Hospital accepts youngster into transplant program

Braden Gendron, 11, will be moving to Toronto temporarily with his family, who just found out he has been accepted to be put on the list for a double-lung transplant for his pulmonary hypertension. Photo: KâtÈ LeBlanc/Telegraph-Journal

By Erin Dwyer for the Telegraph-Journal - Saint John, New Brunswick

HAMPTON - Eleven-year-old Braden Gendron can't wait to play hockey.

A first-time player, he'll need new skates, a new helmet and a stick.

The Hampton boy will also need a new set of lungs.

Braden suffers from pulmonary hypertension, which occurs when tiny arteries and capillaries in the lungs progressively become narrowed, blocked or destroyed, making it harder for blood to flow through the lungs.

This raises the pressure within the pulmonary arteries, making it harder for the heart to pump blood through the lungs. The lack of oxygen makes people with the disease tired, dizzy and short of breath. There is no known cure for this life-threatening and rare disease, which affects only one or two people in a million, except a double-lung transplant.

Last week, Braden and his parents, Jennifer and Dan Gendron, an RCMP officer, found out their son had been accepted into the Toronto General Hospital's Multi Organ Transplant Program.

"He's actually really excited," said his mother, who owns Lifestyles Health & Fitness Studio in Hampton. "He's really ready and looking forward to it. For me, I know he's ready and that takes a little weight off of us.

"I just think he's gotten to the point where he's feeling so miserable all the time and he's really tired of feeling sick. He's on oxygen all the time now, which bothers him a lot. He doesn't really like to go anywhere and be seen. And he doesn't have much energy to do anything."

Braden was only four when he first began to develop symptoms of pulmonary hypertension. At first, doctors attributed the symptoms to asthma until an echocardiogram taken just before he entered kindergarten revealed his heart was enlarged and led to the diagnosis. At the time, the family was given little information and little hope. They were told he had only two to three years to live.

Since then, Braden has been on medications to slow down the progression of the disease. But in recent months, his mother noticed his health was deteriorating and, in May, Braden developed pneumonia.

"Because he was already struggling a little bit, that knocked the last little bit of fight out of him."

The boy had to go on oxygen 24 hours a day.

Earlier this month, Braden went to the Hospital for Sick Kids in Toronto for an assessment. Doctors found a big change in the condition of his lungs and in his heart function. After many tests and consultation with the family and Braden, doctors recommended the 11-year-old be put on a transplant list.

"They don't want to transplant too soon, but yet it's a very fine line between too soon and waiting too long so that things deteriorate to the point where they think it's too risky to transplant," his mother said.

"People have said, 'Oh this is great. He finally qualifies for a transplant.' Well, it's not a good thing. It's a good thing he's still able to be transplanted. But it's not a good thing where we've got him to the point that he needs to be transplanted."

The family was hoping Braden would be older and bigger before he required a transplant.

"People think that once he gets his lung transplant, he'll be cured," Gendron said. "He'll be cured of his pulmonary hypertension, but there a lot of things that can go wrong with a lung transplant. It's not a quick fix and he'll be on medications for the rest of his life for rejection. There are a lot of risks and complications along the road."

Braden won't officially be placed on the transplant list until he lives close to the Toronto hospital. Next month, he, his parents and his nine-year-old twin brothers, Rylan and Jarrett, are making the move for what could be a long wait for a donor. Doctors have told them a lung donor his age could take six months to a year and therapy after the surgery could be several more months.

But if the wait is too long, Braden could also require a new heart.

"As long as he gets a transplant fairly soon, they are looking at just lungs," Gendron said. "But if his condition deteriorates any further, then the possibility is there that he may need a heart-lung transplant."

That's something that's never been done on a child at the Toronto hospital.

"They are prepared to do one, but they've never actually done one," Gendron said.

In the meantime, Braden is excited about the news.

"He's always said he never liked hockey," his mother said. "He didn't like sports. I think it was a coping mechanism because when he found out he qualified for a lung transplant, one of the very first things he said was, 'I'm going to be able to play hockey.'"

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

Register to be a donor in Ontario or Download Donor Cards from Trillium Gift of Life Network. NEW for Ontario: recycleMe.org - Learn The Ins & Outs Of Organ And Tissue Donation. Register Today! For other Canadian provinces click here

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

In Great Britain, register at NHS Organ Donor Register

In Australia, register at Australian Organ Donor Register

Your generosity can save up to eight lives with heart, kidneys, liver, lungs, pancreas and small intestine transplants. One tissue donor can help up to 100 other people by donating skin, corneas, bone, tendon, ligaments and heart valves

Has your life been saved by an organ transplant? "Pay it forward" and help spread the word about the need for organ donation - In the U.S. another person is added to the national transplant waiting list every 11 minutes and 18 people die each day waiting for an organ transplant.

Alfre Woodard to star in 'Three Rivers' - New organ transplant drama on CBS this fall

Viewers can catch all the drama about organ transplantation starting Sunday, October 4th on CBS at 9/8c.

Alfre Woodard replaces Julia Ormond from the pilot, playing Sophia Jordan, head of surgery at Three Rivers Hospital. The show follows the drama of organ transplants from three points of view: the donors, the recipients and the doctors.

Show Synopsis - from the Three Rivers web site

THREE RIVERS is a medical drama that goes inside the emotionally complex lives of organ donors, the recipients and the surgeons at the preeminent transplant hospital in the country where every moment counts. However, dealing with donor families in their darkest hour and managing the fears and concerns of apprehensive recipients takes much more than just a sharp scalpel. Leading the elite team is Dr. Andy Yablonski (Alex O'Loughlin), the highly-skilled workaholic lead organ transplant surgeon, whose good-natured personality and sarcastic wit makes him popular with his patients and colleagues. His colleagues include Dr. Miranda Foster (Katherine Moennig), a surgical fellow with a rebellious streak and fiery temper who strives to live up to her deceased father's excellent surgical reputation; Dr. David Lee (Daniel Henney), a womanizing surgical resident who's broken as many hearts as he's replaced; Ryan Abbott (Christopher J. Hanke), the inexperienced new transplant coordinator who arranges the intricately choreographed process of quickly and carefully transporting organs from donor to patient; Dr. Sophia Jordan, the head of surgery and a dedicated medical professional; and Pam Acosta (Justina Machado), Andy's no-nonsense operating assistant and best friend. In this high stakes arena, in which every case is a race against the clock, these tenacious surgeons and medical professionals are the last hope for their patients.

NOTE: Read more about the cast and their attitudes about organ donation at TV Guide

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

Register to be a donor in Ontario or Download Donor Cards from Trillium Gift of Life Network. NEW for Ontario: recycleMe.org - Learn The Ins & Outs Of Organ And Tissue Donation. Register Today! For other Canadian provinces click here

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

In Great Britain, register at NHS Organ Donor Register

In Australia, register at Australian Organ Donor Register

Your generosity can save up to eight lives with heart, kidneys, liver, lungs, pancreas and small intestine transplants. One tissue donor can help up to 100 other people by donating skin, corneas, bone, tendon, ligaments and heart valves

Has your life been saved by an organ transplant? "Pay it forward" and help spread the word about the need for organ donation - In the U.S. another person is added to the national transplant waiting list every 11 minutes.

