Donor organs kept viable for transplant longer

'Cold' Carriers to up travel time for transplant hearts

You cannot blame transplant surgeons for having high BP. After all, speeding in an ambulance across the city, removing a beating heart (or liver or lung) from a brain-dead patient, putting it in a box of saline and rushing back before the organ gets infected or stops beating... and then operating for 6-12 hours,  cannot be good for the nerves.

The heart transplant team at Global Health City may be able to breathe a little easier soon, when they procure new organ transportation cases that are equipped with cold perfusion technology. “Right now, the organs are carried in sterilized boxes with ice and saline, which keep the organ usable for up to four hours. But the battle against time is a constant worry,” said Dr R Ravi Kumar, senior interventional cardiologist at the hospital.

Despite its having the best organ transplant programme in the country, at least a 100 harvested organs go to waste every year, rued cardiologist Dr Nandkishore Kapadia at the inauguration of Global’s Heart Failure Clinic on Wednesday. Most of it is because the organ gets infected before it reaches the recipient.

In contrast, the cold perfusion boxes will keep feeding the heart cold nutrients that circulate inside the blood-pumping organ, allowing it to stay alive and fresh for longer. “Studies have indicated that these cases will be able to keep harvested cadaver hearts alive for up to nine hours,” he added about the boxes which have been procured at a cost of `60 lakh. (more than $100,000 U.S.)

While the additional time will make it easier for ambulance drivers who battle the city’s traffic every day, what it really does is open up the possibility of procuring organs from further south. “At the moment, we struggle to procure organs from Tiruchy, which is about three hours away through our ‘green corridor’. With the advantage of these boxes, we may be able to receive organs from places like Coimbatore soon,” said Dr Ravi.

Global’s Heart Failure Clinic brings together the whole gamut of heart services from elective surgeries to emergencies in one department and is among the few of its kind in the country.

Source: By Express News Service - CHENNAI

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New Smaller SynCardia Artificial Heart waiting FDA approval

Press Release

New Smaller SynCardia Total Artificial Heart

Will Expand Life-Saving Therapy to
All Adults & Many Adolescents

Once Results of Studies Are Approved by the FDA, the Smaller 50cc SynCardia Heart and
New Permanent Use Indication Will Triple the Number of Heart Failure Patients Who Can Get a 2nd Chance at Life

The 70cc SynCardia Total Artificial Heart, left, has been implanted in nearly 1,300 patients world-wide. The smaller 50cc SynCardia Heart, right, which could go to clinical trials this year pending FDA approval, is designed to fit in heart failure patients of smaller stature, including most women and many adolescents.

TUCSON, Ariz. – March 11, 2014 –Recent developments surrounding the SynCardia temporary Total Artificial Heart will make the life-saving device available to three times the number of people suffering from end-stage biventricular heart failure. Over 300 SynCardia Hearts have been implanted worldwide since 2012.

Clinical trials awaiting FDA approval will document the use of a new smaller 50cc version of the SynCardia Total Artificial Heart, making it available to people of smaller size, including most women, men and many adolescents.

The current 70cc SynCardia Total Artificial Heart, the world's first and only FDA, Health Canada and CE approved Total Artificial Heart, is approved as a bridge to transplant. It has been implanted in nearly 1,300 people worldwide.

Once approved by the FDA, the studies are expected to launch later this year. They will also investigate using the SynCardia Heart for permanent use (also known as destination therapy). This allows patients who do not qualify for a donor heart transplant — because of other health conditions or age — to receive a SynCardia Heart.

About 3,800 people wait for a heart transplant on any given day, according to the U.S. Department of Health & Human Services. The need for donor hearts is increasing, however. For over 20 years, the supply of approximately 2,300 donor hearts annually has been flat in the U.S. and the supply has generally been declining in Europe. Approximately 16% of people on the heart transplant list become too ill or die each year.

Many patients have lived with the SynCardia Heart for months or years while waiting for a matching donor heart. Thelongest a patient has lived with a SynCardia Heart was nearly four years before receiving a successful donor heart transplant. The SynCardia Total Artificial Heart is one of the most reliable approved heart devices. The valves in the heart have never failed and the diaphragms that pump the blood have a failure rate of less than 1% for nearly 1,300 implanted hearts, accounting for 2,600 ventricles.

