An Easter renewal: 3 receive new lungs

"I'm so thankful there's a donor out there. My family is appreciative. It's something you can't thank somebody enough."

From NewsOK.com in Oklahoma:

Three lives lost, three lives saved.
Surgeons at the Nazih Zuhdi Transplant Institute at Integris Baptist Medical Center transplanted three lungs into three patients over Easter weekend.

The total for 2007 was 10 lungs. Baptist is the only hospital in the state to perform lung transplants, according to the United Network for Organ Sharing.

The weekend's transplant efforts also included two livers and one kidney.

A weekend marathon
"We started at midnight on Friday night and finished about 4 in the morning (Monday),” said Dr. John Chaffin, the surgeon who performed the three lung transplants. "When the organ is available, you have to stop everything else.”

Nellie Penner of Meade received a new lung on Easter.

Penner, 57, was diagnosed with pulmonary fibrosis — a scarring of the lungs — five years ago. She had been on oxygen for more than three years. Although she now is able to breathe without it, she still habitually reaches for her mask before remembering she doesn't need it anymore.

"There's just nothing like losing your independence and not being able to do the simplest things for yourself,” she said.

Twice she had a false alarm in which an organ was available that turned out to be unusable. The third time was the charm.

Penner was placed on the lung transplant waiting list Aug. 10. Dr. Nicolas Jabbour, director of the transplant institute, said lung transplant wait times are considerably less at Baptist than elsewhere.

Surgeons have performed 148 lung transplants at Baptist since 1990.

The medical perspective
Dr. Remzi Bag, a pulmonologist and chief of the transplant institute's lung division, said lungs are among the hardest organs to harvest, and transplant recipients require the most challenging care. They are prone to infection and must receive pulmonary rehabilitation. "Despite the fact that they are very difficult to take care of, they can live a very long life,” Bag said. More than 85 percent have no limitation on their daily activities after receiving a lung.

He said only 15 to 30 percent of organ donors can be lung donors.

"Lungs are damaged so oftentimes,” he said.

Bag said he would like Easter weekend's activity to be typical, but the number of donors must increase to allow that to happen. He would like to perform 40 lung transplants a year within two years. He also wants to increase awareness of lung transplants at the hospital.

"They don't know that a lung transplant program exists in Oklahoma,” he said of some Oklahoma doctors. "If you don't know that the treatment exists, you're more shy to bring it up to your patients.”

Jabbour explained the number of people who are involved directly and indirectly with an organ transplant.

The transplant center's organ recovery team must be ready at a moment's notice to travel to recover an organ; lungs may be harvested within a roughly 50-mile radius of Oklahoma City. The transplant coordinator must immediately begin marshaling the doctors and nurses and notify the patient that an organ is on its way. Doctors must determine whether the organ is a match, which requires lab personnel.

There must be an operating room and space in the transplant intensive care unit available. Non-clinical staff ensures insurance coverage and prepare the patient's food.

"To pull three transplants like this on Easter weekend, you can imagine the logistics,” he said.

Two of the three lungs came from out-of-state donors.

Chaffin said lung transplant recipients typically have chronic obstructive pulmonary disease, pulmonary fibrosis and pulmonary hypertension. Many developed lung problems from smoking.

Many doctors tell these people to accept that there is nothing to be done.

The ones who receive transplants will have been "run through a gauntlet” of tests and evaluations to make sure the organs go to the most appropriate recipient.

Chaffin emphasized the role donors' families play.

"We make a big point of telling people when they sign their driver's license that they want to be organ donors that they communicate it to their families as well,” he said.

Getting her life back
When Penner leaves the hospital in a few days and Oklahoma City in about two months, she plans to go to the mall and shop with her family. She plans to see her brother in Tennessee. She plans to bowl, an activity she enjoyed before she became sick.
"You've got to move those muscles. There's a lot that I haven't moved in a long time,” she said. "There's just so much that I'm just looking forward to being able to do.”

She's never been to her grandchildren's games. She's never seen them in cheerleading outfits or playing basketball. They asked, but she was too sick to go. Now, she feels stronger each day.

"I'm going to see one of their ballgames. That's the first thing I'm going to do,” she said.

Penner would like to thank the donor's family and to encourage Oklahomans to consider organ donation. Her first thought upon finding out she would receive the lung was how grateful she was.

"People need them so desperately,” she said of donated organs. "I'm so thankful there's a donor out there. My family is appreciative. It's something you can't thank somebody enough.”

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Docs ordered to apologize after Anton White, 15, dies despite four examinations in four months

"The doctors failed Anton. I don't think I'll ever get over it."

From the Sunday Mail in the UK:

TWO doctors have been ordered to apologize for failing to make simple checks on a teenager who died of multiple organ failure.

A shocking report from a health watchdog reveals Anton White, 15, could have survived if GPs Agnes Wallace, 60, and James Miller, 48, had bothered to check his pulse or listen to his heart.

The schoolboy died after four visits to the medics in four months failed to spot signs of dilated cardiomyopathy, meaning his weakened and enlarged heart could not pump blood properly.

Despite the teen complaining of breathlessness, they did not conduct routine tests but told him he was suffering from panic attacks and had stomach problems.

By the time he was diagnosed properly it was too late to give him the heart transplant that could have saved him.

Scottish Public Services Ombudsman Professor Alice Brown blamed Dr Wallace and Dr Miller and in a rare move told them to say sorry to Anton's parents Bobby and Anna.

The couple, of Clydebank, have reported the GPs to the General Medical Council and are considering legal action.

MumAnna, 48, a learning assistant at Clydebank High School, said: "I felt very angry when the report came out.

"I knew all along they weren't being professional. The most upsetting part is things could have been different.

Had he got into hospital earlier, there would have been a chance.

"Death is so final, we would have taken the heart transplant. Even if he had died while getting it, everything possible would have been tried.

"But it was too late. By the time he got to hospital his heart was the size of a football.There was no chance - all his organs were failing.

"The doctors failed Anton. I don't think I'll ever get over it."

Anton vomited every day for four months, suffered palpitations and ran out of breath going upstairs.

He visited Dr Wallace at Clydebank Health Centre three times before seeing Dr Miller.

Dr Wallace - who has since retired - first prescribed Anton beta-blockers and sent him to a psychiatrist as she thought he suffered from panic attacks.

He got worse and began vomiting blood while his weight plummeted by 10lb and he became lethargic.

A month later Anton again saw Dr Wallace and the Whites say they told him their son was short of breath climbing stairs and his heart was beating fast. The GP agreed to review the effect of the beta-blockers.

Five weeks later Dr Wallace, of Bridge of Weir, Renfrewshire, still failed to examine him properly. She referred him to a stomach specialist and prescribed an ulcer treatment.

Two weeks later Anna returned with Anton as his condition worsened.

The family claim Dr Miller, a married dad of three from Bearsden, near Glasgow, simply changed Anton's medication.

Anton returned three days later on August 27 when he was seen by Dr Michael Fletcher, who spotted a "bluish tinge" in his complexion and immediately sent him to Glasgow's Western Infirmary. He was moved to Yorkhill Hospital the next morning but died after two weeks on a life support machine.

Pipe fitter Bobby, 48, said: "When Anton came out of the doctors, he knew something was wrong and felt he was hitting his head against a brick wall. For most doctors, alarm bells would ring if a 15-year-old was that ill.

"If DrWallace had taken his pulse the first time, she could have found out it was something serious. They have destroyed my faith in the health service."

The ombudsman took evidence from a GP adviser and heart specialist, who criticised Dr Wallace and Dr Miller. Prof Brown said: "This is a tragic case and I can appreciate Mr and Mrs White's concerns that, had an earlier referral and diagnosis been made, their son may have been able to have a transplant.

"The advice I received is that, with appropriate and timely specialist help, he may have survived.

"The ombudsman recommends that Dr Wallace and Dr Miller apologize to Mr and Mrs White for the shortcomings identified in the report."

She also wrote: "Whenever the symptom of palpitation is mentioned, a GP should at least feel the pulse and consider listening to the heart."

