Wednesday, April 30, 2008

Manilla Department of Health prohibits kidney transplants to foreigners

From the Manilla Bulletin:

The Department of Health (DoH) has issued a total ban on foreign kidney transplantation in the country effectively cutting off foreigners’ access to organs from Filipino donors.

"This directive comes at a time when the Philippine government faces the ethical and moral imperative to protect Filipinos, particularly the poor, from the black market sale of internal organs," Health Secretary Francisco T. Duque III said in a statement yesterday.

The health chief said this shift in the kidney transplantation policy was initiated by President Arroyo following the recommendation from the World Health Assembly (WHA) of the World Health Organization (WHO) to strengthen the living-related organ donation and cadaveric donation programs.

The DoH is set to release the amendment to the recently issued Administrative Order 0004 or the Revised Policy on Kidney Transplantation from Living Non-related Organ Donor and its implementing structures on Monday.

The amendment will nullify the policy for foreign patients supposedly allowing them to receive organ donations from Filipino donors only after approval by the Philippine Network for Organ Donation and Transplantation (Phil NETDAT).

"In the past few years, there has been a reported increase in the number of kidney transplants done on foreign patients with kidneys coming from Filipino living non-related donors, most them come from poor communities, 62 percent increase from 2002 to 2006. It was also observed that the 10 percent limit in foreign transplants has been exceeded in many transplant facilities, both in accredited and non-accredited hospitals of DoH," Duque added.

Duque defined a foreigner as "somebody who is not a Filipino even if the foreigner has stayed in the country 25 years but have not changed his citizenship."

He said a foreigner can only be allowed to undergo a transplant if he or she can prove consanguinity with a Filipino.

Earlier, the DoH issued a cease and desist order against eight hospitals found violating the government rule on a 10-percent annual limit on the total organ supply from living non-related donors that can be allocated for foreign kidney transplant candidates.

These include the Vicente Sotto Memorial Medical Center, Cebu Doctors Hospital, Capitol Medical Center, Cardinal Santos Medical Center, Victor R. Potenciano Medical Center, Far Eastern University-NRMF, University of the East Ramon Magsaysay Memorial Medical Center, and St. Francis Cabrini Medical Center.

Six other medical facilities were issued the cease and desist order due to expired accreditation from the DoH. These are National Kidney Transplant Institute, St Luke’s Medical Center, Quirino Memorial Medical Center, Capitol Medical Center, Philippine General Hospital, Chinese General Hospital.

Dr. Ernie Vera, program manager of kidney program of DoH, revealed that most foreign patients come from the Middle East.

The cost of a kidney transplant procedure ranges from P350,000 to P500,000 for a government-subsidized procedure or P1 million to P2 million for patients in private medical facilities, Duque noted.

The health secretary warned that hospitals and medical professionals found violating the directive are criminally liable under Republic Act 9208 or the Anti-Trafficking in Persons Act.

Under the law, it is unlawful to recruit, hire, adopt, transport, or abduct a person, by means of threat or use of force, fraud, deceit, violence, coercion, or intimidation for the purpose of removal or sale of organs.

Violators will be charged with imprisonment of 20 years and a fine of not less than P1 million but not more than P2million.

Duque has instructed the National Center for Health Promotion to promote awareness on the negative implication of selling kidneys.

"We need to educate. We have instructed the national center for health promotion to give posters to iden areas for people who sell their kidneys what are the dangers they are facing if they no longer have one of the two kidneys for example. So you have to give them the whole breadth of information."

"We reiterate that organ transplant is not part of Philippine Medical Tourism and that organ donation is being promoted only among well-informed, free-willing and altruistic donors without any monetary reward or improper or unethical inducements," Duque reiterated.

“You Have the Power to Save Lives – Sign Your Donor Card & Tell Your Loved Ones of Your Decision”

Register to be a donor in Ontario or Download Donor Cards from Trillium Gift of Life Network

In the United States, be sure to find out how to register in your state at or Download Donor Cards from OrganDonor.Gov

Your generosity can save up to eight lives through organ donation and enhance another 50 through tissue donation

Tuesday, April 29, 2008

25th anniversary for liver transplant recipient

From The London Free Press in Ontario, Canada:

Sign donor cards, she urges

A quarter-century ago, Heather Fisher's chances of living another year were slim.

Her liver was failing, she was getting weaker and sicker and her time was running out.

She was given a new lease on life when she became one of the first patients in London to receive a liver transplant.

Twenty-five years later, Fisher is healthy, happy and working as a nurse in a London Health Sciences Center acute pain clinic.

She's been nursing full-time since recovering from the transplant, for several years as an operating room nurse.

"Although the transplant was done years ago, it feels like yesterday," said Fisher.

"I think about my good fortune every day and I feel blessed. The gift of the organ restored my life."

Fisher recently marked the 25th anniversary of her transplant --"liver-versary," as she calls it -- on a day spent with London firefighters, her own salute to Organ Donor Awareness Week.

Although Fisher has to take anti-rejection drugs, she's experienced no appreciable side-effects from the medication.

"I've been remarkably healthy," she said. "I've never had a serious illness since the transplant, just the occasional cold or flu."

Fisher urges people to sign organ donation cards.

Across Canada, about 4,000 people are waiting for organs, including 1,800 in Ontario.

Canada has one of the lowest donation rates in the developed world, said Fisher.

"We can do better as a nation, that's for sure."

Canada's organ donation rate is about 13 donors per one million people, compared with 20 per million in the U.S. and 31 per million in Spain.

Donation rates vary across Canada, with London -- a leading small organ transplant center -- near the top, at 23 per million. As a transplantation center, Londoners have learned and heard more about organ donations, said Fisher.

In the late 1950s, kidney transplants were done in London for the first time at St. Joseph's Hospital.

University Hospital opened in 1972 and quickly established a transplant program.

The city's first liver transplant was done there in 1977, the first heart transplant in 1981 and first lung and bone marrow transplants in 1989.

Fisher was the recipient of the fifth liver transplanted in London. Since then, more than 1,200 others have been done.

Organ donations save lives, she said, adding some people die waiting for one.

"If you decide to become a donor, it's important to sign a donation form and talk it over with your loved ones so they know your intentions," she said.

“You Have the Power to Save Lives – Sign Your Donor Card & Tell Your Loved Ones of Your Decision”

Register to be a donor in Ontario or Download Donor Cards from Trillium Gift of Life Network

In the United States, be sure to find out how to register in your state at or Download Donor Cards from OrganDonor.Gov

Your generosity can save up to eight lives through organ donation and enhance another 50 through tissue donation

Monday, April 28, 2008

Transplant Surgeon Pioneers New Way to Increase Supply of Organs

Donation after cardiac death is becoming more popular as waiting lists for organ transplants far exceed the supply of donors. Where I live in Ontario, somone dies every three days while waiting for a life-saving transplant. For an in-depth overview of Organ Donation after Cardiac Death, read the review in the New England Journal of Medicine.

Transplant surgeon pioneers new way to increase supply of organs

From Newswise Medical News — Transplant surgeons such as Dr. Robert Love of Loyola University Hospital are pioneering a new way to increase the supply of organs from deceased donors.

Today, most organs are obtained from donors on life support who have been declared brain dead. The organs are in good condition because the heart is still beating.

But more surgeons are beginning to use organs from patients who have been declared dead after their hearts have stopped beating. Last year, there were 793 donations after cardiac death in the United States. That’s up from 117 cases in 2000.

Kidneys and livers are the most commonly used organs from cardiac-death donors, but surgeons also are using lungs and pancreases. Love has done about 30 lung transplants from cardiac-death donors.

Nearly 100,000 people are waiting for organ transplants in the U.S. Some people wait for years. And many die while still on the list.

“We must do everything we can to encourage people to become organ donors,” Love said. “And we also have to make sure that every usable organ is used.” Love is a professor of thoracic and cardiovascular surgery at Loyola University Chicago Stritch School of Medicine.

Steve Schumann of Palatine is among the patients of Love who have benefited from a cardiac-death donation. The 60-year-old pharmacist had pulmonary fibrosis, a progressive and incurable lung disease. Schumann had uncontrollable coughing fits, and needed oxygen 24 hours a day, even in the shower.

Without a lung transplant, Schumann did not have long to live. If his only option had been a transplant from a brain-dead donor, an organ might not have become available soon enough to save his life, Love said. Fortunately, Schumann’s time on the waiting list was shortened when a pair of lungs became available from a cardiac-death donor.