Florida launches organ and tissue donor registry

Congratulations to Florida state officials for their initiative in establishing an on-line registry where Floridians can sign up to become organ, tissue and eye donors. Previously state residents indicated their preference to be an organ donor on their driver's license. Those who have become donors on their license are encouraged to sign-up and register on line as well.

Florida now joins a growing list of U.S. states that have on-line registries. For a list of Donor Designation (First Person Consent) Status by state please visit UNOS Newsroom fact sheets.

Also, please see Donate Life America's National Donor Designation Report Card

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

Register to be a donor in Ontario or Download Donor Cards from Trillium Gift of Life Network. NEW for Ontario: recycleMe.org - Learn The Ins & Outs Of Organ And Tissue Donation. Register Today! For other Canadian provinces click here

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

In Great Britain, register at NHS Organ Donor Register

In Australia, register at Australian Organ Donor Register

Your generosity can save up to eight lives with heart, kidneys, liver, lungs, pancreas and small intestine transplants. One tissue donor can help up to 100 other people by donating skin, corneas, bone, tendon, ligaments and heart valves

Has your life been saved by an organ transplant? "Pay it forward" and help spread the word about the need for organ donation - In the U.S. another person is added to the national transplant waiting list every 11 minutes.

Placenta-derived Stem Cells May Help Sufferers Of Lung Diseases

This research study caught my attention because I contracted idiopathic pulmonary fibrosis (IPF) and nothing could be done to slow down or reverse the progression of the disease and loss of lung tissue and eventual organ failure. Now, there may be some hope for the future if this stem cell research proves to have a role in the treatment of lung diseases.

Authors: Cargnoni, Anna1; Gibelli, Lucia; Tosini, Alessandra; Signoroni, Patrizia Bonassi; Nassuato, Claudia; Arienti, Davide; Lombardi, Guerino; Albertini, Alberto; Wengler, Georg S.; Parolini, Ornella
Source: Cell Transplantation, Volume 18, Number 4, 2009 , pp. 405-422(18)
Publisher: Cognizant Communication Corporation

IngentaConnect

Abstract:
Fetal membranes (amnion and chorion) have recently raised significant attention as potential sources of stem cells. We have recently demonstrated that cells derived from human term placenta show stem cell phenotype, high plasticity, and display low immunogenicity both in vitro and in vivo. Moreover, placenta-derived cells, after xenotransplantation, are able to engraft in solid organs including the lung. On these bases, we studied the effects of fetal membrane-derived cells on a mouse model of bleomycin-induced lung fibrosis. Fetal membrane-derived cells were infused 15 min after intratracheal bleomycin instillation. Different delivery routes were used: intraperitoneal or intratracheal for both xenogeneic and allogeneic cells, and intravenous for allogeneic cells. The effects of the transplanted cells on bleomycin-induced inflammatory and fibrotic processes were then scored and compared between transplanted and control animals at different time points. By PCR and immunohistochemistry analyses, we demonstrated the presence of transplanted cells 3, 7, 9, and 14 days after transplantation. Concomitantly, we observed a clear decrease in neutrophil infiltration and a significant reduction in the severity of bleomycin-induced lung fibrosis in mice treated with placenta-derived cells, irrespective of the source (allogeneic or xenogeneic) or delivery route. Our findings constitute further evidence in support of the hypothesis that placenta-derived cells could be useful for clinical application, and warrant further studies toward the use of these cells for the repair of tissue damage associated with inflammatory and fibrotic degeneration.

View the full text

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

Register to be a donor in Ontario or Download Donor Cards from Trillium Gift of Life Network. NEW for Ontario: recycleMe.org - Learn The Ins & Outs Of Organ And Tissue Donation. Register Today! For other Canadian provinces click here

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

In Great Britain, register at NHS Organ Donor Register

In Australia, register at Australian Organ Donor Register

Your generosity can save up to eight lives with heart, kidneys, liver, lungs, pancreas and small intestine transplants. One tissue donor can help up to 100 other people by donating skin, corneas, bone, tendon, ligaments and heart valves

Has your life been saved by an organ transplant? "Pay it forward" and help spread the word about the need for organ donation - In the U.S. another person is added to the national transplant waiting list every 11 minutes.

Ontario couple looking for living liver donor

BY JENNIFER O'MEARA The Independent

COBOURG, ON -- Life-long Cobourg residents Reg and Sara Woods are in a race against time, looking for a living liver donor before Mr. Woods’ liver cancer spreads to the rest of his body.

“Time is of the essence. If the cancer spreads anywhere else, they won’t do the transplant,” said Ms. Woods.

Arriving at the Woods’ east Cobourg home, I think I have the wrong house when I find Mr. Woods outside doing yard work in the immaculately cared for lawn and garden.

“Oh yeah, I look after the yard. Yeah, I feel pretty good,” said Mr. Woods.

Inside the house, he admits it was actually during yard work when he first got a pain in his side that would eventually be diagnosed as liver cancer.

“I thought I’d pulled a muscle. Went to the doctor and he spotted a puffiness in my liver area,” said Mr. Woods.

Mr. Woods was diagnosed with hepatoma, a type of cancer that starts in the liver, in November 2008. After six months of testing he was only recently approved as a potential liver transplant recipient. The surgery could save his life.

“We’re just so lucky to get on the transplant list,” said Ms. Woods. “That’s a big hurdle.”

Now the trick is finding a liver donor. Mr. Woods is on the deceased donor list, but there’s no telling how many are on the list before him and how long he might have to wait. Luckily his AB blood type means he can receive a liver from any donor blood type. Patients can wait from 24 hours to three years for a transplant based on the severity of their illness and the availability of a compatible donor organ, according to the Canadian Liver Foundation.

The wait-time for a liver transplant has motivated the couple to look for a living liver donor. If a compatible donor is found, the entire right lobe of the donor’s liver will be transplanted. It’s a major surgery with a five to 10 day hospital stay and two or three month rehabilitation, but within the first few months the liver regenerates to 90 percent of its original size.

“They’ve done over 300 liver transplants at Princess Margaret. They’ve never lost anyone, they’re very careful,” said Ms. Woods.

While waiting for a new liver, Mr. Woods is undergoing a very targeted form of chemotherapy to fight the tumor’s growth. A catheter is inserted through the groin and fed up into the liver so the chemo can be injected straight into the tumor.

“They’re not comfortable,” said Mr. Woods, with a gift for understatement.

He’s hospitalized for a week for the procedure and it takes around a month for him to get his strength back. Mr. Woods will have to do this every four months while he waits for a donor to be found.

The couple is turning to family, friends and the public looking for a donor who will be compatible for Mr. Woods. Their son is helping with the search by starting a blog at http://www.liverfinder.blogspot.com*. The couple is asking anyone interested in being assessed as a potential donor to call Transplant Coordinator Cailin Macleod at 416-340-4800, ext. 7594.