The General Medical Council said: "We are unable to confirm whether any doctor is being investigated."

NHS Greater Glasgow and Clyde said: "GPs are independent contractors but the board will work with doctors to ensure the ombudsman's recommendations are implemented."

Dr Wallace and Dr Miller declined to comment last night.

'For most doctors, alarm bells would ring if a 15-year-old was that ill' said Anton's dad, Bobby White.

MAILFILE

Dilated cardiomyopathy (DCM) is a condition where the heart gets weakened, enlarged and cannot pump blood efficiently.

The decreased heart function can affect the lungs, liver and other body systems.

It occurs more often in men than women and is most common between 20 and 60.

DCM is often fatal, with a risk of sudden death, but drug treatments can prolong life and a heart transplant may be considered.

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Miracle Lung Transplant Patient at age 76

Many centers still follow the guidelines written in 1998 that limit lung transplants to age 60 for bi-lateral transplants and age 65 for single-lung transplants. Other centers are gradually replacing this protocol with one of assessing each individual on his or her physical status and the probability of a successful outcome to the transplant. Toronto General Hospital where I received my lung transplant has transplanted several men and women over the age of 70 and it's great to see that the Mayo Clinic is also willing to raise the bar and give more people a second chance at life.

From wjhg.com in Florida:
Did you know 65 years old is the cutoff age for people wanting to receive a lung transplant?

One local man is 76 years old and is the oldest living lung transplant patient to ever walk out of the Mayo Clinic in Jacksonville.

"I asked the doctor 'well, what’s the prognosis?' He said, 'well, if you're lucky you have five years.'

Gar Lonberger was 73 when he found out the news he had pulmonary fibrosis, a disease doctors say they do not know the cause and there is no cure.

After Gar couldn't get into any experimental programs, he decided to take another route and apply for a lung transplant, but there was one problem.

"Because of my age, they kept rejecting me for a transplant; 65 is the automatic cut-off age for transplants."

After three years of waiting, Gar says the magic began on October 11, 2007. At the age of 76, Gar went into surgery at the Mayo Clinic in Jacksonville. Doctors say he was the oldest patient ever to receive a lung transplant.

"They were leery to do me, but I guess my attitude showed them that I was gonna do it."

Five months later, Gar attends respiratory therapy several times a week to keep his new lung healthy.

"Before it was time to go to the hospital, I was in a wheel chair and I could barely walk 10 feet, and now I can walk a mile and a half almost and it’s no problem to walk."

Gar adds his age has not been a barrier at all. In fact, he says he feels better than ever.

"I feel just like a kid, I feel great. This is the best part of my life because I saw what it was like to die and then I found out what it’s like to really live."

The article notes that Gar would not be in the shape he's in today without respiratory therapy.

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Transplant pioneer visits Pembroke; Dr. Tom Todd was involved in world's first successful lung transplant

I had an opportunity to chat with Dr. Todd a few months ago at Toronto General Hospital when he autographed my copy of his book (see below). Because of his pioneering efforts in lung transplantation, along with his colleagues such as Dr. Joel Cooper, I am alive today. So I have a special interest in Dr. Todd and am pleased to post news about his life and times. I highly recommend his book for anyone wanting to know more about those early days of lung transplants as well as detailed descriptions of the transplant process.

From The Daily Observer in Ontario, Canada:
While Dr. Todd is best known as one of the surgeons involved in the first successful lung transplant in the world performed at Toronto General Hospital in November 1983, he is also known as the doctor who loved riding shotgun in police cars with lights and siren blasting, weaving through traffic in a desperate race to get the precious cargo of transplantable human organs to the operating room on time.

Now semi-retired, Dr. Todd has written a book titled Breathless: A Transplant Surgeon's Journal. As the title suggests, the book is about his decades-long career as a transplant surgeon.

Louise Edmonds, a professor in the nursing program at Algonquin College in the Ottawa Valley, helped bring Dr. Todd to the city where he took part in a luncheon and book-signing at Wesley United Church, a lecture to bachelor of science nursing students at Algonquin College and a reception with the local medical community at the Pembroke Regional Hospital.

"I was really thrilled when Dr. Todd said he would come to Pembroke and speak," said Ms. Edmonds. "I read an article in the (newspaper) about him when his book was first published and found out he was from Almonte. I thought, that's not very far away, so I just called him up and asked if he would speak to our BScN students up here and he said 'yes' right away," she said.

At book signings held both after his public noon-hour speech and his address at the college, Dr. Todd donated $8 from every book sold to a bursary for a local nursing student.

Paul Petrokov is a first year nursing student at the college who formally thanked Dr. Todd for visiting the city and the college. The moment was a special one for Mr. Petrokov, as he has a medical tie to Dr. Todd.

"I had lung surgery at Toronto General in 2000 where Dr. Todd practiced. My surgery was done by Dr. Todd's colleague. In fact, my personal experience from my surgery is what prompted me to enter the field of medicine," Mr. Petrokov said.

Jane Hebert, administrative assistant with community and student affairs department at the college, said the education institution was proud to host such a distinguished figure.

"Whenever we have the opportunity to have an expert in their field talk, we like to share that opportunity with the community. Getting a doctor of his calibre to come to Pembroke is simply wonderful," Ms. Hebert said.

Dr. Todd's list of accomplishments is truly impressive.

He, along with a team of specialists at Toronto General, performed the first successful lung transplant in the world in 1983. In 1986 he followed that up with the world's first successful double lung transplant.

Dr. Todd remarked that by 1989, 22 lung transplants had been performed at the hospital. Over the years, that total continued to climb except for a blip in the mid-90's when a lack of funding support hurt the program.

In 2007, 100 transplants were performed.

Laurentian Valley resident Esther Gaudet worked as an intensive care nurse at Toronto General Hospital from 1979 until 1989. She did post-operative care on many of the transplant patients while they were in ICU.

"Working with Dr. Todd and the team of transplant surgeons was very exciting but difficult and stressful work, since the patients were so very ill and the techniques sometimes untried. Seeing Dr. Todd and hearing his talk today brought back many great memories. I am very happy to have had the opportunity to hear him speak," Ms. Gaudet said.

Dr. Todd also told the group of about 75 people that attended the luncheon, that recovery times for transplant patients has dropped dramatically over the years while anti-rejection drugs have greatly improved. Where once transplant patients were in the ICU for weeks, today it is often only a couple of days.

In his lecture at the college, Dr. Todd addressed the issue of medical ethics, particularly as it relates to the factors that go into wait list criteria for organ transplants.

Ms. Edmonds remarked that not one student left during the session and Dr. Todd stayed and talked an extra half-hour above his scheduled two-hour block. Following that, Dr. Todd remained at the college to sign copies of his book before heading over to the hospital reception.

"He was so very generous with his time to Pembroke. He was wonderful. The students were very impressed with his compassion and how well he knew each patient that he had worked with. He was so committed to them. His duty of care is very strong," Ms. Edmonds said.

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Ultra-Orthodox rabbis slam organ donation bill

Haredi community sets out to battle new organ donation laws, warn doctors will be accomplices to murder

From ynet news:
"Thou shalt not kill," cried the pashkevils (large posters hung in public spaces) to the ultra-Orthodox community in Jerusalem on Wednesday. The rallying cry asked the haredi public to prepare for a battle that "will shake the very foundations of this country," against the newly approved law regarding brain and respiratory death. The writers accused the new bill of "permitting murder in the case of brain death." Which, they said, was "murder in every sense of the word."

Community rabbis cautioned the public to be aware of the new law and demand Torah commands be fulfilled in their entirety. "Doctors should also beware not to betray the word of God, and not to assist in murder," read the posters, adding blessings of wellness to the people of Israel suffering from illness.

On Wednesday morning two pashkevils ran the views of two of the most prominent rabbis belonging to the Lithuanian non-Hasidic ultra-Orthodox Jewish community. The first was a renewed publishing of a poster from 1991, the year in which Rabbi Yosef Shalom Elyashiv and Rabbi Shlomo Zalman Auerbach determined that the pronouncing one dead on the basis of brain death was tantamount to murder.