Once the clinical trials are underway, both the 50cc and 70cc SynCardia Total Artificial Heart will be available as both destination therapy and bridge to transplant at study sites. The 70cc SynCardia Heart as a bridge to transplant is available at all SynCardia Certified Centers. Like a human heart transplant, the SynCardia Heart eliminates the symptoms and source of end-stage biventricular heart failure, when the left and right ventricles can no longer pump enough blood for the patient to survive.

Watch the Arizona Illustrated video on SynCardia Total Artificial Heart developments

SynCardia CEO and President Michael P. Garippa and Chief Technology Officer Rich Smith detailed these developments in a March 4, 2014 segment of “AZ Illustrated Science,” a Tucson Arizona news and public affairs show that airs on Public Broadcasting. They also provided an update about the Freedom® portable driver, which powers the SynCardia Heart.

The Freedom® portable driver, at only 13.5 pounds, provides patients with almost unlimited mobility. It is pending FDA approval and is approved by Health Canada and the CE Mark for Europe. A majority of clinically stable patients are discharged with the Freedom portable driver to recover at home and in their communities. At home, patients are able to sleep in their own beds, eat out, socialize and be part of their communities. Most patients exercise, helping them become stronger for their donor heart transplant.

“Freedom patients have proven that many activities and daily living are possible, including activities that we don’t necessarily endorse,” Garippa says of some patients. “We’ve had people go four-wheeling. We’ve had people doing tai chi. We’ve had people cycle, run, take driving vacations through many states and countries and do everything but swim.”

The 50cc Total Artificial Heart is designed for use as a bridge to transplant in patients of smaller stature, including women and adolescents. It has been designated as a Humanitarian Use Device (HUD) by the FDA for destination therapy in adults and as a bridge to transplant in pediatric patients. Prior to clinical study, an Investigational Device Exemption (IDE) application that includes each indication must be approved by the FDA.

CAUTION – The Freedom portable driver is an investigational device, limited by United States law to investigational use.

###

About the SynCardia temporary Total Artificial HeartSynCardia Systems, Inc. (Tucson, AZ) is the privately-held manufacturer of the world's first and only FDA, Health Canada and CE approved Total Artificial Heart. Originally used as a permanent replacement heart, the SynCardia Total Artificial Heart is currently approved as a bridge to transplant for people suffering from end stage heart failure affecting both sides of the heart (biventricular failure). There have been more than 1,250 implants of the Total Artificial Heart, accounting for more than 350 patient years of life on the device.

Similar to a heart transplant, the SynCardia Total Artificial Heart replaces both failing heart ventricles and the four heart valves. It is the only device that eliminates the symptoms and source of end stage biventricular failure. Unlike a donor heart, the Total Artificial Heart is immediately available at 97 SynCardia Certified Centers worldwide with 39 others in the process of certification.

The Total Artificial Heart provides immediate, safe blood flow of up to 9.5 liters per minute through each ventricle. This high volume of blood flow helps speed the recovery of vital organs, helping make the patient a better transplant candidate.

For up-to-date information, please visit: http://www.syncardia.com
Like SynCardia on Facebook
Follow SynCardia on Twitter – @SynCardia
Connect with SynCardia on LinkedIn

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Cystic Fibrosis patient runs marathon after double lung transplant

Brighton jewellery designer runs marathon 

Amanda Chalmers gearing up for the marathon

A jewellery designer born with cystic fibrosis will run a marathon less than two years after undergoing a double lung transplant.

Amanda Chalmers, 26, could hardly walk up the stairs and was reliant on oxygen therapy 24 hours a day before her life-saving operation in September 2012.

The University of Brighton graduate will run the Brighton Marathon with six of her friends next month, raising money for the Cystic Fibrosis Trust.

Miss Chalmers, who won gold for archery in the British Transplant Games, said: “I initially signed up for the marathon in 2011 after seeing my friends complete it.

“I had just come out of hospital and for the first time needed to use oxygen therapy at home, but I was determined that by the following year, I would get myself back on track and healthy enough to run the marathon.