“He’s been fairly comfortable and we’ve carried on. He’s been lucky, he’s felt well,” said Ms. Woods.

“I’m lucky so far but eventually luck runs out,” said Mr. Woods matter-of-factly.

*I would also recommend that Mr. Woods sign up with Matching Donors - Merv.

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

Register to be a donor in Ontario or Download Donor Cards from Trillium Gift of Life Network. NEW for Ontario: recycleMe.org - Learn The Ins & Outs Of Organ And Tissue Donation. Register Today! For other Canadian provinces click here

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

In Great Britain, register at NHS Organ Donor Register

In Australia, register at Australian Organ Donor Register

Your generosity can save up to eight lives with heart, kidneys, liver, lungs, pancreas and small intestine transplants. One tissue donor can help up to 100 other people by donating skin, corneas, bone, tendon, ligaments and heart valves

Has your life been saved by an organ transplant? "Pay it forward" and help spread the word about the need for organ donation - In the U.S. another person is added to the national transplant waiting list every 11 minutes.

British surgeons banned from using National Health Service organs in private transplants

By Martin Delgado Daily Mail

Hospitals will be banned from using NHS organs in private transplant operations under new rules being drawn up by the Government.

The move follows a Mail on Sunday investigation last year which found that surgeons were making up to £20,000 ($32,866 US) a time by operating on private patients from abroad, despite a critical shortage of organs to save the lives of desperately sick people on the British transplant waiting list.

A wide-ranging four-month review by an influential committee of experts has concluded the practice should stop because it is undermining public confidence in the national transplant service.

The reform will be welcomed by patient groups, who say financial considerations should play no role in deciding who receives a donor organ.

Three people die in this country every day while waiting for a transplant. Yet hundreds of British organs have been given to overseas patients in private operations at NHS hospitals – 50 in the past two years alone.

The review was led by Elisabeth Buggins, chairman of West Midlands Strategic Health Authority and a former head of the Government’s Organ Donation Task Force.

She was brought in by then Health Secretary Alan Johnson after this newspaper revealed that one leading hospital, King’s College in London, was giving NHS livers to private Greek and Cypriot patients under a deal struck with their governments, even though there was a waiting list of 400 Britons in critical need of livers.

Five such operations at King’s in a 12-month period were performed by Professor Nigel Heaton, footballer George Best’s former transplant surgeon, earning him up to £100,000 ($164,330 US) on top of his NHS salary of around £200,000 ($328,660 US).

Between January 2003 and December 2007, 111 liver transplants were carried out across the country on European Union patients from outside Britain – 72 of them at King’s. Of those, 47 were from Greece or Cyprus.

Prof Heaton, 54, who lives in a £1million ($1.65 million US) house in Beckenham, Kent, is a controversial figure.

In 2002, he was criticised over his decision to give George Best a liver transplant even though the alcoholic football star ignored warnings that his continued drinking was destroying his health. Best died from multiple organ failure three years after the operation.

Mrs Buggins began her review in March and has had confidential discussions with transplant surgeons and other experts to gain as wide a range of medical opinion as possible on what she has called a ‘complex and sensitive’ issue.

The Government is understood to have accepted her recommendations and Health Secretary Andy Burnham is expected to make an announcement this week.

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

Register to be a donor in Ontario or Download Donor Cards from Trillium Gift of Life Network. NEW for Ontario: recycleMe.org - Learn The Ins & Outs Of Organ And Tissue Donation. Register Today! For other Canadian provinces click here

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

In Great Britain, register at NHS Organ Donor Register

In Australia, register at Australian Organ Donor Register

Your generosity can save up to eight lives with heart, kidneys, liver, lungs, pancreas and small intestine transplants. One tissue donor can help up to 100 other people by donating skin, corneas, bone, tendon, ligaments and heart valves

Has your life been saved by an organ transplant? "Pay it forward" and help spread the word about the need for organ donation - In the U.S. another person is added to the national transplant waiting list every 11 minutes.

Woman, 68, gets double-lung transplant after 10 false alarms

Congratulations to Jill Lane on celebrating the first anniversary of her lung transplant July 3rd, 2008. I wish her many more years of happiness in her second chance at life. I can't imagine the disappointment of having one false alarm, let alone ten. I've met Jill on several occasions and and admire her positive attitude and resolve.

No more false alarms for double lung transplant recipient Jill Lane.
Photo: Maggie Riopelle

By MAGGIE RIOPELLE The Tribune - Welland, Ontario

WELLAND — For eight years, Jill Lane spent her life attached to an oxygen tank, gasping for air, weakening as the days crept by.

After 10 false alarms over a donor being available, Lane was starting to wonder whether she would ever get the double lung transplant she needed. Especially when the call came in the middle of the night just one week later — again, a possible donor.

“It’s difficult on you, psychologically,” said Lane. “I got on the list in March of 2005 and was on it for two and a half years.”

This time when she got the call, Lane didn’t even bother packing her bags when she left her Welland home for Toronto. Her daughter, who was about to leave on a two-week vacation, instead also made the trip to Toronto with her mother and father.

This time, however, it was no false alarm, Lane was prepped for surgery and 10 hours later had two new lungs.

“It’s like a blur,” said the 68 year-old mother of three. “All of a sudden, that was it. It seems you always get things when you least expect them.”

Lane was born with a genetic disorder known as Alpha-1, which results in low levels or no levels of protein in the blood.

It was a condition she had all her life, but her doctors didn’t even know of the disorder until the 60s. So while she exhibited the symptoms, Lane didn’t get diagnosed until 2000 — up until that point, she thought she had asthma and emphysema. She was also susceptible to lung infections and pneumonia.

“It was a bit of a shock that I had a terminal incurable genetic disease,” she said.

Shortly after her diagnosis, Lane was put on oxygen 24 hours a day, seven days a week. While the oxygen was a necessary step, Lane said it took away much of her independence and created many fears.

She could no longer garden, play golf or play with her grandchildren. She worried every time she left the house that her destination might include a flight of stairs. She couldn’t drive her car and worried her oxygen tank would freeze up and leave her breathless and alone.

“It’s heavenly not dragging around the chord ... sometimes I go to blow my nose and I go to move it. It was so much a part of me, you know,” she said, adding that while the oxygen tank prolonged her life, it definitely didn’t make living much easier.

“I tried to get out as much as possible. It’s hard to get out when you’re on oxygen, you’re so weak. There must be loads of people on oxygen who don’t get out.”

Lane said the double lung transplant is “freedom,” a true “miracle” in that now she hardly recalls life with an oxygen tank and its chords.

Worry is now a thing of the past.

“I was always worried about stairs, now I just go out. I used to always worry about parking close enough ... people on oxygen have to worry all the time.”

While Lane was ill, she just couldn’t let go of her golf clubs. Now if the weather would co-operate, she looks forward to going out on the green. This spring, she also decided to go “hog wild” on her neglected garden. She can play ball with her grandchildren.