Last July, Love and Loyola surgeon Dr. Michael Eng traveled to the donor’s hospital in Joliet to recover the lungs. Love brought the organs back to Loyola in an ambulance, and performed the transplant along with Dr. Mamdouh Bakhos.

Shortly after waking up from surgery, Schumann’s new lungs filled with air. For the first time in more than two years, he could breathe without an oxygen tank.

“The feeling was indescribable,” Schumann said. “It was such a relief.”

Schumann can walk again, without gasping for breath or being tethered to an oxygen tank. He has just joined an over-fifty softball league, and plans to play as much golf as possible this summer.

“It was a miracle,” he said.

Obtaining organs from cardiac-death donors can be technically challenging. Organs begin to deteriorate as soon as the heart stops beating. Surgeons generally have only a 30-minute to 60-minute window to remove organs.

A typical case involves a patient who has suffered severe and irreversible brain damage from, for example, a car accident, gunshot wound or brain hemorrhage. The patient still has minimal brain function so is not considered brain dead. But the patient is near death, and further treatment is considered futile. The family agrees to withdraw the patient from life support and donate the organs.

The patient usually dies shortly after being taken off the ventilator and other life support, such as medications to maintain blood pressure. Five minutes after the patient's heart stops beating, the body is taken to an operating room, where the organs are recovered.

Donation after cardiac death leaves the family little time to say goodbye. "But families are usually very understanding about this," said Joyce Maly, Loyola's in-house coordinator for organ and tissue donation. Maly's position is a partnership between Loyola and Gift of Hope Organ and Tissue Donor Network.

Families take solace from knowing that their loved-ones' organs will enable other people to live. "They are living on in someone else," Maly said.

“You Have the Power to Save Lives – Sign Your Donor Card & Tell Your Loved Ones of Your Decision”

Register to be a donor in Ontario or Download Donor Cards from Trillium Gift of Life Network

In the United States, be sure to find out how to register in your state at or Download Donor Cards from OrganDonor.Gov

Your generosity can save up to eight lives through organ donation and enhance another 50 through tissue donation

Sunday, April 27, 2008

Double lung transplant gives teen hope after a lifetime of struggle

Samantha Moschetta, right, shares a joke with physician assistant Joanne Snyder at Children's Hospital in Pittsburgh. Photo: Bob Donaldson/Post-Gazette

From the Pittsburgh Post-Gazette:

On Good Friday Samantha Moschetta received a double lung transplant.

And days later, for the first time in years, she was able to walk far enough from Children's Hospital in Pittsburgh to buy Italian ice and chai tea.

The 17-year-old Penn Hills girl returned home on a recent Friday as an example of transplant success.

But that success tops off a lifelong struggle with cystic fibrosis that required daily determination to survive the potentially deadly disease. She had to undergo daily life-sustaining treatments from her parents, David and Betsy Moschetta, and significant expenditures of time and energy just to live a burdensome life.

Samantha's future remains uncertain due to the difficulties inherent with lung transplants, coupled with continuing problems that cystic fibrosis imposes on digestion.

But hers is a story of how persistence and determination -- and her absolute refusal to give up -- paid off.

Today Samantha literally breathes more freely than she has for most of her 17 years. It provides her incentive to resume a relatively normal teenage life, including possibly returning to high school and getting a driver's license.

Which is to say that Samantha Moschetta is back in action.

Five months after she was born, Samantha was diagnosed with cystic fibrosis -- an inherited chronic disease that afflicts the lungs and digestive system of about 30,000 children and adults in the United States and 70,000 people worldwide.

A defective gene and its protein product cause the body to produce unusually thick, sticky mucus that clogs the lungs and leads to life-threatening lung infections. It also obstructs the pancreas and stops natural enzymes from helping the body break down and absorb food, the Cystic Fibrosis Foundation states.

In the 1950s, few children with CF lived long enough to attend elementary school. But advances in research and treatments now allow many to live into their 30s and 40s, if not longer.

But Samantha's prognosis was not rosy. She underwent four breathing treatments each day for most of her life to dislodge mucus buildup in her lungs and make it a bit easier to breathe. She's been on a regimen of strong antibiotics and other medications to prevent lung infections promoted by the mucus.

Then she developed diabetes due to mucus in the pancreas that blocked insulin secretion. Lack of insulin, the hormone needed for blood glucose to enter cells, causes blood glucose to build up in the blood to dangerous and even deadly levels.

It added yet another difficult high-maintenance disease to the challenge of survival. She now uses an insulin pump and continues taking pancreatic enzymes to help her digest food properly.

Her problems grew more severe each year. Two years ago she became wheelchair-bound most of the time because she could not breathe well enough to walk. She's been on oxygen at nights since age 13 but had to go on oxygen full time four months ago.

Her father would awake at 4:30 a.m. each morning to pound on her back and sides for an hour and a half to loosen mucus in her lungs, along with three shorter but still intense treatments throughout the day.

She attended Penn Hills schools until eighth grade, then enrolled in a cyber school. "I'm used to it," she said of her limitations. "It doesn't bother me."

Since age 12, she's been on the transplant list. In the case of CF, one can be too sick for a transplant, and such was the case with Samantha, who at 4 feet ,7 inches tall, weighed a mere 58 pounds. Doctors told her she had to gain weight to qualify for a transplant.

Samantha, unconvinced she wanted a transplant, received encouragement from her parents to go through with it. Without the transplant, Mr. Moschetta was sure, his daughter would not survive 2008.

"My appetite was decreasing because I was not feeling well," Samantha said, noting that she burned many calories struggling to breathe.

To gain weight, she had to have nutrition and lipids or fats pumped directly into her stomach and legs.

Her doctors also gave her incentives. Dr. Timothy Murphy, a Children's Hospital pediatric pulmonologist, told her he'd pay her $10 for each pound she gained. He in turn could reduce that total by $10 for each pound he lost.

The contest was on.

Samantha gained 15 pounds. But to his dismay, Dr. Murphy gained three. So he anted up $180. In the end, she gained sufficient weight to reach about 80 pounds, which qualified her for the transplant.

"I just wanted a normal life again, so I decided to do it," Samantha said.

The wait was on for lungs to become available. The call from Dr. Geoffrey Kurland, Children's Hospital medical director of lung transplantation, came March 20: "We got lungs," he told the Moschettas. "Come on in."

A panicky Samantha threw up. But at 3:30 a.m., the surgery began and was completed by 10 a.m. Once off the ventilator, Samantha finally could breathe. Her new lungs will never be affected by CF.

"It was a shock," she said. "It was different. I could take a deep breath and not cough. I was glad."

She must undergo physical therapy three times a week to build up leg strength and overcome two years of virtual inactivity.

Her parents look forward for the first time in many years of not having to awaken before dawn to give her percussive therapy to help her breathe.

"I've been telling everyone that I'm ecstatic and excited for Samantha, for her health and her future," said Mr. Moschetta, who operates J&M Printing in Penn Hills. "Her future is brighter now.

"I'm looking forward to her doing what typical kids do -- go shopping and go to the movies -- and doing it without her parents attached to her hip," he said. "It's also wonderful for selfish reasons."

Yes, he can sleep in longer.

Dr. Kurland said a lung transplant was a last resort, and in Samantha's case, a necessary risk. Such transplants typically don't last as long as other transplants, so she faces future challenges.

But her prognosis looks strong.

"Her quality of life was pretty abysmal," he said. "She couldn't walk or go to school. No one wants to undergo this, and you have to think carefully beforehand to do it, and she thought about it."

"It was a good feeling to see her walk out of the hospital and not be on oxygen," said Dr. Peter D. Wearden, the cardiothoracic surgeon at Children's who helped perform the transplant.

Samantha's once pale cheeks now are pink. Her fingertips, once blue from lack of oxygen, now have lively color. She has her old spirit and determination, but now with new lungs to power them.

Samantha is back in action.

For information on how to become an organ donor in PA, visit this web site. If you're not from Pennsylvania, register at the links below.

“You Have the Power to Save Lives – Sign Your Donor Card & Tell Your Loved Ones of Your Decision”

Register to be a donor in Ontario or Download Donor Cards from Trillium Gift of Life Network

In the United States, be sure to find out how to register in your state at or Download Donor Cards from OrganDonor.Gov

Your generosity can save up to eight lives through organ donation and enhance another 50 through tissue donation

Friday, April 25, 2008

Getting a second chance at life; Organ donations on the rise in Barrie, Ontario area

Linda Rumble, left, has had three family members donate organs following their death. Cindy Quinn, right, is a living reminder that tissue and organ donation works, as she is celebrating nearly one year with her new heart. Photo: J.T. Mcveigh

From The Barrie Examiner in Ontario, Canada:

Posted By BY NICKI CRUICKSHANK, The Barrie Examiner

Cindy Quinn got some heart-breaking news two years ago when doctors told her that her heart condition could end her life.