“That didn’t happen as I became completely reliant on oxygen 24/7 and my health deteriorated.

“By May 2012, I was on the list for a life-saving double-lung transplant and in September that year I was lucky enough to receive one.”

She said that after her surgery she knew she no longer had an excuse not to run the marathon and that completing it will be a huge achievement.

“Going from hardly being able to walk up my stairs to being able to run – and a bit of walking – in a marathon is something I’m so glad to have the chance to do,” she said.

Miss Chalmers, from Brighton, said that basic care for cystic fibrosis sufferers to maintain life and keep as healthy as possible was improving, but that many people are not lucky enough to receive a transplant.

She said: “Thanks to the Trust putting money into care and gene therapy research, a major trial of new drugs is now under way.

“This work is only possible through the generosity and support of very kind people, so when it came to picking a charity to run for it was an easy choice.”

Ed Bending, the university’s environmental communications officer, who is running the marathon with his friend, said: “Amanda’s life-saving operation and her amazing recovery are just fantastic and we are all so proud of the resilience she has shown and the can-do attitude that has led her to this point.”

Jennifer Westmoreland, head of the Cystic Fibrosis Trust’s community and fundraising events, said: “Amanda is a brilliant example of what people with cystic fibrosis can achieve when they are given the opportunity. I’m sure her story will inspire others waiting for organ transplants.”

To sponsor Amanda go to: www.virginmoneygiving.com/team/justbreathe.

By Siobhan Ryan, The Argus News

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Poor immigrants targeted in illegal organ sale

Police have arrested five people in Spain after a wealthy Lebanese man in need of a liver offered up to €40,000 ($55,000) to whoever was willing to undergo an illegal organ transplant.

According to the police report, the suspects were caught while they were trying their luck with impoverished immigrants in Spain's eastern region of Valencia.

An NGO worker working with migrants in the region was the one who took the matter to local police.

The Lebanese man and his four associates had already covered the cost of several candidates’ medical check-ups to determine their organ compatibility.

Spain has been the world leader in organ transplants for the past 22 years, with 35 out of every million people donating their organs.

A national record was set last February, when 45 organ transplants were performed in a single day.

According to several Spanish media sources, this was the first attempt to carry out an unregulated organ transplant on Spanish soil.

Source: Alex Dunham, The Local, Spain's News in English

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Couple pulling out all the stops in search for a kidney

Jeff Vanderveen and wife Kathy McIntee discuss kidney donation at home in Abbotsford, Feb. 1, 2014.

Photograph by: Nick Procaylo, Nick Procaylo

BY GLENDA LUYMES, THE PROVINCE

Jeff Vanderveen calls Kathy McIntee “the woman who saved my life.”

Two years ago, a few months after the Abbotsford couple began dating, Vanderveen received shocking news: His kidneys were failing due to undiagnosed high blood pressure.

Since then, McIntee has helped her partner through some difficult times. One of his kidneys had to be removed, and he goes to the hospital for dialysis three days a week.

But in McIntee’s mind, her life-saving work is far from over.

“I’m doing everything I can think of to find him a kidney donor,” she said. “We’re trying to keep our faith and hope up.”

B.C. leads the country with the highest rate of living kidney donations, said B.C. Transplant spokeswoman Peggy John. Last year was a record year for kidney transplants, although official numbers were not available by The Province’s deadline.

But for Vanderveen and McIntee, the only kidney that really matters is the one that’s a match for him. They’ve been told he could wait up to eight years. As of mid-December, there were 384 people on the B.C. kidney transplant list, and the median wait time was more than four years.

To cut Vanderveen’s time, McIntee has been trying everything she can think of to find a living donor. Both herself and family have been ruled out for various reasons, causing her to rely on the kindness of strangers.

I’ve posted Craigslist ads across North America and Canada. I’ve joined Facebook groups. I’ve followed up on everything I can think of,” she said.

Recently, she began posting signs in gas station windows, telling the couple’s story and providing a contact email address. She also has a poster on her vehicle, an idea she saw online.

“I know there is somebody out there who can help,” she said. “It’s like a spiderweb, we just have to make the right connections.”