It’s been a year since the surgery and while Lane is still on about 20 pills a day, her anti-rejection medications are being lowered and overall, she feels quite healthy. The hardest part during this whole process, she said, was the wait for the transplant. She did, however, make a lot of friends who were also on the transplant list, some didn’t make it, others are doing very well.

“I’m really not complaining. A lot of people don’t make it. People on the list, waiting for lungs, are very ill. I was 110 pounds, gasping for air. I have almost forgotten what it was like. It’s a miracle, it’s amazing.”

While there is no cure for Alpha-1, Lane said the disease takes so many years to wreak havac on the lungs, it shouldn’t been an issue for the rest of her life. As far as every knows, she is the only family member with the disorder although her children are carriers of Alpha-1.

Lane said she now celebrates two birthdays — the day she was born and the day of her transplant, July 3. She celebrated the first anniversary of her transplant with a few other lung transplant recipients she has met along the way including Don Roy and Darryl Burdon of St. Catharines and Doug Summerhayes of St. Anns.

While Lane was never one to think a lot about signing a donor card — she now recognizes the importance of giving the gift of life to others.

“It’s only because of some family’s generosity that I was able to survive,” she said. “I was able to send a card to the family, thanking them for their sacrifice in their time of sorrow, for deciding to do that. It’s totally anonymous. I’ll never know who my donor was and that’s fine with me.”

According to the Trillium Gift of Life Network, one organ and tissue donor can save up to eight lives and enhance as many as 75 more.

People can register their consent to donation online at www.giftoflife.on.ca. As well, when people register for or renew a health card in Ontario, they can also register consent to donate organs and tissue and the information is stored in a Ministry of Health and Long-Term Care database and passed on to Trillium Gift of Life Network.

On the site, the transplant wait list includes 294 waiting for a liver, 1,201 for a kidney, 48 for a lung, and 44 for heart transplants. In total, there are 1,607 n the transplant wait list in Ontario.

Lane said she is supportive of any changes to the laws that helps increase the number of organ and tissue donors in the province — including presumed consent unless people specify that they do not want to donate.

“I think 98% of people would,” she said, adding that in discussions with others about organ donations, most would be willing.

It’s important, she said, to get the information out there and having been a transplant recipient and survivor, Lane never lets an opportunity pass by to inform people about the importance of organ donation.

“Don’t forget to sign your donor cards, we know that’s what saved our lives,” said Lane.

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

Register to be a donor in Ontario or Download Donor Cards from Trillium Gift of Life Network. NEW for Ontario: recycleMe.org - Learn The Ins & Outs Of Organ And Tissue Donation. Register Today! For other Canadian provinces click here

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

In Great Britain, register at NHS Organ Donor Register

In Australia, register at Australian Organ Donor Register

Your generosity can save up to eight lives with heart, kidneys, liver, lungs, pancreas and small intestine transplants. One tissue donor can help up to 100 other people by donating skin, corneas, bone, tendon, ligaments and heart valves

Has your life been saved by an organ transplant? "Pay it forward" and help spread the word about the need for organ donation - In the U.S. another person is added to the national transplant waiting list every 11 minutes.

New York man accused of trying to broker kidney sale

Other news reports said the 'donor' was paid $10,000 for the kidney while the recipient paid $160,000 for it. A net profit of $150,000 for the broker. I wonder if this isn't just the tip of the iceberg and that this sort of illegal trade in human organs is more widespread?

NEW YORK (CNN) -- One of the sweeping criminal complaints unveiled Thursday in New Jersey against 44 public officials and others includes a New York man accused of trying to arrange the private sale of a kidney from a donor in Israel.

Levy Izhak Rosenbaum, who lives in Brooklyn and is not a licensed physician or medical professional, faces charges of acting as a human organ broker. He offered to obtain a kidney for an undercover FBI agent and a confidential witness working for authorities, the criminal complaint says. The price was $160,000.

"I am what you call a matchmaker," Rosenbaum is quoted as saying at a July 13 meeting with the two undercover agents.

The undercover FBI agent told Rosenbaum one of her uncles needed a kidney because he had been on dialysis for two years and on a transplant list at a Philadelphia hospital, the complaint says. The first meeting took place at Rosenbaum's home on February 18, 2008, three days after the confidential witness contacted Rosenbaum by telephone, the document says.

At that meeting, the complaint alleges, Rosenbaum said he could obtain a kidney for $150,000. He later raised the price to $160,000.

"I'm doing this a long time," the complaint says Rosenbaum told the two agents. He then added: "Let me explain to you one thing. It's illegal to buy or sell organs. ... So you cannot buy it. What you do is, you're giving a compensation for the time."

At their last meeting, on July 13, Rosenbaum said he had been arranging kidney sales for 10 years, the complaint says. Asked how many transplants he had brokered, Rosenbaum is said to have responded, "Quite a lot. ... Quite a lot."

Rosenbaum also told the agents he had brokered a transplant two weeks before their meeting, the document says.

According to the complaint, the undercover FBI agent called a person who was the recipient of a kidney brokered by Rosenbaum, who had provided the telephone number as a reference. The person, a New Jersey-area resident identified in the complaint as Recipient 2, had paid cash for the kidney a little more than a year before the February 2009 call. The surgery was performed at a hospital outside the New Jersey area.

Asked about the donor's motive, the kidney recipient replied, "I guess he needed the money," according to the complaint.

All of the donors "come from Israel," Rosenbaum is alleged to have said.

The price had gone up to $160,000, he said, because "it's hard to get people," noting that Israel had passed laws prohibiting the sale of human organs, the complaint states.

The agents had already paid $10,000 and were told to bring another $70,000 at a meeting scheduled for this week. "I prefer you do it with cash," the complaint quotes Rosenbaum as saying.

The remaining $80,000 would be due "when I get the donor in the hospital, check them out," the complaint says.

***********
Also read the extensive New York Daily News report.

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

Register to be a donor in Ontario or Download Donor Cards from Trillium Gift of Life Network. NEW for Ontario: recycleMe.org - Learn The Ins & Outs Of Organ And Tissue Donation. Register Today! For other Canadian provinces click here

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

In Great Britain, register at NHS Organ Donor Register

In Australia, register at Australian Organ Donor Register

Your generosity can save up to eight lives with heart, kidneys, liver, lungs, pancreas and small intestine transplants. One tissue donor can help up to 100 other people by donating skin, corneas, bone, tendon, ligaments and heart valves

Has your life been saved by an organ transplant? "Pay it forward" and help spread the word about the need for organ donation - In the U.S. another person is added to the national transplant waiting list every 11 minutes.

Swine flu and immunosuppression

The study reported here notes that people who have had solid organ transplants (such as lungs, kidneys or livers) also have higher flu infection rates due to the immunosuppressant drugs they take to prevent organ rejection. Lung transplant recipients are particularly prone to infection and kidney transplant recipients can suffer rejection if they contract flu. As a lung transplant recipient, I'm getting my flu shot as soon as it's available. Most immunosuppressed people can be safely vaccinated.