But receiving a healthy heart from an organ donor was a life-saver for her 10 months ago.

"I wasn't told anything about my donor, but whoever it was, I'm so grateful to them," the 28-year-old Alcona resident said. "Without their donation, I wouldn't be alive today."

Quinn and members of the Trillium Gift of Life Network were on hand during an event surrounding national organ and tissue donation awareness week at Royal Victoria Hospital, yesterday.

Quinn is no stranger to hospitals, tests and living with the effects of her heart condition. But those effects became too much for her about two years ago, and her survival depended on someone else's ticker, and an organ donation ended up changing her life.

"I was diagnosed with a heart condition called hypertrophic cardiomyopathy when I was two years old, and I've been in and out of hospitals all my life," Quinn said. "My parents actually told me about my condition at age 13, and then in November of 2006 I started getting really exhausted and passing out.

"A doctor in Toronto put me on a defibrillator, but it didn't help," she added. "I progressively got worse, and soon I couldn't even walk anymore."

Thoughts of dying often clouded her mind and disturbed her sleep.

"I'd lie awake at night and think, 'I can't go to sleep because I won't wake up again,'" Quinn said. "It was very scary for me. I was put on a donor list in April 2007, but was told not to get my hopes up in case a heart wasn't available.

"Then, a month later, I got a call with the good news," she added. "The surgery went well, only four hours long, and after three days I was up and walking around. Now, I feel like myself again."

Quinn's case isn't unique in Ontario and Simcoe County, with more people needing organ/tissue transplants each year. But with growing awareness of organ donations, more people are opting to donate to save another's life.

"The culture is definitely shifting so people are more aware of organ donation," said Cathy Ritter, RVH's organ/tissue donation co-ordinator. "Numbers are up, and we had 200 organ/tissue donations in 2007. That's up from 150 in 2005.

"At RVH, we've had three organ donors in this fiscal year and over 100 tissue donors," Ritter added. "The hospital started doing recovery surgery for organs and tissue back in 2005."

"Slowly and steadily, donations have improved and continue to improve," said Linda Rumble, a Trillium volunteer. "I've seen so many organ recipients express their gratitude for getting an organ and their life back."

Quinn said her donated heart was her second chance to live, and though it's technically someone else's heart, she's thankful to have it.

"It was hard on me at first, thinking 'This is someone's heart, and they had to die for me to get it,'" Quinn said. "But now I have a whole new appreciation for life and I live every day like it's my last."

Rumble said she plans to donate her organs and tissues when she passes on, and hopes to instill that feeling of renewed life to her recipients.

"It's a wonderful feeling for me to be able to donate them," Rumble said. "I bet there won't be a day that goes by that my organ recipients won't thank me for the organ they got from me."

“You Have the Power to Save Lives – Sign Your Donor Card & Tell Your Loved Ones of Your Decision”

Download Donor Cards from Trillium Gift of Life Network

Download Donor Cards from OrganDonor.Gov

Your generosity can save up to eight lives through organ donation and enhance another 50 through tissue donation

Futile organ donation in Bhopal


In Bhopal, scores of people who have come forward to donate their vital organs find themselves completely disillusioned.

The government has taken little interest in making arrangements to preserve the vital organs and it could be a donation gone waste.

Scores of senior citizens followed the example of first couple to donate their organs and pledged their organs in a special camp. But it may all be a wasted effort.

The city has no facility to preserve organs.

"The sacrifice of the people will prove futile if arrangements are not made to preserve the vital organs. Henceforth, no one will take the initiative in this direction," said SK Saraswat, President, Senior Citizens' Forum, Bhopal.

So far, 137 people have come forward to donate their vital organs. But there is no facility in Bhopal to preserve organs like kidney, liver and skin.

"There is no facility to preserve vital organs as transplantations do not take place here," said Dr MC Songara, Surgeon, Gandhi Medical College.

Concerned about future donations, the senior citizens' forum has written to the centre and the Madhya Pradesh Chief Minister Shivraj Singh Chouhan but so far there has been no response.

“You Have the Power to Save Lives – Sign Your Donor Card & Tell Your Loved Ones of Your Decision”

Download Donor Cards from Trillium Gift of Life Network

Download Donor Cards from OrganDonor.Gov

Your generosity can save up to eight lives through organ donation and enhance another 50 through tissue donation

Thursday, April 24, 2008

UCSF marks a milestone with 500th transplant in heart and lung program

From the University of California, San Francisco:

UCSF marked a milestone this week with the 500th procedure in its Thoracic Transplant Program, which specializes in transplantation of the heart and lung.

“We’re glad to reach this significant point in our program because it means that a great number of patients are receiving improvements to their health that could not otherwise be achieved without an organ transplant,” said Charles Hoopes, MD, director of Cardiopulmonary Transplantation at UCSF since 2002. “UCSF has a highly experienced transplant support team and is dedicated to research focused on continued improvement in patient survival and outcomes for transplanted organs."

Patients in the program have undergone either a heart or lung transplant or both.

According to UCSF clinical specialists, transplant is the best treatment for patients with severe, end-stage disease where no effective medical or nontransplant surgical treatments are available.

Conditions that damage the heart to the point where a transplant is the best chance for improved health include congenital heart disease, coronary artery disease, heart failure, pulmonary hypertension, and valvular heart disease. Severe diseases of the lung that can lead to transplant include emphysema, cystic fibrosis, pulmonary fibrosis, pulmonary hypertension, and sarcoidosis, an inflammation that produces tiny lumps in the lungs.

In January, new data from the Scientific Registry of Transplant Recipients showed that UCSF exceeded national averages for expected survival rates of both heart and lung transplant patients. Known for tackling complex transplant surgeries, UCSF was the only hospital among the U.S. News & World Report top 18 hospitals that exceeded the national averages in both heart and lung transplant programs (See US

Research is making it possible for more patients with uncommon disease types to receive transplants.

“Part of the benefit of being at UCSF is to work on the cutting edge of research, to never be satisfied with the status quo and to identify new recipient populations, new science, and new ways of improving care,” said Jeffrey Golden, MD, medical director of the UCSF Lung Transplant Program. “Our transplant population includes patients with unique rheumatological disorders and those with end stage lung disease secondary to congenital heart disease--patients with diseases that are just now being considered viable for transplantation.”

Research in transplant medicine has been a focus of the UCSF transplant program since it began. UCSF researchers are presently investigating a blood test instead of a biopsy to identify patients who might reject their donor organ and the future possibility of using inhaled immunosuppressants to stop transplant rejection. The Thoracic Transplant Program is also looking into diseases like scleroderma, a chronic autoimmune disease in which the body attacks itself to create both end stage heart and lung disease.

The Heart Transplant Program at UCSF is researching the genomics of heart failure and donor organ rejection. The program began in 1989 and focuses on pulmonary hypertension and right ventricular failure, combined heart-kidney transplant, transplant for Chagas disease, transplant for congenital heart disease, and transplant for patients with heart failure and HIV.

The UCSF Lung Transplant Program began in 1991 and is a specialized center of excellence for treating cystic fibrosis and pulmonary hypertension. The program also focuses on ECMO (extracorporeal membrane oxygenation) as a bridge to transplant for acute respiratory failure, the role of transplant in malignancy (bronchoalveolar carcinoma), and transplant for HIV patients. Current research includes the genomics of transplant rejection, acute lung injury and fungal infections.

Information about all UCSF transplant programs can be found at: UCSF Health.

UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.

Wednesday, April 23, 2008

Organ transplants for immigrants stir debate in California

From (The Boston Globe):

By Anna Gorman
Los Angeles Times

LOS ANGELES - Ana Puente was an infant with a liver disorder when her aunt brought her illegally to the United States to seek medical care. She underwent two liver transplants at the University of California, Los Angeles Medical Center as a child in 1989 and a third in 1998, each paid for by the state. But when Puente turned 21 in June, she aged out of her state-funded health insurance and the ability to continue treatment at UCLA.

This year, her liver began failing again and she was hospitalized at County-USC Medical Center, affiliated with the University of Southern California. In her Medi-Cal application, a USC doctor wrote, "Her current clinical course is irreversible, progressive and will lead to death without another liver transplant." The application was denied.

The county gave her medication but does not have the resources to perform transplants.