The next idea she plans to try is a sandwich board.

McIntee’s tactics are not recommended by B.C. Transplant, said John.

“We would advise people not to take that approach because it opens you up to a lot of risk,” she said. “Of course, it is illegal to buy or sell organs in Canada ... Advertising isn’t recommended because you’re never sure about the intent of the person stepping forward.”

McIntee can relate to that. She posted an ad in an online forum in the United States. Someone offered to give her a kidney for $300,000. She promptly told him to keep it.

But she said one bad experience hasn’t kept her from believing there might be a truly good-hearted person out there.

In fact, Vanderveen was contacted by B.C. Transplant about a possible anonymous donor last week. It’s unclear if the person will be a match, but he’s hopeful, while trying to remain realistic. There have been times when he’s thought there was a match in the past.

“We’re not giving up the search until I actually receive a kidney,” he said. “For everyone on the transplant list, this is their only chance.”

John said most live donations come from people in the patient’s family or community. There is, however, a living anonymous donor program that has resulted in six transplants, according to the B.C. Transplant website. B.C. also participates in a living donor paired exchange program, which runs three times a year and allows patients with a willing donor who is not a blood match to be part of a circle of donors and recipients.

It’s like a domino effect,” said John.

In all cases, donors must go through a rigorous testing process, including physical and psychological exams.

Vanderveen said kidney disease has limited his ability to work. He once pulled 12 to 14 hour days, operating a garbage bin business and helping with field work on his parents’ farm. Now, he’s only able to work four to six hours. He is often tired. His sleeping patterns and appetite have changed, and his legs swell if he consumes too much water. He must also avoid certain foods, like starfruit and Brussels sprouts, which contain enough potassium to kill him.

“I just want to encourage all Canadians to get on the list,” he said of the organ donation list. “It is possible to make a difference and save someone’s life.”

- Visit www.transplant.bc.ca to register to become an organ donor. To learn more about the living anonymous donor program, visitwww.transplant.bc.ca/living_donation.htm

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World's longest surviving heart transplant at 31 years

ITV.com 

Heart transplant patient is a record breaker

Last updated Sat 28 Dec 2013

A man from Newport Pagnell near Milton Keynes has become the world's longest surviving heart transplant patient.

When he had the operation in 1982, John McCafferty was told that if the transplant was successful he could survive for five more years.

Thirty one years on, he says he's forever grateful to the doctors and the donor who saved his life.

Click below to watch Olivia Paterson's report.

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Killer "T" cells “learn” to hunt down and attack cancer cells, researchers claim.

New wonder drug matches and kills all kinds of cancer — human testing starts 2014

By Michael Blaustein Newyorkpost.com

Stanford researchers are on track to begin human trials of a potentially potent new weapon against cancer, and would-be participants are flooding in following the Post’s initial report on the discovery.

The progress comes just two months after the groundbreaking study by Dr Irv Weissman, who developed an antibody that breaks down a cancer’s defense mechanisms in the body.

A protein called CD47 tells the body not to “eat” the cancer, but the antibody developed by Dr Weissman blocks CD47 and frees up immune cells called macrophages — which can then engulf the deadly cells.

The new research shows the miraculous macrophages effectively act as intelligence gatherers for the body, pointing out cancerous cells to cancer-fighting “killer T” cells.

The T cells then “learn” to hunt down and attack the cancer, the researchers claim.

“It was completely unexpected that CD8+ T (killer T) cells would be mobilized when macrophages engulfed the cancer cells in the presence of CD47-blocking antibodies,” said MD/PhD student Diane Tseng, who works with Dr. Weissman.

The clinical implications of the process could be profound in the war on cancer.

When macrophages present “killer T” cells with a patient’s cancer, the T cells become attuned to the unique molecular markers on the cancer.

This turns them into a personalized cancer vaccine.

“Because T cells are sensitized to attack a patient’s particular cancer, the administration of CD47-blocking antibodies in a sense could act as a personalized vaccination against that cancer,” Tseng said.

The team of researchers at Stanford plan on starting a small 10-100 person phase I clinical human trial of the cancer therapy in 2014.