Nathional Health Service (NHS - Britain)

A review of research on how flu affects immunosuppressed people and the effects of vaccination on them has been published in The Lancet Infectious Diseases. The authors specifically looked at susceptibility in people with HIV/AIDS, cancer, those who have had a solid organ transplant or bone-marrow transplant and patients on haemodialysis or steroids.

Such groups are thought to be at higher risk of serious influenza-associated complications and as such are priority groups for immunisation.

However, treatments for immune dysfunction may also limit the effectiveness of vaccination and there may be complications from the vaccination itself in these groups. The evidence behind these issues is discussed in this review.

Key points from the review

• There is little research on using vaccination to prevent influenza in immunosuppressed people. This review found just one randomised clinical trial. This trial of HIV-infected patients found high vaccine effectiveness.


• The same immune dysfunction that can increase the risk and consequences of influenza infection might also compromise vaccine responses and effectiveness.


• Most immunosuppressed populations are at higher risk of influenza-associated complications, have a general trend toward impaired antibody responses but can be safely vaccinated.


• The priority for control of influenza is focused on generating effective antibody responses with vaccines. Progress is being made at increasing the scale, duration, and breadth of vaccine responses to the two main surface proteins H and N (haemagglutinin and neuraminidase) in both healthy and immuno-compromised populations.


• There are two main types of influenza vaccine and both are being developed for the new H1N1 swine flu virus. One involves inactivated vaccines that contain viruses grown in eggs (mostly) and then killed. The other involves live weakened H1N1 vaccines. The researchers say that previous concerns that these live attenuated vaccine would pose a risk to people that are immunocompromised have not been demonstrated by the studies in their review. Research into this area and into and other novel approaches to flu vaccine development are important. They ask that efficacy studies of attenuated vaccines in adults that are immunocompromised are also considered.

Where was the article published?

The research was carried out by Dr Ken M Kunisaki from the Minneapolis VA Medical Center and Edward N Janoff from the University of Colorado Denver School of Medicine.
The study was published in The Lancet Infectious Diseases. It was supported by grants from the National Institutes of Health and the Veterans Affairs Research Service.

What kind of study was this?

In this review, the researchers looked at the susceptibility of immunosuppressed people to the H1N1 swine flu virus, and the possible effectiveness and side effects of upcoming vaccines. Specifically, the authors looked at susceptibility in people with HIV/AIDS, cancer, those who have had a solid organ transplant, or bone-marrow transplant and patients on haemodialysis.

They say: “Although influenza vaccination is widely recommended for people that are immunosuppressed, the same immune dysfunction that can increase the risk and consequences of influenza infection might also compromise vaccine responses and effectiveness.”

The researchers aimed to investigate:

• the incidence and mortality rates of influenza infection among adults who are immuno-compromised,


• the risks and adverse effects of vaccination,


• the ability of a vaccine to get appropriate immune responses, and


• the clinical effectiveness of vaccination in these populations.

The researchers searched Medline through the years 1966-2009 for articles on adult influenza, its frequency, complications, and antibody or clinical responses to vaccination. The antibody responses were measured as the percentage of people with levels of antibody protective against H3N2, and the clinical responses were defined as the frequency of influenza reported during the total observation period. They also looked for policy recommendations and guidelines. Excess deaths and hospitalisations were also reported. They only included articles reporting outcomes related to inactivated vaccines, because live attenuated vaccines are not recommended in immuno-compromised groups because there is a theoretical possibility of causing the disease itself.

What was found?

The researchers discussed the following:

HIV/AIDS

Studies show that the numbers of HIV/AIDS patients admitted to hospital with flu has fallen substantially since the introduction of effective antiretroviral therapy. However, admissions are still higher than in the general population.

HIV/AIDS patients generally have lower antibody responses to vaccination, but several studies have shown that vaccination leads to fewer and less severe cases of flu in these patients. Larger randomised trials are needed to assess vaccination, particularly among those with more advanced disease as measured by low CD4+ cell counts.

Transplantation

People who have had solid organ transplants (such as lungs, kidneys or livers) also have higher flu infection rates due to the immunosuppressant drugs they take to prevent organ rejection. Lung transplant recipients are particularly prone to infection and kidney transplant recipients can suffer rejection if they contract flu. In theory, vaccination in these populations could also stimulate a T-cell response, leading to rejection, but the researchers say that most studies say this does not occur.

The intensive pre-transplantation regimens used in preparing people for bone marrow (haematopoetic stem cell) transplants leave patients deeply immunocompromised for up to several months after transplantation. A study on 10 patients’ response to vaccination showed that there was a complete lack of serological response within six months in all 10.

Malignancies and chemotherapy

Chemotherapy can produce major immunosuppression in people with cancer and one study shows that 21-33% of cancer patients contracted flu and were admitted to hospital with respiratory symptoms during one recent seasonal flu epidemic.

Timing of flu vaccination can be crucial in cancer patients. The response might be best between chemotherapy cycles, or more than seven days before chemotherapy starts.

Haemodialysis

Infections are the second leading cause of death in patients on dialysis, and lung infections such as flu are particularly serious. Vaccinated patients on dialysis have been shown to have a lower chance of hospital admission or death from any cause than unvaccinated patients.

Systemic corticosteroids

The authors also looked at people taking oral or inhaled steroids, saying that the evidence shows flu vaccination is both safe and often stimulates an immune response. However, the vaccine’s clinical effectiveness in reducing episodes of flu in people taking the drugs has not been well tested.

What were the researchers’ conclusions?

The researchers say that most immunosuppressed populations are at higher risk of influenza-associated complications. These people have impaired antibody responses to the vaccine (although data for this conclusion is mixed. For example, in some trials, HIV patients with low CD4+ counts developed only 30% of the antibody response of healthy controls, and in one trial of patients on chemotherapy, there was even less of a response. However, other studies have shown that patients who have had haemodialysis and transplant managed up to 80% protective titres.

They say that most immunosuppressed people can be safely vaccinated (although longitudinal data that follows up patients over time are largely lacking).

They also say that the small number of studies of cellular responses to influenza vaccination, in relatively small numbers of immunosuppressed individuals, showed impaired cellular responses among a few patients.

The researchers call for better trial data to inform vaccination recommendations based on the effectiveness and cost in these at-risk populations.

What does the NHS Knowledge Service make of this study?

This study has addressed an important question in vaccination research and one that has become topical with the spread of the new H1N1 swine flu virus. It is disappointing that there are so few high quality trials in this area and that the trials that exist are observational studies.

This means that the evidence presented may be prone to bias. Nevertheless, decisions on vaccination in high-risk groups need to be made on the balance of the evidence that exists. This review has presented a useful summary, which can guide practice.