Late last month Puente learned of another, little-known option for patients with certain healthcare needs. If she notified US Citizenship and Immigration Services that she was in the country illegally, state health officials might grant her full coverage through Medi-Cal, the state health services assistance program for the poor. Puente did so, her benefits were restored, and she is awaiting a fourth transplant at UCLA.

Puente's case highlights two controversial issues: Should illegal immigrants receive liver transplants in the United States and should taxpayers pick up the cost?

The average cost of a liver transplant and first-year follow-up is nearly $490,000, according to the United Network for Organ Sharing. Donor livers are in scarce supply. In California, nearly 3,700 people are on a waiting list for livers, according to the network. Last year, more than 90 percent were given to US citizens.

Donor livers generally are allocated through a geographic-based distribution system on the basis of how sick the patients are and how long they have been on the transplant waiting list. Immigration status does not play a role in allocating organs. But some people say that it should.

"All transplants are about rationing," said Roy Beck, executive director of NumbersUSA, which favors stricter controls on immigration. "I just don't think the public ought to be funding any kind of benefits for people who are breaking the law."

Larry Gonzalez, a US citizen who has hepatitis C, has known for a decade that he needs a new liver but was placed on the transplant waiting list only last week.

"Why do we have to get in line behind immigrants, foreigners, when we have enough people here to fill the hospitals?" said Gonzalez, 54, who lives in Ventura.

But Dr. Michael Shapiro, vice chairman of the ethics committee for the organ sharing network, said illegal immigrants have just as much right to receive organ transplants as US citizens. He said it is likely that more illegal immigrants donate organs than receive them. "People are people, and when you make an incision in an organ donor, you don't find little American flags planted on their organs," Shapiro said.

Illegal immigrant children with certain severe, chronic illnesses are eligible for funding under a state program. But the coverage ends when they turn 21.

State health officials said California law is designed so there is no gap in coverage, so children move seamlessly from state-funded treatment to county care. But that doesn't always happen. When they become adults, patients like Puente often must switch doctors and hospitals and might lose access to necessary medical care.

That break can be life-threatening. "It doesn't matter if I'm undocumented," Puente said. "They should take care of me at UCLA for the rest of my life because I've been there since I was a baby."

“You Have the Power to Save Lives – Sign Your Donor Card & Tell Your Loved Ones of Your Decision”

Download Donor Cards from Trillium Gift of Life Network

Download Donor Cards from OrganDonor.Gov

Your generosity can save up to eight lives through organ donation and enhance another 50 through tissue donation

Tuesday, April 22, 2008

Ontario, Canada creates $500,000 fund for families of patients awaiting organ donation

It is nice to see that the Ontario Government has not only provided help with out-of-town living expenses for families but has also announced details of a program to cover out-of-pocket-expenses for people who agree to become living organ donors.

TORONTO - Ontario families who must temporarily move to another city while a loved one awaits a life-saving organ donation will get some financial help from the province with their living expenses, Health Minister George Smitherman said Monday.

Smitherman announced the creation of a $500,000 annual fund for the Trillium Gift of Life Network - the organization that administers Ontario's organ donor program - to provide direct aid to families who have to spend months living near a hospital waiting for the transplant operation.

"We'll ask Trillium Gift of Life to develop some criteria that will allow us to reach out to provide some direct financial support to ease the burden associated with the disruption that comes from having to move to a transplant centre, in the hope that that page or call will come very quickly," he said.

"We must remain, every single day, focused on those who are on a wait lists, for whom that call cannot come too soon, in the hopes that we can prevent the loss of life for those people who wait for tissue and organ donations."

Trillium president and CEO Frank Markel said 1,600 people in Ontario are waiting for an organ or tissue donation, a reduction of about 100 from last year.

There were 200 deceased organ and tissue donors in Ontario last year - up from 172 in 2006 - that helped save more than 600 lives, Markel said.

"(Trillium) will continue to make crucial strides in increasing the number of lives saved through organ donation," he said.

"We all have the power to save lives."

Manuel Castillo of Mississauga, Ont., whose 15-year-old son Manny died last year after a rugby accident, joined Smitherman and Markel at a news conference to talk about the need for more organ donors, and said he's certain his son would be proud to have helped save five other lives.

"We're so glad about the decision we made to donate Manny's organs," Castillo said.

"For us, it's really healing to know that Manny gave many others a new life, but also it's good to know that after he died, some of his friends already signed a card or talked with their parents about organ donations."

The government also announced details of its program to cover out-of-pocket-expenses for people who agree to become living organ donors. There were 264 living Ontario residents who donated organs or tissue for transplant last year, down from 274 in 2006.

Effectively immediately, people in Ontario who agree to donate an organ or part of an organ can apply to be compensated for travel costs, hotels, meals and even lost income. The program will be retroactive to last August, when Premier Dalton McGuinty first promised up to $5,500 in compensation for living organ donors.

Manitoba and British Columbia already offer similar compensation programs to help living donors cover some of their expenses.

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Monday, April 21, 2008

U.S. National Donor Designation Report Card shows a 10% increase in organ donors since 2006

From Nephrology News & Issues:

A national report card prepared by Donate Life America shows a 10% increase in U.S. donor designations over the last 18 months, bringing the total number of registered donors in the United States to almost 70 million.

Thirty-five percent of licensed U.S. drivers and identification cardholders are registered as donors through their state registry or motor vehicle department. But the Donor Designation Collaborative (DDC), DLA’s donation education effort, wants to attain a 50% designation rate among licensed drivers in each state.

In 2006 DLA launched the DDC as a nationwide effort to improve organ, eye, and tissue donation rates in the United States.

One of the main tactics to achieving the DDC’s goals is ensuring that each state has an effective system for allowing individuals to legally designate themselves as donors. In 2007, four states had a designation rate of at least 50%: Iowa (67%), Colorado (60%), Ohio (52%) and Utah (50%). Six other states are nearing the goal. Click here to download a PDF of the national report card. – Powered by Nephrology News & Issues – Renal News for the Kidney Care Community.

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Sunday, April 20, 2008

Today is the six-year anniversary of my lung transplant

Im off to Toronto General Hospital early tomorrow for the six-year assessment of my single left-lung transplant. I will be forever grateful and thankful to all those who made it possible for me to have a second chance at life. I was in end stage repiratory failure due to idiopathic pulmonary fibrosis with little hope for the future. I say silent thanks each day for my donor and donor family, for my surgeon Dr. Shaf Keshavjee and his lung transplant team and for the entire staff at Toronto General who were so wonderful to me. I'm also very thankful to the staff of Trillium Gift of Life Network in Ontario for promoting organ donation and coordinating with critical care staff and donor families in our hospitals.

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Friday, April 18, 2008

Blue Jays ease Sudbury boy's wait for lung transplant

Sudbury's Ian Smyth, 13, throws the first pitch at the Toronto Blue Jays game in Toronto on Thursday. Smyth is waiting for a lung transplant and was given the chance to throw the pitch in recognition of National Organ and Tissue Donation Awareness Week. Photo Supplied The Star

From The Sudbury Star in Ontario, Canada:
Throwing the first pitch at last night's Toronto Blue Jay game was a thrill of a lifetime for Ian Smyth - the only thing better would be to hear he is going to receive the lung donation he needs to save his life.

The 13-year-old Sudbury boy - who has a rare lung disease that plugs up the bronchial tubes - has been waiting for a lung transplant for four months.

He threw the first pitch of the game in recognition of National Organ and Tissue Donation Awareness Week, which starts Sunday.

"I'm so excited. This is a once in a lifetime thing," Ian said.

"It means a lot to me that I can help raise awareness for organ and tissue donation."

It's difficult for Ian being away from home because he and his mom, Susan Smyth, have to live in Toronto to be near the hospital when a transplant becomes available.

"We are extremely fortunate for the moral support and great financial support from our community," Susan said.

Organ donation is close to the heart of Blue Jays shortstop, David Eckstein - four of his family members have had life-saving kidney transplants.

"It is devastating to learn that someone you love needs a transplant. But, there is something that every one of us can do to help - talk to your family about organ donation wishes today. This could be one of the most important conversations your family will have," Eckstein said.

Everyone is a potential organ and tissue donor. Today in Ontario, 1,665 patients are on the transplant waiting list.

One organ donor can save up to eight people and enhance the lives of up to 75 others through tissue donation.

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Wednesday, April 16, 2008

Niagara Health System lauded for organ donations

From The Standard in St. Catharines, Ontario, Canada:

The Niagara Health System (NHS) was honored Tuesday for achieving an outstanding level of successful organ and tissue donations.