The second poster was published solely in Elyashiv's name, and said: "As I have already stated, as long as the heart (of the prospective organ donor) is still pumping blood, even in the case of 'brain death,' it is not permitted to remove any organ from the patient.

'Provocative and shameless intervention'
A related article published in the community's paper read: "In the world of the Torah and the Halacha, much concern has been expressed regarding the provocative and shameless intervention in the grave subject of murder and (the Jewish law of) saving a life."

The newly approved organ donation law will give every family the right to decide by which halachic ruling they prefer the pronouncement of death to occur – whether based on brain death or heart failure.

Meanwhile, Sephardi Chief Rabbi of Israel, Shlomo Amar, and Shas spiritual leader Rabbi Ovadia Yosef have both voiced their support for the new law, which is intended to encourage organ donation among the religious community in Israel.

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

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How to fight organ shortages and "transplant tourism"

From the European Parliament:

Reducing the organ and donor shortage is “the main challenge that EU Member States face with regard to organ transplantation”, said the Committee for Environment, Public Health and Food Safety on Wednesday. MEPs propose a wide range of measures, including a European donor card, to tackle problems like organ shortage, transplantation risks and organ trafficking.

Although the use of human organs for transplantation has steadily increased in recent years across the EU, the number of people requiring a transplant is still greater than the number of organs available for transplant. The own-initiative report drafted by Adamos Adamou (GUE/NGL, CY) recalls that currently many thousands of patients in Europe are registered on waiting lists, which have a significant mortality rate

Organ donation has to remain “strictly non-commercial”
The committee stresses that organ donation must stay “strictly non-commercial” and should be made altruistically and voluntarily, ruling out payments between donors and recipients. Compensation should be possible only to make good expenses and inconveniences related to the donation. “Any commercial exploitation of organs is unethical and inconsistent with the most basic human values”, and organ donation out of financial motivation “degrades the gift of an organ to a mere commodity which constitutes a violation of human dignity”, say MEPs.

Prevent organ trafficking and "transplant tourism"
The report stresses that “organ trafficking undermines the credibility of the system for potential voluntary and unpaid donors”. The Commission and Member States are asked to take measures to prevent "transplant tourism", including drawing up guidelines to protect the poorest and most vulnerable donors from being victims of organ trafficking and adopting measures that increase the availability of legally procured organs . Moreover, Member States should take the necessary measures to prevent insurance companies reimbursing costs incurred in obtaining illegal organ transplantation.

A European donor card
The committee proposes to introduce a European donor card, complementary to existing national systems. MEPs also note that those who are not suitable donors should be encouraged to carry a card to that effect as well in order to facilitate a swift identification of organs. Additionally, Member States should make it possible to appoint a legal representative who can decide on donation after one's death, states the report.

Organ sharing and new biotechnology to tackle organ shortage
Establishing well-structured operational systems and promoting successful models in and between Member States and at international level is of “utmost importance” to fight organ shortage more effectively, say MEPs. They call on the Commission to promote research in biotechnology which, in the future, “may offer the possibility for researchers to grow organs from existing tissues and cells, either from the patients themselves or from other tissue donors”.

MEPs support reinforced cooperation between Member States leading to increased organ sharing between EU Member States. In particular small Member States with a limited donor pool could clearly benefit from European co-operation, says the report. The Commission should, therefore, facilitate alliances between national transplantation organisations in Member States.

Transplant hotline for better information
Committee members stress that “a very effective way of increasing organ availability is to provide more information to the public”. They propose establishing a transplant "hotline" with a single telephone number managed by a national transplantation organisation and manned 24 hours/day, which can rapidly provide relevant and accurate information.

Reduce transplant risks
Finally, MEPs recognise that it is “vitally important to improve the quality and safety of organ donation and transplantation” to reduce transplant risks. Hence, the committee looks forward to the Commission’s proposal for a directive setting requirements to assure the quality and safety for organ donation across the EU. However, the forthcoming legislative framework should not create an additional administrative burden nor should it jeopardise the use of existing good practices or lead to a decrease in the number of potential and actual donors, stress MEPs.


The report was adopted by 60 votes in favour with one member abstaining -- Procedure: own-initiative -- Plenary vote: April II in Strasbourg

25/03/2008
Committee on the Environment, Public Health and Food Safety
In the chair : Miroslav Ouzký (EPP-ED, CZ)

Knesset approves organ donation law

In a historic move, MKs vote in favor of two bills regulating organ transplants in Israel in compliance with Jewish law. First defines brain death as an acceptable indication of death, second law approves benefits to organ donors.

"The law includes an innovative clause giving preference to people who sign the donor card should they be in need of an organ transplant in the future"

From ynetnews.com:
Two bills aimed at encouraging organ donations were approved by the Knesset on Monday in second and third readings.

The first law on brain and respiratory death states that brain death would be defined as death with all its implications. The bill was approved by 24 Knesset members; five voted against it.

Earlier, the MKs approved a governmental bill on organ donations stating that a person who donated his organs while still alive will receive the status of a chronic patient after giving the donation. Thirty-eight Knesset members voted in favor of this law, while 17 opposed it.

First law: Defining time of death
The issue of defining the time of death was raised in an attempt to encourage the religious public to donate organs. Members of the Knesset's Labor, Welfare and Health Committee sought to reach an agreement with the Chief Rabbinate and rabbinical religious authorities on a definition of the donor's death.

MK Otniel Schneller (Kadima), the bill's initiator, held negotiations over the past few months with different elements in the haredi world and among the religious public before reaching the historic agreement that led to the formation of a law defining brain death.

According to the law, the time of brain-respiratory death will be in a situation when the person is proclaimed dead by two certified doctors, according to fixed parameters (no blood pressure, failure to breathe without need for life support, no response from the pupils and an absence of other reflexes).

The cessation of brain activity will be defined through objective tools (such as the CFM device which tests electric cerebral activity).

The law also defines that the team authorized to proclaim a person dead in any hospital will include at least two senior doctors who have no link whatsoever to organ transplants. These doctors will not treat the patient and will not represent the interests of another patient in need of an organ transplant.

The patient's family will be informed of the fear that their loved one may be brain dead, and the family's opinion regarding the patient's will should be taken into account before proclaiming the patient dead.

MK Schneller told Ynet after the vote, "The Knesset legislated a law today which will cause an education and perceptional change and save many lives.

"All those who supported the law saved many lives. I believe that the entire organ recipient community – and the rest of the public – should be proud that Israel's Knesset approved such a law."

MK Moshe Gafni (United Torah Judaism), who voted against the law, said that "according to Jewish law, death is only heart death and not brain death, and that's why I opposed the law."

Second law: Living donor entitled to benefits
The new law states that a living person who donated his organs will receive the status of a chronic patient after the donation is made, and will not have to pay the self-participation fee for any medical service resulting from the donation, in addition to NIS 18,000 (about $5,100) in compensation from the State.

In addition, the donor will be entitled to a recovery of expenses for psychological treatment and a recovery leave, and will receive a merit certificate from the State. The donor will also be exempted from paying the entrance fee to nature reserves and national parks.

The new law prohibits organ trafficking, receiving compensation for organs and mediation in order to receive a donation.

The law includes an innovative clause giving preference to people who sign the donor card should they be in need of an organ transplant in the future.The new law prohibits organ trafficking, receiving compensation for organs and mediation in order to receive a donation.

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Activist, recipient seek to 'inspire' with controversial kidney transplant

From the Victoria Times Colonist in British Columbia, Canada:
A long-suffering Canadian woman with a new lease on life, and the Christian activist from Australia who gave up one of his kidneys to save her, say they want to "inspire" the world with their controversial transplant - performed Thursday in Cyprus after a Toronto hospital refused to do the operation last year on ethical grounds.

Sandi Sabloff, a Toronto woman in her 50s, and Ashwyn Falkingham, a 23-year-old member of the Jesus Christians - an Australia-based religious group dedicated to organ donation as a supreme act of generosity and faith - spoke with Canwest News Service this weekend while recovering from surgery at a transplant center in Nicosia.