Links to the science

See the NHS report

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British man, 22, dies after being denied liver transplant

'Please help me Mum, I don't want to die': Last words of Binge drinker Gary Reinbach in hospital with his mother Madeline Hanshaw shortly before he died

Doctor's refused to give Gary Reinbach a liver transplant because of strict rules about who can or cannot be a candidate for the life-saving procedure. Gary had been drinking since a teenager and it ruined his liver. Readers can decide for themselves whether or not the hospital made the correct decision.

The sad case of a young sick British man has raised new questions about the fairness of the rules for organ transplants.

ABC News, Australia

Gary Reinbach, 22, an alcoholic, died yesterday after authorities in the UK refused to give him an emergency liver transplant.

Doctors there said he could not jump the queue and had not served the mandatory six-month period of being sober before having the operation.

Gary Reinbach was 11 when his parents split up. As a youth he turned to alcohol, by 13 he was binge drinking and at 22 he ended up in hospital with severe liver failure and in desperate need of an organ transplant.

Professor Ian Gilmore is a liver specialist at the Royal Liverpool Hospital. He told the BBC Gary Reinbach was unlucky to be in his position at such a young age, and that the odds were stacked against him.

"The saddest aspect of this case is it's because of the severe shortage of donors livers that these decisions are faced every day," he said.

"And we know, for example, that those who do get onto a liver transplant list will wait on average more than three months before finding an organ.

"One in six of those who are accepted with a wide range of liver disease, will die. One in six dying before they get their transplant."

Professor Gilmore says it was a hard decision to say no to Gary Reinbach and his family.

"It's never one single person's decision, it's a multi-disciplinary team that review it, it's made on practical grounds," he said.

"We know that these patients, who present very acutely like this with no past history, actually don't survive transplantation as well as some other groups."

'Tough calls'
Jeremy Chapman is a Professor at Sydney University and currently the President of the International Transplantation Society.

In general terms, he says scarce resources have forced tough calls to be made on the suitability of the patient for an organ transplant.

"Two things that matter in this situation, the first is waiting list acceptance - how does a patient get onto a transplant waiting list?," he said

"And secondly, once they're on a waiting list, how does the allocation of what is still a very rare and precious resource get made?"

And does the behaviour of the patient become a factor for example in the case where it is liver damage caused by alcohol, is it absolutely imperative that they give up alcohol?

"The criteria for acceptance onto the transplant waiting list are to do with, first of all, whether a transplant is actually needed, and secondly what the outcome would be after transplantation," Professor Chapman said.

"It is pointless trying to put somebody onto a transplant waiting list when you know that their success after transplantation would be very poor."

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FDA Approves Vaccine for 2009-2010 Seasonal Influenza

Although this seasonal flu vaccine will not protect against the H1N1 virus (swine flu), receiving the seasonal vaccine is still critical for those of us who are at risk due to being immuno suppressed as well as older people, young children and people with chronic medical conditions. It's expected that a vaccine for the H1N1 virus will be available later this fall.

For Immediate Release: July 20, 2009

The U.S. Food and Drug Administration today announced that it has approved a vaccine for 2009-2010 seasonal influenza in the United States.

The seasonal influenza vaccine will not protect against the 2009 H1N1 influenza virus that resulted in the declaration of a pandemic by the World Health Organization (WHO) on June 11, 2009. The FDA continues to work with manufacturers, international partners and other government agencies to facilitate the availability of a safe and effective vaccine against the 2009 H1N1 influenza virus.

Although this year’s seasonal vaccine is directed against other strains of influenza expected to be circulating and will not provide protection against the 2009 H1N1 influenza virus, it is still important for those Americans for whom it is recommended to receive the seasonal influenza vaccine. No vaccine is 100 percent effective against preventing disease, but vaccination is the best protection against influenza and can prevent many illnesses and deaths.

“The approval of this year’s seasonal influenza vaccine is an example of the FDA’s important responsibility to assure timely availability of vaccine to help protect the health of the American public,” said Margaret A. Hamburg, M.D., commissioner of food and drugs. “A new seasonal influenza vaccine each year is a critical tool in protecting public health.”

The six vaccine brand names and manufacturers are: Afluria, CSL Limited; Fluarix, GlaxoSmithKline Biologicals; FluLaval, ID Biomedical Corporation; Fluvirin, Novartis Vaccines and Diagnostics Limited; Fluzone, Sanofi Pasteur Inc.; and FluMist, MedImmune Vaccines Inc.

Each year, experts from the FDA, WHO, U.S. Centers for Disease Control and Prevention (CDC), and other institutions study virus samples and patterns collected from around the world in an effort to identify strains that may cause the most illness in the upcoming season.

Based on those forecasts and on the recommendations of the FDA’s Vaccine and Related Products Advisory Committee, the FDA determines the three strains that manufacturers should include in their vaccines for the U.S. population. The closer the match between the circulating strains and the strains in the vaccine, the better the protection against the disease.

The vaccine for the 2009-2010 seasonal influenza contains:

• an A/Brisbane/59/2007 (H1N1)-like virus


• an A/Brisbane/10/2007 (H3N2)-like virus


• a B/Brisbane/60/2008-like virus

There is always a possibility of a less than optimal match between the virus strains predicted to circulate and the virus strains that end up causing the most illness. Even if the vaccine and the circulating strains are not an exact match, the vaccine may reduce the severity of the illness or may help prevent influenza-related complications.

According to the CDC, between 5 percent and 20 percent of the U.S. population develops influenza each year. More than 200,000 are hospitalized from its complications and about 36,000 people die. Older people, young children, and people with chronic medical conditions are at higher risk for influenza-related complications. Vaccination of these groups is critical.

Additionally, influenza immunization of health care personnel is important in protecting them and others from influenza.

For more information:

FDA Web Page on Influenza Vaccine Safety & Availability

FDA List of Strains Included in the 2009-2010 Influenza Vaccine

U.S. Centers for Disease Control and Prevention Web Page on Seasonal Influenza Resources for Health Professionals

U.S. Centers for Disease Control and Prevention Web Page with Key Fact About Seasonal Flu Vaccine

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Register to be a donor in Ontario or Download Donor Cards from Trillium Gift of Life Network. NEW for Ontario: recycleMe.org - Learn The Ins & Outs Of Organ And Tissue Donation. Register Today! For other Canadian provinces click here

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

In Great Britain, register at NHS Organ Donor Register

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Your generosity can save up to eight lives with heart, kidneys, liver, lungs, pancreas and small intestine transplants. One tissue donor can help up to 100 other people by donating skin, corneas, bone, tendon, ligaments and heart valves

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Protecting yourself against H1N1 Virus (Swine Flu)

Officials say that the next wave of H1N1 flu could arrive in September and governments worldwide are planning for a pandemic. No one knows for sure if it will continue to cause mostly mild illness or if it will strike with the vengeance of the 1918 Spanish flu, which hit with a mild form in the spring but returned in the fall to infect one-third of the world's population and contributed to the deaths of 50 million people.

Organ transplant recipients, who are immunosuppressed, need to be especially vigilant and use common sense to avoid infection, especially during the flu season.