At a board of trustees meeting held at the Ontario Street site of the NHS, Frank Markel, the president and CEO of the Trillium Gift of Life Network, congratulated health providers at the NHS for their efforts.

The NHS recognition was for a 75 per cent "conversion rate" benchmark in which three of every four potential donors at the hospital actually had their organs donated to people in need.

It is one of 12 hospitals or hospital systems in Ontario to reach the benchmark.

"This is a very strong performance," Markel told board members.

He also reminded the board of a stark fact: "One person on the transplant waiting list dies every third day in Ontario."

Trillium Gift of Life Network was created in December 2000 by the Ontario government and acts as the province's central organ and tissue donation agency.

Last year in Niagara, five people got life-saving organ donations, the NHS said in a news release. There were also 92 people who received eye donations and more than 300 benefited from tissue donations, including skin, bone and heart valves.

Of particular note is that eye donations climbed steadily from 18 in 2005 to 92 last year.

Markel told the board it is important for people to realize their organ-donation intentions can easily be made known when getting a driver's licence renewed or when applying for an OHIP photo ID card. "If you tell your family you've done this, that's very helpful," Markel said. "Remember, the conversation (when you've died) is going to be with your family, not with you.

"If your family know your wishes ... most often they let us proceed."

There are currently 1,665 people waiting for a transplant in Ontario, 54 from Niagara, the NHS said in a release. One donor can save up to eight lives through organ donations and enhance the lives of up to 75 others through tissue donations.

At a break during the board meeting, NHS chief of staff Dr. Bill Shragge said his organization is "blessed with having a team of individuals who really have that dedication, compassion, empathy and insight and see (donations) as a priority.

"Therefore, at times of tragedy, they're able to bring a perspective at those most difficult times, which, in turn, yields the kinds of results that we're seeing here."

On April 23, the NHS, along with the Trillium Gift of Life Network, is holding a "Living Green Ribbon" event at the NHS Greater Niagara General site in Niagara Falls.

It will be held, rain or shine, in the area adjacent to the Allied Health Building parking lot off North Street from 1 p.m. to 1:45 p.m.

All are invited to the gathering, which will see people join together in support of organ and tissue donation.

Green ponchos will be handed out on site to participants and parking will be available at the Allied Health parking lot, but carpooling is encouraged.

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Tuesday, April 15, 2008

More Countries Introducing Organ Donor Registers

More and more countries and states are introducing Organ Donor Registers and we are seeing news reports almost daily during April, which is Donate Life Month. No doubt this will have a huge impact on the rate of organ donation. As an example, Illinois has a campaign to register 3.5 million donors by April, 2008 and they have been extremely successful as you can see by reading their blog.

From SCOOP in New Zealand:

More Countries Introducing Organ Donor Registers

Wisconsin, USA has become the latest in a long list of countries and US States to introduce an Organ Donor Register to improve their organ donor rates.

Wisconsin is not content with already leading the USA in the percentage of people who are potential organ transplant donors. "A bill recently signed into law should help to significantly increase that number," the US media reports today.

The measure, called the Anatomical Gift Act, establishes a donor registry that people can sign onto at any time — not just when they renew their driver's license. It also lowers the age of consent for organ donation from 18 to 15.

The bill also clears up a grey area in cases where it is unclear if the person wanted to be an organ donor.

But the most important part of the new law is the creation of the database of registered donors. This will make it easier —and quicker — for medical professionals to determine if a person wished to donate organs.

Hong Kong announced the introduction of an organ donor register last month, and follows a string of other countries and US States to introduce registers.

The New Zealand Government recently announced that they would be going back on their 2005 pre-election promise of a register on the grounds that "There is no evidence that registers improve the organ donor rate." The Ministry of Health's Chief Medical Advisor further announced that, 'We' (the New Zealand public) "are not capable of making the decision to be a donor," a comment that the group that controls the amount of organ donors NZ has strongly agrees with.

"It's ironic that the countries with high organ donation rates say that registers work. New Zealand which has the lowest organ donor rate in the developed world say registers don't work, who would the public rather believe?" said GiveLife Director Andy Tookey. "One would presume that all these other countries did extensive research before embarking on introducing new registers."

"If there is no evidence that registers work, then why did the Government announce that they were going to start one, with that knowledge, just prior to the last election?" People less cynical than me would know the answer to that question."

"Apathy is not an option for the public on this issue." says Andy Tookey. "In 2006 there were just 25 organ donors, a rate of just 6 donors per million of population. At the same time the number of 'new' patients entering renal failure programs was 117 people per million of population. At this rate it won't take long before everyone in this country will know of a family member, friend or acquaintance in need of a life saving organ."

Minister of Health, David Cunliffe told Parliament earlier this week that "a diabetes epidemic is about to break like a wave over this country." In spite of this there were only 41 cadaver kidney transplants performed in 2006 and the level of transplants for all organs was at its lowest level in 14 years.

Later this month GiveLife will be launching a 'Major New Initiative' that aims to increase the organ donor rate, and give the public a choice in organ donation. Previous Minister of Health, Annette King has previously said that New Zealanders 'should not' be able to have a choice when it came to donating their organs to others who would do the same for you.

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Monday, April 14, 2008

Religious hypocrites who oppose organ donation simply heartless

From The Sault Star in Ontario, Canada:

Posted By Dr Gifford Jones

Why would I rather deal with the Mafia than some religious people? Because I hate hypocrisy above all other things. I know the mob has a code it follows strictly, such as it is, and it's crystal clear to everyone what it's all about. But religious people talk constantly about brotherly love and yet condemn fellow humans to death. It's hypocrisy at its worst.

A report in the Medical Post says that Canadians are being forced to travel to China and India to purchase heart and kidney transplants. Their only alternative is death. How can you blame people for seeking what's been labeled "transplantation tourism", to buy an organ in a foreign land? We all share the desire to live at any cost. So put yourself in the place of those facing untimely death from organ failure. Consider the odds they face in this bountiful country.

It's unbelievable that in Canada there are only 12.8 organ donors per million of population. That is why every day two to three Canadians die from organ failure. In 1995 there were 2,500 people waiting for life-sustaining body parts. Today the number has increased to 4,277. So why wouldn't patients facing certain death without a transplant start to look at foreign lands?

But what awaits them in surgery in these countries? I wish I could give a first-hand account. But one patient described the scene to me. "It was small bare bones. It was in a row of buildings in a commercial area. Patients were standing around outside and there were overhanging wires. It was a poor area." And these patients are thousands of miles from family and friends realizing they may die from the transplant operation. Let's not forget the poor, naive and unfortunate person who provides the organ. It appears that some young donors in poverty-stricken countries have no idea of what the kidney does or where it's located in the body.

Dr. Francis Delmonico, professor of Surgery at Massachusetts General Hospital, in Boston, reports that 3,000 people in a Philippine slum area sold one of their kidneys. It had the dubious distinction of being called Kidneyville. Other reports claim that after losing an organ brokers either refused to pay the donor or gave them a small fraction of the money collected. It's a cruel world for these innocents while scoundrels take advantage of their unwitting donation. The grim, grisly fact is that Canadians should not have to go shopping for organs in foreign countries. Not when, day after day, religious people bury their useful organs in caskets that could be life-saving to another human. (It's also a useless waste of trees.) Moreover, the majority of religions claim to support organ donation.

So it's high time ministers of these religions stepped up to the plate and stopped the hypocrisy. Don't preach to me about brotherly love while desperate people search in vain for life-saving organs. But I'll make a bet today. Several years ago I pleaded with religious leaders of this country to preach a sermon supporting organ donation. I'm not a graduate of any theological college. But for those who are it shouldn't require much homework to deliver the message. Yet to my knowledge not a single sermon was delivered on this matter.

I'm sure there are those in congregations, similar to my religious patients, who exclaim, "I don't want to lose an organ because I believe it's important that my body remain whole." And yet some of these same people say they intend to be cremated. Religious preachers could surely, if they tried, reassure their flock that no one will be denied admittance to Nirvana if they're missing a leg or a kidney. Isn't it just the soul that supposedly goes to heaven?

It's time those in the pulpit rise to the occasion and deliver this Good Samaritan sermon. But hell will probably freeze over before that happens. They'll continue to preach, "Do unto others as ye would have them do unto you." Then sit on their hands about this humanitarian matter. For shame, for shame, for shame.

Visit Dr. Gifford-Jones's website.

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Importance of organ donation emphasized

From the China Post:

TAIPEI, Taiwan -- The rate of organ donation in Taiwan is not as good as it could be due to cultural obstacles, Taichung Mayor Jason Hu said Saturday at a commemoration ceremony to honor those who had decided before they died to donate their organs.

