.”

But it’s still not that easy.  Petz and his colleagues have tested 17,000 samples of cord blood so far, and found just 102 that have the genetic HIV-resistant mutation.  The team performed the first cord blood transplant on an HIV-infected patient a few weeks ago, and they have another transplant planned for a similar patient in Madrid, Spain, later this year.  It will still be months before researchers can tell if the transplants have any effect on the patients’ HIV.

Petz also noted that transplants aren’t performed solely to treat AIDS.  Patients who get them have an additional condition that requires a blood stem cell transplant.  Curing their AIDS would be an incredible bonus.

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

Thursday
May242012

Baby Saved by Smallest Artificial Heart

Alessandro Di Meo/EPA(ROME) -- An artificial heart the size of a pinky finger kept a 16-month-old baby alive for nearly two weeks while he waited for a heart transplant.

The Italian baby, whose name has not been released, had dilated cardiomyopathy, a disease that stretched the muscular walls of his heart so thin they could no longer contract to pump blood. He needed a transplant. But without a suitable donor on the horizon, doctors had to improvise.

“This patient, he was a mascot for us,” said surgeon Antonio Amodeo of Rome’s Bambino Gesu Hospital, explaining how the baby had been in the hospital’s intensive care unit since he was one month old. “I said, ‘He cannot die; I have to do something for him.’”

Amodeo and his team had already tried a Berlin Heart, a scaled-down version of the left ventricular assist device once worn by former Vice President Dick Cheney. But the device, with its tubes that run outside the body, triggered a risky infection. So they turned to a tiny, 11-gram implantable pump invented by American entrepreneur Dr. Robert Jarvik that had only been tested on animals.

“I said, ‘Dr, Jarvik, please help me. I don’t want to lose this patient,” Amodeo said, adding that the hospital needed special permission from the U.S. Food and Drug Administration and the Italian Ministry of Health before proceeding with the unapproved device. “We knew there were only a few animal experiments, but we knew it could probably work.”

And it did work, keeping the baby alive for 13 days before electrical problems forced the doctors to switch back to the Berlin Heart. Two days later, a donor heart became available.

“It’s incredible,” said Amodeo, adding that the transplant, which took place in April, was successful and the baby will be discharged any day now. “We are all extremely happy because the little boy will be in his mother’s hands. He’s going to be fine.”

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

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







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