Following the advice of experts, such as can be found at Flu.gov I plan to avoid large groups of people; wash my hands frequently with soap and water; avoid shaking hands; use a tissue when sneezing or coughing and place it in the trash. Our hands have poison on them and washing is a huge thing. I'll get a flu shot as soon as it's available and I've already had a pneumonia shot to protect against secondary infection.

I hope the epidemic doesn't come but I, for one, intend to protect myself. I hope you will also.

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In Great Britain, register at NHS Organ Donor Register

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Your generosity can save up to eight lives with heart, kidneys, liver, lungs, pancreas and small intestine transplants. One tissue donor can help up to 100 other people by donating skin, corneas, bone, tendon, ligaments and heart valves

Has your life been saved by an organ transplant? "Pay it forward" and help spread the word about the need for organ donation - In the U.S. another person is added to the national transplant waiting list every 11 minutes.

FDA Requires Labeling Change for Some Drugs Used to Prevent Rejection of Kidney Transplants

This press release from the FDA caught my eye because I'm taking most of the anti-rejection drugs mentioned here. Although I'm a lung recipient and this alert is for kidney transplants I wonder if it could be potentially applied to all organ transplant recipients? The FDA advises healthcare professionals that adjustments in immunosuppression therapy should be considered for patients who develop BK virus-associated nephropathy.

For Immediate Release: July 14, 2009

The U.S. Food and Drug Administration today said that it will require manufacturers of some immunosuppressant drugs used in kidney (renal) transplantation to update their labeling to reflect an increased risk of infections.

The FDA is requiring the labeling changes based on its review of reported adverse events. The labeling changes must reflect the reported increased risk for opportunistic infections, including activation of latent viral infections. These include BK virus-associated nephropathy, which can mainly affect kidney transplant patients. Such infections may lead to serious outcomes, including kidney graft loss.

The required label changes affect the following immunosuppressant drugs used to help prevent rejection of transplanted organs:

• Rapamune (sirolimus)


• Sandimmune (cyclosporine) and cyclosporine generics


• Neoral (cyclosporine modified), and generics


• Cellcept (mycophenolate mofetil) and generics


• Myfortic (mycophenolic acid)

*************

• Information about the increased risk for opportunistic infections already is included in the labeling of the immunosuppressive drug Prograf (tacrolimus)

The FDA is requiring the labeling changes based on its review of reported adverse events. The labeling changes must reflect the reported increased risk for opportunistic infections, including activation of latent viral infections. These include BK virus-associated nephropathy, which can mainly affect kidney transplant patients. Such infections may lead to serious outcomes, including kidney graft loss. Read Information for Healthcare Professionals.

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Baking Soda May Slow Progression of Chronic Kidney Disease

One of the major side effects of anti-rejection drugs is impairment of kidney function. When my Creatinine blood levels (A fairly reliable indicator of kidney function) started increasing soon after my lung transplant, the nephrologist put me on several medications, including Sodium Bicarbonate tablets. Since then, my kidney function has remained stable.

Medscape Pulmonary Medicine

July 16, 2009 — Daily supplementation with sodium bicarbonate slows the progression rate of renal failure to end-stage renal disease (ESRD) and improves nutritional status among patients with chronic kidney disease (CKD), according to a randomized, open-label study reported online July 16 in the Journal of the American Society of Nephrology.

"Metabolic acidosis..., generally perceived by clinicians as a low plasma bicarbonate, is a common complication in patients with [CKD], particularly when [glomerular filtration rate] falls below 30 ml/min," write Ione de Brito-Ashurst, from the Department of Renal Medicine and Transplantation at the William Harvey Research Institute, and Barts and the London National Health Service Trust, United Kingdom, and colleagues. "This, in turn, may bring about a variety of sequelae, such as stunted growth in children, loss of bone and muscle mass, negative nitrogen balance, and possible acceleration of progression of CKD."

Past studies have shown that bicarbonate supplementation preserves renal function in experimental CKD, but whether the same benefit occurs in humans is unknown, the authors write. "The lack of long-term studies examining the impact of alleviation of metabolic acidosis on renal function in predialysis patients and on nutritional status was the particular stimulus to perform this study."

The primary endpoints were rate of creatinine clearance (CrCl) decline and the proportion of patients with rapid decline of CrCl (>3 mL/minute/1.73 m2/year) and ESRD (CrCl < 10 mL/minute). Secondary endpoints were dietary protein intake, normalized protein nitrogen appearance, serum albumin, and midarm muscle circumference.

The investigators enrolled 134 adult patients with CKD (CrCl 15 – 30 mL/minute/1.73 m2) and serum bicarbonate levels of 16 to 20 μmol/L. All patients were randomly assigned to receive either 600 mg oral sodium bicarbonate tablets at 1.82 ± 0.08 g/day (n = 67; mean age, 54.78 ± 2.56 years; 52% men; 52% white) or standard treatment (n = 67; mean age, 54.77 ± 2.56 years; 51% men; 52% white) during a 2-year period.

All patients performed 24-hour urine collections at the study's start and then every 2 months, which the investigators used to measure serum HCO3 −, potassium, creatinine, urea, albumin, and C-reactive protein. At each follow-up visit, blood pressure, drug compliance by direct questioning, body weight, and midarm circumference were documented. The phosphoenolpyruvate method was used for measuring bicarbonate levels. An estimate of the habitual dietary intake of each patient was made from a 4-day food diary completed before each follow-up appointment.

At the end of the study, the rate of decline in CrCl was significantly slower for those treated with the bicarbonate supplementation compared with the control group (5.93 vs 1.88 mL/minute/1.73 m2; P < .0001).

In addition, rapid progression occurred in just 9% of the patients receiving bicarbonate supplementation vs 45% of those receiving standard care (relative risk [RR], 0.15; 95% confidence interval [CI], 0.06 – 0.40; P < .0001).

Four patients in the bicarbonate group developed ESRD requiring dialysis (6.5%) compared with 22 patients in the control group (33%; RR, 0.13; 95% CI, 0.04 – 0.40; P < .001).

Several nutritional parameters also improved significantly with bicarbonate supplementation. Dietary protein intake showed a significant increment compared with that in the control group (P < .007), whereas normalized protein nitrogen appearance decreased (P < .002). This increase in dietary protein intake and reduction in normalized protein nitrogen appearance led to an increment in the lean body mass as assessed by midarm muscle circumference in the treatment group from 24.8 (23.7 – 25.8) to 26.3 (25.0 – 27.5) compared with no change in the control group (P < .03).

In addition, serum albumin levels rose in the treatment group but remained unchanged in the control group, and serum potassium levels declined (P < .05).

Although sodium intake did increase for the sodium bicarbonate group vs the control group, it did not lead to increased blood pressure.

"This is the first randomized, controlled clinical study in which oral sodium bicarbonate supplementation was associated with positive results in both primary and secondary endpoints in patients with CKD," the study authors write. In addition, "there was no effect on [blood pressure] or evidence of worsening edema as assessed clinically at every clinic consultation."

Limitations of the study include the absence of a double-blind design — the researchers were aware of which patients were receiving the supplement — and the lack of placebo.