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Scientists used human stem cells for lung tissue

Mywebhealthreport.com

Scientists had previously converted stem cells into cells of the heart, intestine, liver, nerves and pancreas, Fox News reports.

"Now, we are finally able to make lung and airway cells," study leader Dr. Hans-Willem Snoeck, a professor of microbiology and immunology at Columbia University in New York, said in a statement.

Patients who receive lung transplants today have a poor prognosis. But future approaches involving transplants that use the patient's own stem cells to generate lung tissue could reduce the chances that a patient's immune system would reject the transplant, the researchers said. 

In the new study, Snoeck's team found evidence suggesting the cells could develop into six types of lung and airway epithelial cells.

The technology could enable researchers to model certain lung diseases.

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Left ventricular assist device (LVAD) and an association with substantial morbidity and mortality.

Increased rates of LVAD pump thrombosis reported at 3 centers

Starling RC. N Engl J Med. 2013;doi:10.1056/NEJMoa1313385.

Healio.com/Cardiology Today
Three US centers report increasing rates of pump thrombosis related to the use of the HeartMate II left ventricular assist device and an association with substantial morbidity and mortality.

“Pivotal trials and postmarketing approval studies of the HeartMate II provide a reference occurrence of thrombosis of 2% to 4%; however, an unexpected abrupt increase in the incidence of pump thrombosis was observed in a single-center quality review,”Randall C. Starling, MD, MPH, of Cleveland Clinic, and colleagues wrote inThe New England Journal of Medicine. “To confirm that this finding was not an isolate phenomenon, two additional experienced centers pooled data to investigate the incidence of pump thrombosis and of elevated lactate dehydrogenase (LDH) levels as its clinical biomarker (indicating hemolysis), LDH levels that may presage thrombosis and outcomes of thrombosis-management strategies.”

The analysis included data on 837 patients and 895 HeartMate II devices (Thoratec) that were implanted from 2004 to mid-2013 at Cleveland Clinic, Duke University Medical Center and Washington University Barnes-Jewish Hospital.

Confirmed pump thrombosis served as the primary endpoint. According to results, 72 pump thromboses were confirmed in 66 patients. Thirty-six additional thromboses of unique devices were suspected.

From March 2011 to January 2013, the occurrence of confirmed pump thrombosis at 3 months post-implantation increased from 2.2% to 8.4%. The median time from implantation to thrombosis decreased, from 18.6 months before March 2011 to 2.7 months after March 2011.

An increased occurrence of elevated LDH levels at 3 months post-implantation also increased during the study period. Thrombosis was presaged by LDH levels that increased from 540 IU/L to 1,490 IU/L in the weeks before diagnosis, according to the study results.

Eleven patients had their pump thrombosis managed by heart transplantation; one patient died 31 days after transplantation. Twenty-one patients had their thrombosis managed by pump replacement. In this group, mortality was similar to that of patients with no thrombosis. The researchers also reported data on 40 thromboses in 40 patients not managed by transplantation or pump replacement; in the 6 months after pump thrombosis, the actuarial mortality was 48.2%.

“Further investigation of predisposing patient and device factors and preventive and therapeutic strategies are urgently needed to resolve this important safety issue,” the researchers concluded. “We recognize that LVADs provide life-sustaining treatment for many patients with advanced heart failure. However, recommendations for LVAD therapy should account for this updated risk-benefit profile.”

Disclosure: See the full study for a list of the researchers’ relevant financial disclosures.

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Rehospitalization after kidney transplant caused by complexity of the condition, not poor quality of care

Most early rehospitalization after kidney transplant caused by complexity of the condition, not poor quality of care

A study of over 750 kidney transplant patients over a five-year period conducted by researchers at the Perelman School of Medicine at the University of Pennsylvania has found that 90% of early rehospitalizations (within 30 days of surgery) were caused by complex medical factors related to the transplantation process. Only nine percent of rehospitalizations – which occurred among only three percent of the entire group of patients – were categorised as potentially preventable.