Hu presided over the unveiling of a plaque that commemorated organ donors, while recipients presented bouquets of flowers to the families of donors, at ceremony held at China Medical University in the central city of Taichung.

Hu expressed gratitude to the families of the organ donors, and noted that there was still ample room for improvement in organ donation rates and in overcoming the psychological barriers to organ donation.

"Taiwan faces various obstacles to promoting organ donation," Hu said, citing the example of the cultural belief in keeping the body intact after death so that the deceased could enter the spirit world.

Hu said that it is also a common view that requesting organ donation immediately after the death of a potential donor deepens the surviving family's grief.

He noted, however, that some people are reluctant to have organ transplants as they fear transplant failure.

Even though it is difficult to change the public mindset against organ donation, government agencies and the private sector has a responsibility to help raise awareness of the importance of organ donation in saving lives, Hu added.

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Saturday, April 12, 2008

CellCept Linked to Fatal Neurological Disease

This caught my attention because I have been taking CellCept since my lung transplant six years ago. I'm not overly alarmed because just about every drug I take has potentially harmful side effects and Roche says that there have been only 10 cases of progressive multi-focal leukoencephalopathy reported in the half-million patients who have been on CellCept since 1995. I'm betting on being one of the lucky ones who do not experience this side effect.


Last November, Swiss drug maker Roche alerted the US Food and Drug Administration (FDA) about reports of a neurological disease—progressive multi-focal leukoencephalopathy—that is often fatal, occurring in patients taking its drug CellCept. CellCept is used to help the body avoid rejection following organ transplantation. Now, regulators trying to determine whether organ transplant drugs made by Roche and Novartis increase the risk of the often-fatal disease. The FDA also said today that it is reviewing similar risks with Myfortic, a drug made by another Swiss drug maker—Novartis—that is used to prevent kidney transplant rejection.

CellCept—generically known as mycophenolate mofetil—is part of a class of drugs called immunosuppressants and was approved in 1995 to prevent rejection of solid organ transplants, including kidney, heart, and liver. When CellCept is used in with cyclosporine and corticosteroids, it greatly reduces the patient’s immune system from attacking the transplanted organ. As with all immunosuppressants, CellCept carries certain risks, including development of lymphoma and other malignancies and is also linked to an increased risk of developing opportunistic infections and sepsis.

The FDA announced the process to review the reports and consider revised labeling for the medications takes approximately two months. Until then, regulators advise doctors and patients to watch for neurological symptoms. Progressive multi-focal leukoencephalopathy attacks the brain and central nervous system and is usually fatal. Symptoms include vision problems, loss of coordination, and memory loss. According to the FDA, patients who the disease are often permanently disabled.

Christopher Vancheri, a Roche company spokesman, confirmed 10 cases of progressive multi-focal leukoencephalopathy in CellCept patients, adding that over 500,000 patients have used CellCept since 1995, when it was approved in the US.

Last October, CellCept was linked to miscarriage and birth defects, prompting the FDA to add a new boxed warning to its label last November. That labeling remains under FDA review. The potential for side effects was considered so great that the FDA advised women of childbearing age to use two methods of birth control before, during, and after CellCept treatment. Meanwhile, European regulators added language about the neurological disease to CellCept packaging and, this February, Roche sent a letter to European doctors, highlighting the labeling changes. The letter stated problems were reported in kidney, heart, and lung transplant patients and the neurological disorder was seen in patients taking the drug for a form of lupus, a CellCept use not approved by regulators.

Roche said it is difficult to sort out the role of its drug in the reports since many patients had other diseases and were taking other drugs. According to the Roche letter—which the FDA posted to its Website today, determining the role of the drug in the reports poses some challenges because many patients taking the drug were suffering with other illnesses and also on other drugs, “However, the contributory role of CellCept cannot be excluded.”

A spokeswoman for Novartis said the company is not aware of any instances of the neurological disease in patients taking its drug and plans to cooperate with any labeling changes recommended by regulators.

Progressive multi-focal leukoencephalopathy is associated with at least one other drug, Tysabri, which is used to treat multiple sclerosis. Tysabri was actually removed from the market in 2005 because several patients taking it had died of the disorder. In 2005, the law firm of Parker Waichman Alonso filed suit against Elan Inc. and Biogen Idec, the makers of Tysabri, on behalf of a woman who died from progressive multi-focal leukoencephalopathy while taking that drug. When contacted, Jerry Parker, the managing partner of Parker Waichman said that Tysabri case had been resolved, but that the resolution remained confidential.

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Friday, April 11, 2008

Heart and lung transplant patients may no longer need biopsies

Biomarkers may reduce need for biopsies
Heart and lung transplant patients may no longer need biopsies and could receive personalized care from biomarkers

From the International Society for Heart and Lung Transplantation:
BOSTON, MA April 10, 2008 – Data presented at this week’s 28th Annual Meeting and Scientific Sessions of the International Society for Heart and Lung Transplantation (ISHLT) suggest the potential of a significant impact of using biomarkers to reduce the need for biopsies and personalize transplant patient care. Non-invasive testing using gene-based blood or urine samples called biomarkers could offer transplant patients personalized care and medication and may replace the need for costly, invasive biopsy procedures that can be risky for patients. The meeting will run through Saturday at the Boston Marriott Copley Place and Hynes Convention Center.

Personalized care is an integrative process of tailoring care to an individual patient’s characteristics or preferences, based on each individual’s unique biology, behavior and environment. At this year’s meeting, researchers are presenting data from gene and protein based blood testing that may be helpful for reducing immunosuppression. Related data suggests gene analysis may allow for prediction of future occurrence of cardiac allograft rejection and its diagnosis.


Today’s plenary lectures provide current perspectives on biomarkers in transplantation. In Biomarkers: What Are They" How Might They Aid in Care of Allograft Recipients and Other Patients, Christopher J. O’Donnell, MD, MPH, from NIH National Heart, Lung and Blood Institute/Framingham Heart Study, Framingham, MA, will present data pertaining to personalized care, its benefits and future impact on heart and lung patients.

Following, Dr. Christoph Borchers, Director of the Genome Canada Proteomics Platform at the University of Victoria, British Columbia, will provide a look at the emerging strategies for plasma protein analysis in New Tools, Technologies and Results for Probing Proteomic Biomarkers in Plasma of Transplant Patients.

Finally, Dr. Ralph Weissleder from Massachusetts General Hospital/Harvard will discuss Imaging Biomarkers: New Horizons and Opportunities in Transplantation, and will share the latest information on imaging biomarkers and how advanced imaging techniques may soon help in the management of transplant patients. Three related biomarker abstracts are also slated for presentation during the session.

“In recent years, there has been an intensive focus on enhancing our ability to provide the most particular predictive, diagnostic, prognostic and therapeutic guidance for patients. This intent has been enabled by unbiased and targeted examination of genotypes and haplotypes that may convey risk or protection against certain disease processes like immune rejection, as well as by defining the molecular signatures of a disease process like rejection by measuring mRNA, proteins or metabolites in the blood or urine. Distillation of such data, along with clinical features, is intended to improve care, reduce costs, and make patients lives more enjoyable,” said Bruce McManus, MD, PhD, University of British Columbia, one of the Co-Chairs for the biomarkers plenary session.

Until recently, heart muscle biopsy was the only method available to rule out heart transplant rejection and guide treatment with anti-rejection, or immunosuppressive, therapy. Aside from the invasive and painful nature of the procedure, a biopsy is only able to detect rejection after damage has already occurred to the heart tissue. Similar dilemmas exist in the monitoring of lung transplant recipients.

Alternatively, non-invasive molecular testing of a routine blood sample allows analysis of gene expression in white blood cells, proteins in the plasma, and metabolites in blood and urine. The latter biomarkers provide information on the immune, inflammatory and injury status of the transplanted heart before tissue damage occurs. The new and original information on biomarkers and personalized care in lectures given at ISHLT will offer a deeper knowledge of this innovative direction that is revolutionizing health care. The discussion will also raise awareness of alternatives to biopsy procedures that are on the horizon.


The International Society for Heart and Lung Transplantation (ISHLT) is a not-for-profit organization dedicated to the advancement of the science and treatment of end-stage heart and lung diseases. Created in 1981, the society now includes more than 3,000 members from more than 45 countries, representing a variety of disciplines involved in the management and treatment of end-stage heart and lung disease.