Sabloff praised her donor and the Jesus Christians in general, who give up their kidneys "out of spiritual and religious conviction, and just personal goodwill - because they are saving somebody's life. They are truly saving lives, and that's more than I can say for our government."

Falkingham said: "I just think it's really important to get the message out there that this is something people can do. It's almost like we've become so afraid that there may be money being exchanged or some coercion, that we've forgotten that this is something people can do to help someone out, and that there are many people who would step forward."

After finding each other in 2006 at an Internet site that links kidney patients with potential donors, Sabloff and Falkingham searched for a hospital to carry out the transplant to extend her life and fulfil his dream of giving the ultimate gift. Read the full story.

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Research promising for cystic fibrosis

May also serve as model for HIV therapies

Studies targeting bacterial resistance to pseudomonas aeruginosa such as this one at the University of Toronto may give a glimmer of hope for cystic fibrosis patients who are vulnerable to chronic lung infections due to pseudomonas, which establishes itself in the airways and defies treatment. The bacteria cluster in communities called biofilms, and are far more impervious to a broad range of antibiotics than their counterparts swimming about freely. This is a major problem for lung transplant patients with CF. Also read about a concurrent study at Dartmouth Medical School.

From the University of Toronto:

New U of T research holds promise for developing innovative therapies against cystic fibrosis and may also serve as a model for future therapies against the HIV virus.

Led by Professor Igor Stagljar, University of Toronto scientists have identified several compounds that block activity of a key protein (exoenzymeS or ExoS). One of these compounds, exosin, significantly inhibited infections in mammalian cells, showing promise for increasing the effectiveness of antibiotics in the treatment of chronic and acute bacterial respiratory infections in cystic fibrosis patients.

Past studies have shown it is possible to prevent or delay the onset of certain chronic or deadly infections in cystic fibrosis patients with early antibiotic treatment. But the current availability of antibiotics against Pseudomonas aeruginosa, a pathogen that can cause urinary tract infections, respiratory system infections, dermatitis, soft tissue infections, bacteremia, bone and joint infections, gastrointestinal infections and a variety of systemic infections, is limited and the pathogen shows signs of drug resistance.

In an article published in the online edition of the journal PLoS Genetics, a team of investigators, including first author and U of T graduate student Anthony Arnoldo, identified several drugs that block a Pseudomonas aeruginosa toxin called ExoS.

"These studies created a road map to the rational design of more potent, highly selective inhibitors against other similar toxins using a totally novel yeast-based approach," said lead author Stagljar. “This innovative approach is an important advance, not only for the value it may have in cystic fibrosis treatment, but also because this technique could be used to design novel therapies for any bacterial pathogen as well as the HIV virus.”

In the next phase of their research, Stagljar and his colleagues plan to test the action of their inhibitors in an animal model of cystic fibrosis. If successful, the therapeutics may provide an avenue for the treatment of this debilitating disease.

This project is funded by the Gebert Ruf Foundation from Switzerland and the Canadian Institutes of Health Research (CIHR).

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Leanne Myles gets triple organ transplant

"There is not a day goes by that I do not give thanks for what has happened to me."

From The Daily Telegraph in Australia:

LEANNE Myles was on her death bed when she was given the gift of life with the world's first triple organ transplant in 2006.

"I used to wonder how long I was going to live. Now I feel I have a new chance at life," Ms Myles, 34, said yesterday.

She said she still marvelled at the generosity of both the person who donated their organs and their family who agreed to the donation. "They are the brave ones, not me," she said.

With 30 per cent of people dying while on the waiting list for an organ because of a lack of donors, Ms Myles knows how lucky she was.

She was on life support in intensive care at the Royal Prince Alfred Hospital with only weeks to live when a donor became available.

Ms Myles suffered from a rare type of hepatitis that caused her body to attack itself and doctors knew her only hope for survival was the simultaneous transplant of a liver, kidney and pancreas.

After the operation, she returned home to Cowra where she remains on anti-rejection drugs and regularly travels to the RPA for check-ups with the hospital's transplant service director Professor Richard Allen.

"I'm his pet project. He keeps an eye on me and says I'm doing well.

"I think they are all chuffed about it. I just think the whole thing was amazing," said Ms Myles, who is rebuilding her life after putting it on hold because of her illness.

Former media boss Sam Chisholm also knows what it is like to be given a second chance. He is celebrating five years this weekend since he was given a double lung transplant.

By the time he joined the other 1800 Australians on the long waiting list for an organ donor, his father and two brothers had been killed by a terrifying hereditary lung disorder which causes emphysema.

The former head of the Nine Network, chairman of Foxtel and executive at the Packer family's PBL, was on oxygen and unable to get out of bed when he got the call from St Vincent's Hospital to say a donor had been found.

Grateful for the work of the surgeons including the hospital's director of lung transplantation, Associate Professor Allan Glanville, and his colleague Michael Wilson, Mr Chisholm never misses a chance to promote organ donation.

In 2004, he helped form the David Hookes Foundation which helped encourage more than 900,000 Australians to register as organ donors in the three years since the cricketer's death.

Hookes became the face of organ donation after his family complied with his wishes and agreed to donate his organs while he was on life support.

Mr Chisholm said there was a tremendous opportunity to save lives.

"In Australia we have brilliant doctors and surgeons. We have the technology and the world's best practise," Mr Chisholm said from his Murrumbidgee farm yesterday.

"We also have long waiting lists of people in need.

"There is not a day goes by that I do not give thanks for what has happened to me."

Among the 198 people around the country waiting for a liver transplant to save their life is Cordelia Whatman.

With the average waiting time for a liver transplant at 205 days, little Cordelia has already been hanging on for longer than that.

Diagnosed shortly after birth with the rare liver disorder bilitary atresia, she celebrates her first birthday next week.

Bilitary atresia is a disorder that destroys the liver's bile ducts, preventing bile from draining and also damaging her liver.

Currently she is undergoing fortnightly check-ups at the Children's Hospital at Westmead and her parents Rachel Vance and Warrick Whatman have been told to remain within a three-hour drive of the hospital in case a liver becomes available.

Latest figures show 1875 Australians are waiting for organ transplants, kidney (1388), heart (100), liver (198), lung (141) and pancreas (48).

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Organ group folds as donations dwindle

• Transplant rates in Australia plummet


• Major organ donation body folds


• Report says system is too complicated

From News.com.au in Australia:

THE nation's organ donation system is in unprecedented crisis as the transplant rate remains one of the worst in the world - and falling.

And experts fear the situation could worsen and rates plummet even further with the closure of one of the nation's leading organ donation groups.

The Daily Telegraph reveals Australians Donate, the driving force in raising awareness since 1998, has been axed.

Despite nearly 5.5 million registered organ donors in Australia, there are almost 1800 Australians waiting for a transplant.

In 2007, only 198 people donated their organs, down from 202 the previous year.

A recent Federal Government report blamed a complex system involving too many organisations and lack of co-ordination for Australia's low donation rate.

The report also accused Australians Donate of being "ineffective". Its closure next week will leave a void in the organ donor sector, with the Government yet to decide how to resolve the dire situation.

Donation rates have slumped since a peak 20 years ago despite a recent aggressive campaign to boost numbers.

The Government's answer to the crisis is to start from scratch -- but it has no immediate plans to set up another co-ordinating body to take over from Australians Donate. Read the complete story.

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'Rolling billboards' try to boost organ-donor awareness

Alexis McMillian's face is going up on the side of a tractor-trailer rig, and it's for a good cause.

From the News-Record in North Carolina:

McMillian, who lives in Greensboro, underwent a kidney transplant in 2006 after her kidneys failed. Since then, she has worked to educate the public on the need for organ donors.

As part of that work, she agreed to be depicted on a vinyl film wrap applied to a truck trailer. The wrap includes information touting the need for more people to become organ and tissue donors. The truck will display the wrap as it goes on its regular runs across the state.

The need for donors is critical. Some 2,928 North Carolinians remained on a waiting list for an organ transplant as of Friday. In 2007, 174 North Carolinians died waiting for a transplant.