The study, published online this week in the American Journal of Transplantation, found that 237 patients (nearly one-third) were rehospitalized early following surgery, with a median of nine days to rehospitalization after discharge from kidney transplant. In most of these cases, the readmissions were unplanned and occurred as a result of common postsurgical complications. Deep vein thrombosis (blood clots), post-operative pain, organ rejection, fluid imbalances including volume overload (too much fluid in the blood) or volume depletion (decrease in volume of blood plasma, potentially leading to shock), and wound infections were key complicating factors leading to early rehospitalisation.

“Nationally, high rates of early rehospitalization after kidney transplantation have been reported, but little information is available about what caused these events and whether they could be prevented,” said lead study author Meera Nair Harhay, MD, MSCE, instructor of Medicine in the Renal, Electrolyte and Hypertension Division at Penn. “Early rehospitalization has also been examined by Medicare as a hospital quality of care indicator, with financial penalties for early rehospitalization after certain medical conditions. However, our findings indicate that transplant recipients are a particularly vulnerable group that often requires additional care after undergoing surgery and being exposed to new medications.”

In the study, which is the first to use intensive chart review to assess preventability of early rehospitalization, two physicians independently examined the medical charts of the 237 readmitted transplant patients. Only 19 cases were found to be preventable readmissions by the reviewing physicians. Preventable causes of readmission identified by the study include 1) patients not having had an outpatient physician/nurse practitioner assessment before being admitted, 2) an alternative medical regimen not having been prescribed at discharge, 3) patients not having been compliant with their medication regimen, and 4) inadequate outpatient diagnostic or therapeutic procedures having been available.

The study also found that 30% of rehospitalized patients were originally discharged after their transplant on the weekend, versus 23% of patients who were not readmitted –a statistically significant finding highlighting the need for careful transitions of care when staffing is variable and more limited, such as occurs on the weekends. “If further multicenter studies confirm these findings, transplant centers should consider augmenting staffing and the oversight related to weekend discharges,” said senior author Peter Reese MD, MSCE, assistant professor of Medicine and Epidemiology at Penn.

The study also revealed how long waiting times for transplantation increase the risk of post-transplant complications. For every year of additional waiting time prior to kidney transplantation, recipients were 10% more likely to experience early rehospitalization. Kidney transplant recipients who were rehospitalized within 30 days of transplant were 55% more likely to die within a six-year follow-up period than those who were not rehospitalized. “These findings indicate that early rehospitalization may be a strong signal of patient vulnerability, and such patients may benefit from more careful clinical monitoring post-transplant,” said Harhay.

virtualmedicalcentre.com

(Source: University of Pennsylvania, American Journal of Transplantation) 

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Happy Thanksgiving Weekend

My very best wishes for a happy Thanksgiving weekend to my American friends. For us in the transplant community Thanksgiving takes on a very special meaning. Transplant recipients, their families and friends have much to be thankful for. Those of us who received transplants, such as myself, have been given a "second chance" at life and we will always be thankful and grateful to our donors and donor families for the extra time we've been given.

In the U.S. 18 people die every day while on the waiting list for a transplant. Here are the latest statistics
on waiting list numbers and transplants year to date:

The Organ Procurement and Transplantation Network (OPTN)

Waiting list candidates 120,965 as of today 1:56pm

Active waiting list candidates 77,586 as of today 1:56pm

Transplants January - August 2013 19,262 as of 11/22/2013

Donors January - August 2013 9,446 as of 11/22/2013

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Lungs that live on after donor's death give hope to transplant patients

Pair of lungs that live on after donor's death give hope to transplant patients

• University of North Carolina found lungs kept alive by air for up to 4 hours
• Surgeons could now recover organs from people who die suddenly at home
• Experts predict the procedure could see thousands more transplants a year

Breakthrough: Though organ donors are still few, the new procedure could significantly boost transplant numbers

By MIA DE GRAAF, Daily Mail online

A pair of lungs that survive a donor's death have been hailed as a breakthrough for transplant patients.

Scientists found the organs can live for up to four hours after someone dies.

Unlike other organs, the air left inside keeps them from deteriorating.

In a groundbreaking $4million experiment, researchers at the University of North Carolina managed to recover lungs from people who died suddenly at home by pumping air into them within an hour of death.

Experts predict the procedure could see tens of thousands more transplants a year in America and the UK - and has paved the way for tests on other parts of the body.