ISHLT maintains two vital databases. The International Heart and Lung Transplant Registry is a one-of-a-kind registry that has been collecting data since 1983 from 223 hospitals from 18 countries. The ISHLT Mechanical Circulatory Device (MCSD) database has been collecting data since 2002 with the aim of identifying patient populations who may benefit from MCSD implantation; generating predictive models for outcomes; and assessing the mechanical and biological reliability of current and future devices. In fall 2006, ISHLT released the first international guidelines for heart failure patient management. For more information, visit ISHLT web site.

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Heart transplant patient survives thanks to tiny temporary pump

From McGill University Health Center in Montreal, Canada:

Heart specialists at the McGill University Health Centre are the first in the world to implant a minimally-invasive cardiac support system called the Impella 5.0 into a patient who was suffering from acute rejection after a heart transplant. The procedure was performed in the heart catheterization lab by Dr. Renzo Cecere, Director of the MUHC Mechanical Heart Program, and Dr. Jean Philippe Pelletier, an MUHC Interventional Cardiologist, on February 19.

"In the worldwide experience of about 300 implants of the Impella 5.0, this is the first case of its use in a heart transplant patient suffering from severe acute rejection,” states Dr. Cecere. “This device allowed us to stabilize the patient's condition until she responded to the powerful anti-rejection medications. Without this new technology, this patient would likely not have survived."

Already available in the US and Europe, the Impella 5.0 is most often used as a bridge to a more permanent therapy, allowing doctors more time to develop a definitive treatment strategy. It is designed to help restore cardiac stability in patients who develop heart failure after heart surgery and who have not responded to standard medical therapy. In this case however, the device was implanted in transplant patient where the main purpose was to take the pressure off the patient’s heart in order to allow it time to heal from the trauma of an acute rejection.

The Impella 5.0 is made up of a miniature pump which is mounted in a catheter and inserted through a small incision in the patient’s groin area. The catheter is advanced from the groin to the left ventricle of the heart, where it can stay for up to ten days.

"The Impella system is the most recent acquisition of the MUHC Mechanical Heart Program, and further expands our ability to offer state-of-the-art treatments to patients with advanced heart disease," says Dr. Cecere. Health Canada accepted the technology for use in this country in June, 2007.

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Thursday, April 10, 2008

Illinois Lung transplant: 'like being reborn'

Judy Emmart, 65, of Oak Forest, sorts the 16 medications she takes after having a lung transplant. (Brett Roseman/SouthtownStar)

Oak Forest, Illinois recipient has second chance at life, urges others to be organ donors

April is Donate Life month and this is one of the many personal stories that promote organ donation awareness. It's also an overview of the lung transplant process.

From the Southtown Star in Illinois:

Judy Emmart finally can breathe.

Last summer, emphysema and chronic obstructive pulmonary disease barely allowed her to walk across the room.

Then, on July 7, 2007, she hit the jackpot.

"Everybody was getting married, and I was getting a lung," the Oak Forest resident said. "It's like being reborn."

Thanks to a family who decided to donate its deceased family member's organs, Emmart now has a new right lung.

She's telling her story to make the public aware of how big an impact organ donation can make on one person's life, in light of National Organ and Tissue Donor Awareness Week, which begins today.

Steps toward eligibility

Doctors can't tell Emmart whom her lung came from, but a complex and highly controlled process brought the organ to her. Before she could even become eligible, Emmart went through a battery of tests to look for anything that might compromise her recovery.

"From head to toe I had to be clean," she said. "I had to have tests I didn't want to have."

A colonoscopy revealed an issue doctors treated fairly easily. Her heart tests showed a blockage, so surgeons had to insert a stent.

"The final thing was my teeth," she said. "I went to an oral surgeon because I thought I should have my teeth out. They weren't good to begin with."

Because of her health issue, the surgeon couldn't put Emmart under anesthesia unless she was admitted to a hospital. So she had 19 teeth pulled in the oral surgeon's chair with only local anesthetic.

'We have a lung for you'

Once cleared for takeoff, doctors at Loyola University Medical Center in Maywood registered Emmart with the United Network for Organ Sharing, through which all organ and tissue donations process, according to Michele Martin, heart transplant coordinator at Christ Medical Center in Oak Lawn.

"This is to be sure the organs are allocated equally," Martin said.

The agency categorizes patients according to the urgency of their status and the length of time they've been waiting for an organ.

"One week later, they called and said, 'We have a lung for you.' I almost had a heart attack," Emmart said.

It's uncommon for a match to be made so quickly. And considering what course of events has to happen to make a match, Emmart's case is remarkable.

First-person consent

According to Martin, organs can be removed only from a donor who is brain dead. After the brain dies - which might be caused by events like drowning, a gunshot wound or a drug overdose - the body begins to shut down, but this process takes a while.

Once someone is brain dead, he or she legally is declared dead, Martin said. Doctors might keep the body living with machines so the family can say goodbye and so it can talk about donating its loved one's organs.

"Of course, many families struggle with questions," Martin said. "What did their loved one want?"

This question often is answered now, Martin said, through the policy of first-person consent. According to a law enacted Jan. 1, 2006, Illinois residents can register their wish to be a donor with the secretary of state's office. Simply signing the back of your driver's license is not legally binding. First-person consent is, and it takes the decision out of family members' hands.

People still are encouraged to discuss their wishes with family, however, to ease grieving minds.

Dispelling myths

If a person didn't register his or her wish and didn't relate it to family, the survivors are left to decide. Martin said Gift of Hope, a nonprofit organization and independent third party, intercedes to help the family.

"It's often difficult for people to let go because they look at the person and think, 'They're not really dead,' because they have a heart rate and they're still warm," Martin said. "But at that point, it's the machines keeping them alive."

Also, definitive tests determine whether someone is brain dead. It's not subjective. Some people also bring up religious questions. But Martin said through her research, she's found no religion against organ donation, even Jehovah's Witnesses, who have certain medical objections.

Another myth Martin encounters is people who claim doctors will let a person die, knowing they're an organ donor.

"That's one of the biggest fallacies," she said. "The donation department has no idea who's dying in other parts of the hospital. And the organ is not necessarily going to your hospital."

Once organs become available, doctors notify UNOS, which assesses the available organs and the area hospitals' needs. Martin said a page goes out to hospitals housing patients with the highest priority.

Donation centers on the receiving end access a secure Web site to review the donor's information. Blood types must match, along with close similarities in height and weight.

Once a match is made, the organ moves to the recipient's hospital in no more than four hours total travel time. Any longer, and it loses viability.

Post-surgery changes

When Emmart awoke after her transplant, she didn't remember what happened.

"The surgeon said, 'I just gave you a new lung,' " Emmart said. "The tears flowed for three days."

Though organ recipients often have a new lease on life, their lifestyle takes a hit afterward. Emmart has reduced her daily medication from 20 to 16 prescriptions. All those drugs gave her diabetes, so she also injects insulin.

For a long time, she couldn't go to restaurants, and she can't eat fast food. She said she misses bleu cheese, which is banned because it's a fungus.

"People don't know how much work it takes," she said. "It's not just a bed of gravy when you're done."

Both Martin and Emmart said though they believe in donation, it's a personal decision each family must make on its own.

"People don't realize how hard that decision is to have someone close to them die and leave a gift for someone else," Martin said. "But you're giving someone a second chance at life."

Emmart said she recognizes this gift and prays every night for the man who gave his lung to her. It was a man; that's all she knows.

Emmart was a smoker, but she quit three years ago. She takes the gift too seriously to ever compromise her health again, she said.

"The nurse said people get discharged, and she knows they're going to hit McDonald's. That's saddening," Emmart said. "I talk to my lung every day and tell it, 'You're perfectly content where you're at. Don't give me no static.' "

Organ donations

When one becomes an organ and tissue donor, he or she could save up to 26 lives.

For more information about organ and tissue donation and Gift of Hope, visit their web site.

To register first-person consent and become a donor, visit the secretary of state's donation web site, or call (800) 210-2106 or visit any secretary of state's office (where you get your driver's license).

Also, in Illinois visit Donate Life Illinois blog. If you're not from Illinois, be sure to find out how to register in your state at

“You Have the Power to Save Lives – Sign Your Donor Card & Tell Your Loved Ones of Your Decision”

Download Donor Cards from Trillium Gift of Life Network

Download Donor Cards from OrganDonor.Gov

Your generosity can save up to eight lives through organ donation and enhance another 50 through tissue donation

Wednesday, April 09, 2008

Bonspiel promotes organ donation

From the Brantford Expositor in Ontario, Canada:

This article has a special interest for me because Barry Chadbolt and Judy Postma are good friends of mine. We all had our transplants at Toronto General Hospital and like most organ transplant recipients, continue to promote organ donation awareness so that others may enjoy the same "second chance" at life that we were given.