The wraps are being created by the Rotary Club of Clemmons' "Have a Heart, Give a Part" campaign, using $5,000 of the club's money and a $50,000 grant from the state.

The group negotiated with trucking companies and independent truckers to find trucks on which to place the wraps. The first two wraps were unveiled Wednesday in Winston-Salem. One is on a truck operated by Triangle Warehouse and Distribution Services, the other on a Republic Waste Services truck.

Vomela, a High Point company, printed the wraps, which are guaranteed to last five years and should last seven to eight, said Rotary Club spokesman Ken Burkel.

The Rotary Club hopes to use the rest of the money to put 15 to 18 trucks on the road that will serve as rolling billboards for organ donation. It hopes other Rotary clubs in the state will join the project, raising the number of trucks to about 50.

The group is targeting trucks that operate exclusively in North Carolina.

Also, the trailers must have flat sides for the wrap to be applied.

"The trailers are not an end, but only a means to an end," Burkel said. "The end is zero deaths for lack of organs. ... There's not a shortage of organs. There's a shortage of donors."

People can register to become organ donors when they renew their driver's licenses. Previously, the heart icon on a person's license was not legally binding, but a state law that took effect in October makes the donor indication on the license a legally binding document.

People also can visit the N.C. Coalition on Donation online to download an organ-donor card. A way to register online is expected to become operational later this year.

McMillian began volunteering to help with organ-donation education efforts after her transplant. Working through a volunteer group affiliated with Carolina Donor Services, the federally designated organ-procurement agency for this area, she has spoken to schools, health fairs and religious and civic groups.

"It's important to get the information out to the public so they can be educated and make an informed decision on being an organ donor," she said.

Even if it means putting her face on the side of a truck.

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Bone marrow transpant operation a success

From Chronical Live in the UK:

BACK from the brink, Jack Close grins after being told his swap op was a success.

Doctors told the eight-year-old his bone marrow transplant went well.

Medics broke the news to Jack’s anxious family just as they were concerned he was taking a turn for the worse.

His dad Bryce, 48, said: “It’s fantastic. We weren’t expecting them to know how he was doing until the weekend but the doctors came in and told us the new bone marrow has won against the old.

“For a few days he was great but then he got poorly, he was sick a few times and had a temperature. The doctors weren’t sure whether that was the old bone marrow or the new bone marrow coming through.

“We knew he had to get worse before he could get better. In fact the reason he was poorly was because the new bone marrow was working.”

The Chronicle launched the Give Jack a Chance campaign in September asking people in the North East to register as blood marrow donors in the hope of finding a match.

The Rowlands Gill Primary School pupil suffers from a blood condition, chronic granulomatous disorder, which is destroying his immune system.

The condition means cells in his marrow cannot fight off bacteria and Jack is left open to infection.

Hundreds turned up to a donor session organised by his parents and the Anthony Nolan Trust in his home village of Rowlands Gill, wanting to go on the list of potential donors.

Happily a match was found in October and he was admitted to Newcastle General Hospital where he was given a course of chemotherapy in preparation for his operation on February 28.

Despite losing his hair because of the treatment, Jack is said to delighted.

Bryce said: “He was still feeling very poorly when the doctors came round. But when I explained to him what it meant he perked right up. It’s such a relief for him and everyone.

“I’ve rung all our family and his friends to tell them and everyone’s so happy. Now we can really enjoy Easter.”

Taxi driver Bryce, dinner lady mum Laura, 39, and Jack’s sister, 12-year-old Lyndsay, are now hoping they will soon be able to welcome him home, although he will have to be kept in isolation to prevent him catching any infections.

Bryce added: “The way the doctors are talking he might get out for a walk around the hospital in a week or two. And several days after that he will be able to go home, although he will have to come back for tests.”

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Fund-raising ball to celebrate heart transplant milestone

From the Sunderland Echo in the UK: HEART transplant success Kaylee Davidson will be 21 next month – and there will be a big fund-raising party to celebrate the milestone.

The Northern Transplant Charity Ball will be held on Saturday, April 26, – two days before her birthday.

Kaylee became an inspiration for all transplant patients when she made medical history at the age of five months by becoming Britain's youngest successful heart transplant baby.

Now one of the longest-surviving heart transplant babies in the world, she has represented the UK at the World Transplant Games.

Kaylee's mum Carol, of Biddick Woods, Houghton, said: "She's really looking forward to the day and plans to celebrate with friends, as well as attending the charity ball."

In October, Newcastle's Freeman Hospital marked the 20th anniversary of Kaylee's transplant, when she got the chance to speak via a video link with her surgeon, Christopher McGregor, who is now based at the Mayo Clinic in the United States.

The heart transplant programme was started at the Freeman Hospital in 1985 by Mr McGregor and since then there have been many well-publicised milestones and innovations.

It was at the Freeman that the first successful single lung transplant in Europe was carried out, and this was followed by many other pioneering operations, including heart and lung, double lung, and live lung transplants. Read the full article.

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Donate an organ, save a life

From Trinidad & Tobago's Newsday:

SAMANTHA Pierre is a determined vibrant, bubbly and courageous young woman who is living with a life threatening condition — her kidneys have failed.

Pierre was diagnosed with renal failure two years ago and since then she has been enduring dialysis treatments at least three days a week to stay alive. If she does not get treatment, she will die.

Patients usually require dialysis when the kidneys lack the ability to cleanse the body of waste products. The waste products in the body become so high that patients become sick.

Many people do not even realise they have the illness until their condition deteriorates, as in the case of Pierre.

Pierre, a storyteller/teacher who uses storytelling as a tool to educate children regionally, was completely ignorant of the illness. Her only knowledge of renal failure was that people living with HIV/AIDS succumb to the illness.

“Before I was diagnosed with the illness, I associated it with AIDS. I never knew exactly what renal failure was. In fact, in 2006, when they told me that my kidneys had failed, I wanted to know how I contracted AIDS.

“I broke down, trying to figure out how I was going to deal with it. Eventually, they told me that they would put my name on a list for dialysis. I knew the list was long. They told me once they found a slot for me for treatment, the cost would have been subsidised by the government.

“I worried about finding the funds to pay for treatment. Then they told me I had to talk to a social worker to determine my financial situation,” Pierre explained.

The number of people needing a transplant continues to rise faster than the number of donors. Right now, there are approximately 500 people in TT in need of kidney transplants and the number grows by 40 each year. A very large number of people die each year waiting for a transplant.

For those who need dialysis treatment and are not fortunate to get it for free, the cost is overwhelming. In some cases a patient pays $1,000 a day for treatment. The life saving treatment can cost a patient up to $3000 —$4,000 a week.

Eventually, Pierre was signed up with the National Organ Transplant Unit, at Eric Williams Medical Sciences Complex, where she receives free dialysis treatment for four hours, three days a week. However, there is only one thing that stands between the hard working mother and living a long fruitful life - she desperately needs an organ donor. Read the full article.

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Organ donors' families refusing consent

"People waiting for transplants can and do die. That is why it is so important to make sure that if you would like to donate organs in the event of death that your family are aware of your wishes."

From the Belfast Telegraph in Northern Ireland:

Nearly half the families of people on the Organ Donor Register in Northern Ireland who died between 2005 and 2007 refused to give consent for a transplant to take place, the Belfast Telegraph reveals today.

Almost as many people waiting for a transplant in Northern Ireland have died since 2005 as the number of families here who said they did not want their loved ones' organs being used to save a life.

According to shock figures held by UK Transplant, 104 families of potential deceased donors were approached between the beginning of April in 2005 and the end of March in 2007 - only 56 gave consent for organs to be used.

During this period, 35 people on the organ transplant list died - nine of whom were waiting for a kidney, seven for a liver, three for a new heart and one person required a heart and lung transplant.

In total, 667 transplants have taken place since 2003 in Northern Ireland.

There are currently over 396,433 people residing in Northern Ireland on the UK Organ Donor Register and 313 people on the UK Transplant waiting list.

The majority of these are waiting for a kidney transplant.