Before, surgeons believed organs could not be retrieved from people who died unexpectedly.

As just two to three per cent of people die in circumstances appropriate for organ donation, lung transplants are rare and doctors often tell patients not to hold out hope.

But the new procedure could ease waiting lists which fail to save thousand each year.

In the on-going, three-year study, researchers used a pump to inject a small amount of air into the lungs of someone that died at home before transporting the body to hospital.

When it reached the theatre, the lungs were still 'breathing'.

'There aren't enough lungs. We're burying them,' said Dr. Thomas Egan of the University of North Carolina, Chapel Hill, who is leading the project. 'It turns out your lungs don't die when you do.

'There are huge logistical hurdles,' he said. 'But if we're right, this would have a profound impact on the number of lungs that are available for transplant.'

Lung cells don't depend on blood flow for oxygen, Dr Egan explained. When the heart stops beating, they use what oxygen is left in the air sacs and airways.

In a series of experiments with animals, Dr Egan showed lungs stay viable for an hour, or four hours if they are ventilated, before they're cooled to await transplant. 

Currently, only 15 per cent to 20 per cent of donated lungs are usable, often because complications during the donor's hospitalization damaged them.

Just 1,700 lungs transplants are performed each year, compared with nearly 11,000 kidney transplants from deceased donors.

Dr Egan, a cardiothoracic surgeon, said doctors don't even suggest the possibility of a lung transplant to thousands who might benefit because there aren't enough donors.

However, surgeons don't know if nontraditional organs work as well, cautioned Dr. Bryan Meyers of Washington University School of Medicine in St. Louis.

And critics warn even an hour is a limited amount of time to get hold of families to get consent for the procedure.

Dr Egan blasts ethical gripes with his project, claiming the ventilation process is merely an extension of CPR.

Typically, paramedics leave the breathing tube inserted in the person's throat. That makes it simple to restart ventilation to preserve the lungs, Egan said.

'If we can get the lungs ventilated within an hour, and then removed within an hour or two and cooled, we think they'll work just fine,' he said.

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Cleveland Clinic creates transplant ethics fellowship

By Michael C. Butz, Cleveland Jewish News

A fellowship focused on developing physician expertise on the ethical issues involved in organ transplantation has been created by Cleveland Clinic, the medical center recently announced.

“Organ shortages, allocation issues and informed consent policies for living donors are among the many ethical issues that confront the transplant field,” said Dr. Eric Kodish, director of Cleveland Clinic’s Center for Ethics, Humanities and Spiritual Care, in a Nov. 7 statement. “By establishing the nation’s only current transplant ethics fellowship, we will develop experts in an area of medicine that will only become more complex in terms of ethics.”

Dr. Eric Kodish

Dr. David Shafran is the program’s first fellow. Shafran graduated from the Sackler School of Medicine in Tel Aviv, Israel; completed his pediatrics residency at Jacobi Medical Center in the Bronx, N.Y.; and is currently a pediatric nephrology fellow at University Hospitals Rainbow Babies & Children’s Hospital.

Shafran and Dr. Kathryn Weise, the program’s director, are developing a curriculum that will effectively familiarize fellows with the core ethical issues surrounding organ transplantation and provide ample material and opportunity for independent research, according to the Clinic. Once adequately established, the curriculum and program in general could potentially serve as a model for similar projects at other health care institutions.

“The goal and challenge in bioethics is to keep the conversation about the emerging issues on pace with rapid advances in medical technology,” Shafran said. “Similarly, as our medical capabilities in organ transplantation progress, it behooves us to address the commensurate ethical issues methodically and comprehensively. This fellowship represents an acknowledgement of that responsibility.”

A donation from former U.S. Treasury Secretary Robert E. Rubin and his wife, Judith, helped create the fellowship. The program’s steering committee includes Dr. David Goldfarb, director of the renal transplant program; Dr. Charles Miller, director of the liver transplant program; and Martin Smith, director of clinical ethics. Weise also directs the Cleveland Fellowship of Advanced Bioethics.

More than 120,000 people are awaiting organ transplants in the United States. In 2012, 28,051 people received organ transplants, according to the U.S. Department of Health and Human Services.

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