Barry Chadbolt, 56, tears up when he thinks of the anonymous person whose untimely death allowed him to continue living.

Three years ago this month, Chadbolt, of Brantford, received a double-lung transplant after only six weeks on the organ transplant recipient list.

He later wrote an anonymous letter expressing his gratitude to the organ donor's family through the Trillium Gift of Life program and received an anonymous letter in return.

"It was a really nice experience and quite tearful," he said on Saturday morning at the Brant Organ Donor Awareness Curling Bonspiel, held at the Brantford Golf and Country Club.

Now in its 14th year, the event attracted 66 participants, including four donor organ recipients. Reg Madison, chairman of the bonspiel committee, said the bonspiel is held annually during organ donor awareness month. The goal is to get people thinking about organ donation and let their relatives know their wishes should tragedy strike, Madison said.

The day's events included short presentations by organ recipients who shared their stories.

"There's not a dry eye left in the place," he said.

Chadbolt said he suffered from chronic obstructive pulmonary disease (COPD), having "smoked myself into a hole" for 30 years.

It took a year for his name to be placed on the transplant list but only six weeks passed before he received a call from Toronto General Hospital about matching donor organs.

Chadbolt said his experience has prompted several of his friends to quit smoking or sign organ donor cards.

Another curler at Saturday's bonspiel was Judy Postma, a 37-year-old Etobicoke resident who received a heart and double-lung transplant in 2001.

Postma was born with a congenital heart defect and underwent corrective surgery at the age of 18 months. She later developed another heart condition so serious that she was placed on the organ donor recipient list.

She was on the list for two years and had less than a month to live when her transplant took place.

Postma said she never thought about organ donation until she got sick, adding that events such as the annual bonspiel help create awareness.

“You Have the Power to Save Lives – Sign Your Donor Card & Tell Your Loved Ones of Your Decision”

Download Donor Cards from Trillium Gift of Life Network

Download Donor Cards from OrganDonor.Gov

Your generosity can save up to eight lives through organ donation and enhance another 50 through tissue donation

First Ever Sextuple Kidney Transplants

12 People, 6 Donor-Recipient Pairs, Interchange Kidneys in Simultaneous Group Procedure

From ASCRIBE Public Interest Newswire:

SAN FRANCISCO, Calif., April 9 (AScribe Newswire) -- A Bay Area couple participated in an historic kidney swap Saturday, April 5, at The Johns Hopkins Hospital in Baltimore, Maryland. Jeanne Heise, a Peninsula resident, has suffered from kidney disease for more than 30 years and was about to go on dialysis as her kidneys shut down. Her husband, Randy Bolten, brother of Josh Bolten, White House Chief of Staff to George W. Bush, wanted to donate one of his kidneys to his wife, but their blood and/or tissues were incompatible.

"I feel great," said Jeanne Heise, just days after the surgery. "Living organ donation and this type of group surgery offers hope to many people in need," continued Heise.

"Johns Hopkins has performed similar group surgeries, but none with this large number of recipients and donors," said her husband, Randy Bolten. "Jeanne received a compatible kidney, I helped someone else by donating one of my kidneys to a person in the group, everybody wins," he continued.

Surgical teams began the marathon surgeries - the first six-way donor kidney swap among 12 individuals and largest group transplant procedure ever to take place - early Saturday morning, April 5, and occupied six operating rooms staffed by nine surgical teams.

The transplant candidates each had a willing donor whose blood and/or tissue types were not compatible with the intended recipient and who therefore could not donate to their loved one. Using a previously developed living donor matching system, the Johns Hopkins transplant team arranged a six-way swap, in which all six candidates received compatible kidneys from someone they had never met.

"We want to spread the word about this sort of group surgery and living organ donation. The waiting list for a kidney is very long and too many people die while waiting. With this group procedure, more and more people can beat kidney disease and live long productive lives," said Heise. "We support the National Kidney Foundation (NKF) of Northern California and Northern Nevada because they assist thousands affected by kidney disease and help many more learn about organ donation," continued Heise. "I want all kidney patients to feel as good as I do now, and they can if people become living donors," she concluded.

“You Have the Power to Save Lives – Sign Your Donor Card & Tell Your Loved Ones of Your Decision”

Download Donor Cards from Trillium Gift of Life Network

Download Donor Cards from OrganDonor.Gov

Your generosity can save up to eight lives through organ donation and enhance another 50 through tissue donation

Tuesday, April 08, 2008

US deaths prompt organ donor fears

From ABC in Australia:

Reporter: Emily Bourke
MARK COLVIN: News that donated organs contributed to the deaths of two people in the United States may have done some damage today to the campaign to improve the rates of organ donation here.

A New York teenager was diagnosed with bacterial meningitis and after his death, his organs were donated to four different people. It was several weeks after his death that an autopsy revealed the boy had in fact died of a rare form of non-Hodgkins lymphoma.

Within months, two recipients of his organs, died from the same blood cancer. Australian health authorities say the case is extremely unusual and it should not deter Australians from donating organs.

Emily Bourke reports.

EMILY BOURKE: In March of last year 15 year old Alex Koehne was admitted to a New York hospital suffering from what doctors thought was bacterial meningitis. He was treated with antibiotics but deteriorated and died within weeks. In keeping with his wishes, his parents decided to donate his organs.

MRS KOEHNE: It was very important to us…

MR KOEHNE: Very important to us.

MRS KOEHNE: …Because ever since he was a little boy Alex knew what he wanted.

EMILY BOURKE: Weeks later the results of an autopsy found Alex Koehne had died from a rare form of lymphoma. But by then, his liver had been transplanted into a 52-year-old man, while his pancreas went to a 36-year-old woman. Within months, both of recipients died after developing lymphoma.

MRS KOEHNE: When we found out that they had died our hearts went out to them.

EMILY BOURKE: The donated kidneys went to two different men and both are still alive after they underwent chemotherapy and the diseased kidneys were removed. Lewis Teperman is the director of transplantation at New York University Medical Centre where two of the transplants were done.

LEWIS TEPERMAN: We're alerting people to the fact if someone calls a death from bacterial meningitis and there is no bacteria we are saying, you know what let's back off for a little bit and reconsider if we going to use these organs.

EMILY BOURKE: Professor Jeremy Chapman is from the International Transplantation Society. He says the American case is cause for concern but not alarm.

JEREMY CHAPMAN: If we have any suspicion of a malignancy of this sort in a donor we would go for a biopsy immediately or we would default to not proceeding with the donation.

EMILY BOURKE: How common would this type of transplant be from someone who presented with an illness, bacterial meningitis, but it turned out to be something else?

JEREMY CHAPMAN: It's uncommon but not zero. So in Australia in the 1980s there was a donor with a lymphoma. I looked after one of the recipients of that of one of the kidneys. We did exactly what they've done here and that is took the kidney out straight away. So they do happen, but they don't happen very often.

EMILY BOURKE: Professor Bruce Pussell is the head of the Transplant Unit at Sydney's Prince of Wales Hospital. He says that risk of contracting an infection or disease from a donated organ is far greater for those who travel overseas for their transplants.

BRUCE PUSSELL: Well in depends entirely on the country that you go to and the screening procedures that are in place in that country. We've been advising our patients to take with them the protocol that we've developed for screening donors here and to ensure that those people are protected in some way. That's if they insist on going.

We would strongly advise them not to go of course because of the risks involved and they are serious. I think that the survival rate of those patients was only about 50 or 60 per cent compared with Australia where the patient survival is well and truly 97 or 98 per cent. So there's a big risk that they are carrying of death or disease otherwise.

EMILY BOURKE: And Professor Chapman from the Transplantation Society says the American experience should not deter potential Australian donors or recipients.

JEREMY CHAPMAN: Nothing is ever 100 per cent safe. You can't cross the road 100 per cent safe and unfortunately transplantation is like that. And that is why we have very highly-trained professionals in the transplant programs and in the intensive care units in Australia to ensure that it is as safe as it can possibly be.

MARK COLVIN: Professor Jeremy Chapman from the International Transplantation Society ending Emily Bourke's report.

“You Have the Power to Save Lives – Sign Your Donor Card & Tell Your Loved Ones of Your Decision”

Download Donor Cards from Trillium Gift of Life Network

Download Donor Cards from OrganDonor.Gov

Your generosity can save up to eight lives through organ donation and enhance another 50 through tissue donation