People signing up to the register or those who are already on the register were last night urged to ensure their families are aware of their desire to donate organs in the event of their death in order to save as many lives as possible.


Joining the register records your agreement to the use of your organs and tissue for transplantation after your death.

Eleanor Donaghy, regional transplant co-ordinator based at Belfast City Hospital, explained: "People who require kidneys are slightly better off than other patients waiting for transplants because there is a treatment which can keep them alive.

"They can undergo dialysis but life is very restricted. You must attend hospital for your dialysis treatment on a frequent basis and if you don't you will die."

Ms Donaghy explained that the outlook for patients waiting for other organs is even more bleak: "If you need another organ, like a liver, you don't go onto the waiting list until your life expectancy is about six months because so few organs are available.

"People waiting for transplants can and do die. That is why it is so important to make sure that if you would like to donate organs in the event of death that your family are aware of your wishes.

"In my experience I have never had a family refuse the wishes of their relative but that doesn't mean it couldn't happen. Donation happens at a time of great emotional trauma for a family and if it comes as a shock that the person is on the Organ Donor Register that makes the decision even more difficult. It is better if there isn't that shock factor."

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Lung transplant pioneer to visit Pembroke

From The Daily Observer in Ontario, Canada:

Pembroke and area residents will have the opportunity to meet a surgeon who, in 1983, assisted in the first successful lung transplant in the world.

Dr. Thomas Todd will be at the Wesley United Church Fellowship Hall on Thursday, March 27, for a luncheon and book signing at noon.

In 1983, Dr. Todd was 38, and the youngest member of a team of surgeons at the Toronto General Hospital. This group of innovators established the legacy of thoracic surgery and lung transplantation that earned the hospital a reputation as one of the world's leading transplant and research centers.

Dr. Todd has written about his experience in his book, Breathless: A Transplant Surgeon's Journal. In the book he writes of the drama of donor runs - often accompanied by the bells and whistles of police escorts.

This personal account also chronicles the difficulties of early procedures, and the improvements that occurred over time.

Tickets for the luncheon are available Algonquin College, Room 214; at Turbo Graphics, the Pembroke Mall office, and Fraser's Flowers.

Dr. Todd will be donating the proceeds of his book sales to Algonquin College for a bursary for students. After the luncheon, he will visit the college as a guest lecturer for nursing students. He will also be at a reception with local health care professionals later in the afternoon.

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Breathless: A Transplant Surgeon’s Journal

Publisher's Press Release
Breathless A Transplant Surgeon’s Journal (270pp, $19.95) by Dr. Thomas R.J. Todd, is primarily a book about people. It relates the human interest stories of lung transplant patients both before and after the team at the University of Toronto performed the world’s first successful single and double lung procedures.

Dr. Todd, who was a member of the original surgical team, participated in many of the early procedures and eventually became the program’s director.

He writes of his adventures with donor runs—including the “bells and whistles” of police transport from airports—and his relationship with his colleagues, staff, and, most importantly, his patients. This personal account, along with the difficulties around the early procedures and the improvements that occurred over time, make for fascinating reading.

Enjoy this sometimes sad, sometimes humorous, but always courageous and inspirational inside look into a remarkable human drama whose real-life characters are true pioneers in Canadian medicine.

Breathless A Transplant Surgeon’s Journal (ISBN#978-1-897113-54-7), by Dr. Thomas R.J. Todd, is published by General Store Publishing House, Renfrew, Ontario, and retails for $19.95. Contact Ann Forgie: Tel: 1-800-465-6072 Fax: (613) 432-7184 or Email.

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Presumed Consent and Organ Transplants: The Spanish Connection

As more and more countries are studying the adoption of "presumed consent" for organ donation, such as the UK and Australia, India's authorities have proposed a law that would place such a policy in force within a few months. However, this article notes that religion and culture may combine to stir up a major controversy.

From MSN News:
It’s on paper, and would be in force in the country within three months. At least that’s what Union Health Minister Anbumani Ramadoss has proposed after his team got lured by the Spanish model.

Hold; do not assume the model to be a belle from Spain. She is just a human organ transplant law India is about to adopt from the West. A model which is likely to fall off the ramp.

The reason: It would not be an easy affair for the Government to force the concept of `presumed consent’ in a religiously and culturally sensitive country like India.

Aimed to tackle the shortage of organs for transplant, the law will enable the government to harvest the organs of all brain dead people in government hospitals; that too without the consent of relatives.

The near and dear ones can raise an objection. But only if the brain dead person has specifically stated that he or she is against organ transplant.

One of the amendments proposed in the Transplantation of Human Organs Act, 1994, the legal `harvest’ is supposed to begin with cornea. Other organs will be harvested only at a later stage as the Ministry wants people to learn about presumed consent first.

And, the amendment was initiated after the police unearthed a multi-billion dollar kidney transplant racket in Gurgaon, on the outskirt of Delhi in January.

Though it is expected that the `presumed consent’ will check illegal organ trade and help scores of visually impaired, Ramadoss seems to have ignored the larger implications of this concept.

People here hold the dead dearer to their hearts and it could stir up a major controversy.

It would be totally foolish for him to presume that the presumed consent’ will lead to increased donor rates in India like in Spain. The team headed by the Director General of Health Services R.K. Srivastava, had preferred this model to those existing in US, Iran, Belgium, France and Singapore.

Though eye donation is an accepted practice in India, removal of other vital organs from the cadavers or brain dead patients is likely to be objected by relatives. With a huge population of illiterates and less-educated, the country will have to face repeated law and order problems once the concept is introduced.

Even in the United States, it is mandatory for the hospitals to get the consent of the immediate kin for organ donation. Being more ritualistic, the Indians will be lot more unhappy if the hospitals proceed to cut open their dear ones’ mortal remains without any consent.

Besides, the Ministry has to guard against the possible misuse of the law by the government medical practitioners, who are not free of corruption and unethical practices.

And the Ministry’s job doesn’t end with the setting up of Organ Retrieval and Banking Organisations (ORBO). Strict monitoring has to be in place before allowing the centres to harvest organs, that too with `presumed consent’.

Let not the Health Ministry’s Spanish connection turn a bloomer.

Source: Indiasyndicate.

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Lung transplant recipient Gill Hollisfronts TV organ-donor drive to save lives

"Some of the people I have talked to have died while still on the waiting list. That has really brought home to me the shortage of donors. It's not just a statistic. I saw people dying for the want of organs, and they were people just like me.

"There's no way I can thank the donor's family and doctor enough, but I can raise awareness about this awful shortage of organs."

From The Scotsman in the UK:
WHEN Gill Hollis went to see a consultant four years ago she told him she didn't think she would see another Christmas. The investment banker had gone from being sporty and adventurous to virtually housebound because of a lung disease.

But – after a lifesaving transplant – she is now to appear on television urging more people to become organ donors.

The Scottish Government asked her to be one of the faces of their new campaign of one-minute films on STV.

Mrs Hollis, 43, who lives in the New Town, had suffered from lymphangioleiomyomatosis (LAM), a degenerative lung disease, for about 20 years when she spoke to her consultant in January 2004.

The disease had slowly sucked the life out of her, and by then she needed oxygen treatment round the clock and was barely able to get out of her chair.

She was put on a transplant list in July 2003 and had waited seven agonising months for a donor to come forward.

"By that stage I knew it was my only chance of survival so I was really excited when the call came through," she said.

"I'd had a false alarm before so I was hoping so much that it would go through."

The operation took place at Freeman Hospital in Newcastle, one of three specialist centres in the UK and the nearest to Edinburgh. Mrs Hollis said: "I had spent a couple of years where I could not go out of the house very much. Just to be able to go to the cinema, or for dinner with friends, or play with my nephews is wonderful."

She makes time between her hectic work schedule and social life to help others who have not been as fortunate as herself, and has spoken at conferences urging people to join the register.

"I counsel people who are on the waiting list," she said.

"Some of the people I have talked to have died while still on the waiting list. That has really brought home to me the shortage of donors. It's not just a statistic. I saw people dying for the want of organs, and they were people just like me.

"There's no way I can thank the donor's family and doctor enough, but I can raise awareness about this awful shortage of organs."

About 700 people are waiting for a transplant in Scotland, and almost 8000 in the UK as a whole, many of whom will die if more donors do not come forward.

However, less than one-in-three Scots are on the register.

Health Secretary Nicola Sturgeon said: "The shortage of donor organs for transplantation is an increasingly acute problem and we are determined to tackle this.

"One of the greatest successes of modern medicine is organ transplantation. We only need to look at the extraordinary recent achievement of the transplant unit at the Edinburgh Royal Infirmary in carrying out the first living donor liver transplant.

"But that is a reflection of the steps people are having to take to compensate for the lack of organs from deceased people."

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New Cystic Fibrosis Model Sheds Light on Harmful, Drug Resistant Lung Infections

Pseudomonas has long been a problem for lung transplant patients with Cystic Fibrosis because of the difficulty in treating it. This study shows that researchers are trying hard to discover why it is so resistant to antibiotics in an effort to find ways to eradicate this stubborn infection.

News release from Dartmouth Medical School:
Using a promising model they devised to study the stubborn lung infections that plague cystic fibrosis (CF) patients, Dartmouth Medical School researchers have discovered strikingly strong resistance to conventional antibiotics, and suggest that the intense therapy needed to combat infection may contribute to its persistence.

The novel tissue culture system can help provide insights into the unique interactions between the tenacious microbial colonies and their host and lead to the development of effective therapies to eradicate the damaging infections.

The work, published online for the April Infection and Immunity, and cited as a "Spotlight" article, was led by DMS professors George O'Toole of microbiology and immunology, and Bruce Stanton of physiology. It builds on the expertise of Dartmouth's interdisciplinary Lung Biology and Cystic Fibrosis Research Development programs that focus on the common inherited disorder. Study coauthors are postdoctoral fellows Greg Anderson and Sophie Moreau-Marquis.

Patients with cystic fibrosis are vulnerable to chronic lung infections of the bacterium Pseudomonas aeruginosa, which establishes itself in the airways and defies treatment. The bacteria cluster in communities called biofilms, and are far more impervious to a broad range of antibiotics than their counterparts swimming about freely.

Biofilms can grow many places--on metal or plastic or in animal tissues -- but most studies to date have focused on nonliving surfaces as models for medical implants, catheter lines or artificial joints, where the biofilm populations are relatively common.

"This is really the first model system to look at biofilms on airway cells and a model for understanding interactions between bacteria and the host in the context of cystic fibrosis. We think formation of biofilms on airway cells and this high level of intrinsic resistance in part explains why antibiotic treatment fails in patients," said O'Toole.

The genetic defect in cystic fibrosis causes abnormally profuse mucous production that clogs the lungs, providing a slimy environment for the bacterial biofilms to breed. Therapies can improve lung function, and reduce, but do not clear the infections, which typically begin in teen years or earlier. Biofilm pockets escape treatment, becoming more harmful over time.

The immune response patients mount entails recruiting cells that produce inflammation. "This same mechanism the body normally uses to kill bacteria also can damage host tissue if immune responses are excessive and long-term," O'Toole explained. "So partly due to chronic immune response and partly to factors the bacteria make, there is progressive lung damage, impairing function, leading to respiratory failure and shortened lifespan."

The DMS team developed a model for biofilm formation on bronchial epithelial cells, using cells derived from a CF patient with the most common mutation - a missing amino acid. They allowed airway cells to grow, infected them with P. aeruginosa to colonize as biofilms, then tested their response to tobramycin, the antibiotic routinely used against the infections.

The most striking aspect of the airway models was their high antibiotic resistance, far exceeding levels in the plastic or glass surfaces used for implant models, O'Toole noted. It took 25 times more tobramycin to kill the P. aeruginosa biofilms grown on the airway cells than was needed for the same communities grown on plastic.

"The biofilms we see on airway cells are resistant to antibiotic levels 10 times greater than what can be delivered to a patient. The most tobramycin that can get into the lung of CF patients is about 1,000 micrograms/ml and biofilms have a resistance to greater than 10,000," O'Toole said.

Adding to the complexity, genetic analysis of the antibiotic-treated biofilm colonies indicated that tobramycin regulates genes involved in bacterial virulence. The researchers identified a gene mutation that may influence the tenacity and toxicity of biofilms on airway cells.

The next steps are to use the model system to delineate the basic biology to help understand why these bacteria are so resistant, especially on airway cells, and to test therapeutics, O'Toole said. "One of the rationales we're excited about is the preclinical aspect, before things go into a patient, to test to see how effective they are."

Additional studies on the advantages of the system are in press.

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Egypt's organ donors: Looking within for wealth

We recently read about the black marketing of kidneys in India and Pakistan that is fed by the poverty stricken laborers who are willing to sell a kidney in an effort to improve their lot in life. Now we read about the tragic situation in Egypt and as the article notes, there are no laws and little oversight governing organ transplants.

From the Los Angeles Times:
A thriving black market exists to match those in need of money with those in need of a transplant.

CAIRO -- He sits quietly at the corner cafe, a gold watch flickering on his wrist. If you need a liver, or want to sell a piece of yours, grab a chair and get acquainted with Mustafa Hamed, a 24-year-old ex-bus driver who fell unexpectedly into a life as a broker in human organs.

Hamed's 4-year-old son, Mohamed, was dying of cancer and needed an artery transplant that cost $5,000. The only savings Hamed had was what he fished from his pockets at the end of the day.

There was another way, one whispered about for those with nothing. A man could wager part of himself, slip into a hospital gown, and wake up with an incision above the gut.

Hamed sold a section of his liver for a bit more than the price of his son's operation. The boy died in surgery.

With his scar healing and his son buried, Hamed, whose knowledge of anatomy would perhaps fill a single page, decided that driving a bus was not the fate of the man he wanted to be. He brokered his first liver deal four months ago. He earned $900. Four more sales have followed.

"Things shouldn't be this way, but they are," he says. "I sold part of my liver to save my son. I had to do it. . . . You cut your body and sell your pieces. But some people who come to me aren't that desperate. They could find other solutions. Many men I see now want to sell their organs so they can afford to buy an apartment to get married. That doesn't seem desperate enough to me. I try to tell them: 'Be patient. You don't need to do this.' "

Patience and desperation move in curious currents in Cairo. Nearly half of Egyptians live in poverty, and although the nation's economy is privatizing and growing, inflation is crushing the poor and working class. The price of green peppers has risen 90% in the last year.

Thousands have moved to the richer Persian Gulf; many have put off marriage, a delay that in Egypt is the stinging sign of a man's failure. Others, such as Hamed, have bartered kidneys and livers to pay off debts and reinvent dreams.

Similar tales echo around the globe. Human organs are brokered from Pakistan to China; kidney-theft rings have swept through villages in India. The poor in underdeveloped nations, such as Moldova and the Philippines, are offered "transplant tourism" packages that arrange for them to travel to another country and sell their organs to rich patients. It is a market of desperation and ingenuity in which doctors ask few questions and donors often end up ill, and sometimes dead.

The business has thrived for years in Egypt. The country has no laws and little oversight regarding most transplants. Statistics are unreliable. Medical groups estimate that as many as 500 unlicensed kidney transplants are performed each year, but a legislator investigating the practice indicated that the actual number is much higher.

Donors and patients in Cairo know where to go. There are cafes near clinics and labs where the brokers sit, stirring tea and smoking, cellphones buzzing like insects on the tables.

Those needing organs are easy to spot. They carry X-rays and blood work charts under their arms. Some are ashen, some drawn; they need what they need quickly. They come from Upper Egypt and the Nile Delta, their purses and wallets bulky with borrowed money, and if they're lucky enough they'll be able to hire the Japanese transplant surgeon who flies in once a month.

"My doctor told me to come to this place," says an agricultural engineer from Upper Egypt who was shopping for a kidney near a lab in Cairo's Dokki neighborhood, where horse carts clatter and puffed bread cools in the breeze.

He will not give his name as he straightens his pressed tunic. "I'm 58 years old. I'm in renal failure and I have no children. I need a donor. Kidneys sell for between 20,000 and 40,000 pounds [about $3,600 to $7,300]. I'm bargaining, but I can't pay more than 30,000 pounds."Read the full story.

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Gran's death saves lives through organ donation

Dale Dunton, a Tyneside, UK grandmother seen here with husband Paul, is being hailed as a heroine in Turkey after her death saved the lives of three people.

From the Chronicle Live in the UK:
Smiling in the picture above with husband Paul, Dale Punton was living her dream after the couple swapped their home in Gateshead for a new life in the Turkish sun.

Sadly, their two years of paradise ended when she collapsed and died from a brain aneurysm at just 50. But by donating her organs, Dale will now live on in the three Turkish people whose lives she has saved.

Her story has touched the whole nation of Turkey, and as the face of a campaign to encourage an act that is rare in the country, her memory could insprire more lives to be saved.

Speaking from their home in Alanya, in southern Turkey, heartbroken husband Paul, said: “It was like a light went out. One minute she was here and the next she had gone.

“She went out onto the balcony to light the barbecue and when she didn’t come back in I went to look for her and found her collapsed.

“The doctors said she had had an aneurysm. It was like a ticking timebomb and could have gone off at any time. But it was such a shock. She was so healthy and we never thought there was anything wrong with her.

“I knew she wanted to be an organ donor so we carried her wish. The reaction here has been amazing. In Turkey organ donation is just something they don’t do. But now Dale seems to have started some kind of campaign to change attitudes.

“Her story has been in all the papers and we’ve been interviewed on the television. It’s all been a circus, but if it can make a difference it will be worth it. She loved life so much I am glad she has been able to give life to others.”

Mum-of-three and grandmother-of-five Dale died on February 29. But she is now setting an example to people in Turkey, where waiting times for organs can be as much as 10 years.

Her kidneys were given to a 61-year-old man and a 50-year-old woman and her liver went to a 31-year-old man. They have spoken on television praising Dale’s generosity and want to meet the family to thank them in person.

Paul, 48, said: “I am happy for Dale as she would have been pleased her organs have been used to help others. Read the full article.

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Starbucks barista donates kidney to one of her regulars

Annamarie Ausnes, left, greets barista Sandie Andersen with a rose on Andersen's arrival at Virginia Mason Medical Center for the kidney transplant surgery Tuesday. All went fine. "If you can save somebody's life, it's special," said Jeffrey Andersen, Sandie's husband. Photo by Paul Joseph Brown.

This story is another fine example of human kindness. A waitress in a coffee shop donated one of her kidneys to a regular customer and is a hero in my book. I know of many other instances where chance conversations have led to a living organ donation, sometimes even when the donor and recipient were complete strangers.

From the Seattle Post-Intelligencer:
Annamarie Ausnes had been visiting her local Starbucks for coffee and small talk with the barista for three years. During their conversations, they talked about almost everything, but Ausnes never once mentioned her failing health.

Ausnes, 55, who works at the University of Puget Sound in Tacoma, has known about her polycystic kidney disease for nearly 20 years. The genetic disorder causes numerous cysts in the kidney and eventual kidney failure. When her health suddenly began to decline and her kidneys were functioning at only 15 percent, she knew she needed a transplant.

Had her kidney function deteriorated to 12 percent, she would have faced painful dialysis treatments and possible death. Her only option was a transplant. Her husband and son weren't matches. She was facing a long wait on a transplant list.

One day last fall, she mentioned to Sandie Andersen -- the barista she casually knew through her morning caffeine runs -- that her kidneys were shutting down. Andersen, 51, didn't hesitate. She had a blood test to see if she matched her customer. She did.

Tuesday morning, Andersen donated a kidney to Ausnes at Virginia Mason Medical Center. Now, Ausnes has three kidneys. Surgeons said that unlike a heart transplant, her old kidneys "didn't interfere" with the transplant and she had room for the new one to fit.

After what surgeons called a successful surgery, both women face a few days in the hospital, and weeks of recovery, but are expected to be fine, surgeons said.

Their husbands and family members gathered at the hospital Tuesday afternoon, relieved the ordeal was over and thankful their wives found each other.

"I have felt all along something special was going to happen for my wife," said John Ausnes. "She's a special person and she ran into a special person. We've been married for 30 years, and this was my opportunity to be a supportive husband."

Jeffrey Andersen said his wife was groggy when he visited her immediately after surgery, and admired her selflessness at wanting to help a casual acquaintance.

"If you can save somebody's life, it's special," Andersen said. "It's what Sandi wanted to do."

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GIFT OF LIFE: Plight of patients waiting for new organs

This story is typical of the struggles a lung transplant patient must go through while waiting for their transplant. I can certainly relate to this and I remember all too well the difficulties I had in performing simple tasks such as tying my shoes or trying to climb a set of stairs.

From The Sheffield Star in the UK:
Around 250 people in South Yorkshire and North Derbyshire are waiting for an organ transplant to transform their lives. To launch a regular feature as part of The Star's Gift of Life campaign, Kate Lahive speaks to one woman on the waiting list.

BRAVE Helen Miller finds every day a struggle as she waits for her chance of a life-saving transplant.

The 38-year-old has spent almost a year on the waiting list for a new lung or set of lungs and her health is steadily, getting worse and affecting all aspects of her every day life.

The mum-of-two says the day of her operation can't come soon enough because she can't work, is reliant on oxygen for 24 hours a day and struggles to climb the stairs of her South Anston home.

Just cleaning her teeth leaves her struggling for breath and she feels too exhausted to even raise her arms to dry her hair or put on her make-up.

But Helen, a witty and intelligent woman, refuses to feel sorry for herself and has agreed to contribute a weekly diary about her experience to support The Star's Gift of Life campaign.

She said: "I think people are interested in what it's like for people waiting for a transplant, and if it helps to raise public awareness about organ donation I hope it will make a difference."

Helen had an auto-immune disease as a teenager and developed emphysema, a serious lung disease five years ago.

Gradually her health has become steadily worse as her lungs have deteriorated, until doctors said she needed to join the waiting list for a transplant.

Helen was a busy working mum but her illness has had a dramatic impact on her life. Just leaving the house is far from easy and Helen's mum Pat Eaton, 57, cares for her in the daytime.

She said: "I was very poorly on Sunday and I couldn't get out of bed. On Monday I was sat on the settee.

"On Tuesday I went to see my friends where I worked and I went to Morrison's and on Wednesday I stayed in and spent a bit of time on the computer. On Thursday I saw my friends again."

Helen has to have enough oxygen with her in a portable cylinder and can only be away from home for a few hours at a time because the supply is limited and needs to be topped up.

And then there are the medical appointments to schedule in. On Friday Helen had an appointment with a dietician because her weight has fallen. She now finds it too exhausting to chew, swallow and breathe at the same time so can only eating soft food such as soup.

"Because of the effort involved in breathing and eating you don't feel like eating.I've lost weight but I need to keep my weight up as you need to be at a certain weight to be able to have transplant," she explained.

She's now been given shakes and powders to add calories and nutrients to her diet and hopes this will prevent any further weight loss.

After her appointment Helen had to go home to get more portable oxygen and then she spent three hours at the Northern General Hospital, having treatment to protect her bones from thinning.

It is clearly a tough time for Helen and her family - but she is determinedly optimistic and holds on to the firm belief she will be one of the lucky people who gets a transplant.

"I can't afford to feel sorry for myself," she said. "There are some days when I don't feel positive but I know have to be strong, stay positive and fight on."

Across the UK as many as 8,000 people are waiting for organ transplant but there are not enough donor organs available. Although 3,000 people had organ transplants last year, 1,000 people died while on the waiting list. The Star is aiming to persuade 25,000 readers to sign on to the NHS Organ Donor Register by August, when the 31st Westfield Health British Transplant Games take place in Sheffield.

The Games will bring together hundreds of people who've received organ transplant to celebrate the success of the programme, promote a healthy lifestyle and encourage more people to join the register.

“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