"Oral sodium bicarbonate supplementation in patients with low plasma HCO3 − levels slows the rate of decline of renal function and the development of ESRD in patients with advanced stages of CKD," the study authors conclude. "This cheap and simple strategy...improves the nutritional status of patients and has the potential of translating into significant economic, quality-of-life, and clinical outcome benefits."

Barts and the London Charitable Foundation provided support for the study but had no part in the design, conduct, collection, management, analysis, or interpretation of data. The study authors have disclosed no relevant financial relationships.

J Am Soc Nephrol. Published online July 16, 2009.

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Register to be a donor in Ontario or Download Donor Cards from Trillium Gift of Life Network. NEW for Ontario: recycleMe.org - Learn The Ins & Outs Of Organ And Tissue Donation. Register Today! For other Canadian provinces click here

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

In Great Britain, register at NHS Organ Donor Register

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Your generosity can save up to eight lives with heart, kidneys, liver, lungs, pancreas and small intestine transplants. One tissue donor can help up to 100 other people by donating skin, corneas, bone, tendon, ligaments and heart valves

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$80,000 raised for a 14-year-old boy in need of a lung transplant

I've seen many creative fundraising initiatives to help patients in need of an organ transplant to help them pay for it but this is right up there with the best of them. Organizers were able to solicit donations of unique items to be auctioned off and it seems that the bidders were willing to dig deep into their pockets. Well done!

The Dallas Morning News

Associated Press

Duck decoys donated from people all over the nation were sold at an auction in Larose that raised $80,000 for a 14-year-old boy in need of a lung transplant.

Dylan Danos, an incoming freshman at South Lafourche High, has cystic fibrosis. The disorder has weakened his lungs to the point that a transplant is necessary for survival.

About 200 duck decoys were sold at Sunday's acution to raise money for the as-yet unscheduled transplant at Texas Children's Hospital in Houston. The decoys were donated by carvers from across the country. Some also came from Nova Scotia, Canada. Other auction items included collectible posters, stays at luxury hotels and restaurants and ice chests filled with bottled water.

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

Register to be a donor in Ontario or Download Donor Cards from Trillium Gift of Life Network. NEW for Ontario: recycleMe.org - Learn The Ins & Outs Of Organ And Tissue Donation. Register Today! For other Canadian provinces click here

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

In Great Britain, register at NHS Organ Donor Register

In Australia, register at Australian Organ Donor Register

Your generosity can save up to eight lives with heart, kidneys, liver, lungs, pancreas and small intestine transplants. One tissue donor can help up to 100 other people by donating skin, corneas, bone, tendon, ligaments and heart valves

Has your life been saved by an organ transplant? "Pay it forward" and help spread the word about the need for organ donation

Flu Shot May be Less Effective after Transplant

This study was done with kidney recipients but I wonder if the same results would be found in other organ transplant patients, who also have suppressed immune systems? This should be of particular concern in light of the H1N1 (swine flu) impending epidemic we are told to expect this fall.

From the U.S. National Kidney Foundation

Kidney transplant patients have a weaker response to influenza immunization than healthy individuals, especially in the first six months after receiving a transplant, according to a study published in the July issue of the American Journal of Kidney Diseases, the official journal of the National Kidney Foundation.

Respiratory viral infections are common among transplant patients, and are cause for concern because they can be particularly harmful to people with suppressed immune systems, noted Kelly A. Birdwell, MD, MSCI, of Vanderbilt University Medical Center in Nashville, Tennessee in her report.

Should transplant recipients receive a flu shot?

The Centers for Disease Control and Prevention recommends influenza vaccine for kidney transplant patients, but little is known about what kind of antibody response they are able to mount to a flu shot. What’s more, no studies have looked exclusively at patients on tacrolimus, now the most commonly used immunosuppressant in kidney transplant patients.

The researchers looked at the response to influenza vaccine in 53 kidney transplant recipients and 106 healthy controls during the 2006-2007 flu season. All of the patients were receiving tacrolimus for immunosuppression.

Dr. Birdwell and her team checked vaccine response by testing study participants’ levels of antibodies to three different influenza strains--A/H1N1, A/H3N2, and B--before they received the vaccine and again one month later. The researchers used two criteria to gauge the effectiveness of the vaccine: seroresponse, defined as a four-fold increase in levels of antibodies against a viral strain; and seroprotection, meaning levels of antibodies adequate for protection against infection.

A smaller percentage of the transplant patients achieved seroresponse or seroprotection than the healthy controls. But the differences were statistically significant only for one strain, A/H3N2; among controls, 62.3% achieved seroresponse, compared to 34% of the transplant patients, while 91.5% of controls and 69.8% of transplant patients were seroprotected.

Patients who had undergone transplants within the last six months were significantly less likely than the healthy controls to show seroresponse or seroprotection to any of the three viral strains contained in the flu shot. Dr. Birdwell and her team point out that during the first six months after transplant, patients are typically on the highest doses of immunosuppressant medication to prevent their bodies from attacking the transplanted organ. This translates to a weaker immune system, and a weaker response to the flu vaccine.

There are several possible approaches to providing additional protection against the flu to kidney transplant patients, Dr. Birdwell said. “Possibilities include the provision of a booster dose of the influenza vaccine, or the use of an adjuvant, or substance given along with a medication or vaccine to enhance its effects,” the researcher said.

“In addition, the live intranasal vaccine may provide a more vigorous protective response, though the use of a live vaccine in this immunosuppressed population certainly requires formal investigation for safety and efficacy. As always, routine hand washing is one of the best defenses.”

Any new influenza vaccines—including those targeting H1N1, also known as the swine flu—may not provoke the same protective response in kidney transplant patients, she added, and this should be taken into consideration.

“Kidney transplant recipients should still be immunized against influenza, as recommended by the CDC,” said Dr. Kerry Willis, Senior Vice President for Scientific Acitivies, National Kidney Foundation. “There are several promising approaches to providing additional protection against the flu for these patients, but more research is necessary before any can be recommended.”

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

Register to be a donor in Ontario or Download Donor Cards from Trillium Gift of Life Network. NEW for Ontario: recycleMe.org - Learn The Ins & Outs Of Organ And Tissue Donation. Register Today! For other Canadian provinces click here

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

In Great Britain, register at NHS Organ Donor Register

In Australia, register at Australian Organ Donor Register

Your generosity can save up to eight lives with heart, kidneys, liver, lungs, pancreas and small intestine transplants. One tissue donor can help up to 100 other people by donating skin, corneas, bone, tendon, ligaments and heart valves

Has your life been saved by an organ transplant? "Pay it forward" and help spread the word about the need for organ donation

New technique to repair lungs outside the body may double transplants worldwide

Dr. Shaf Keshavjee (above), the surgeon that performed my lung transplant in 2002, is a world leader in lung transplantation and lung transplant research. His body of work is having a global impact and this article exemplifies that. The XVIVO Lung Perfusion Technique has the potential to double the number of lungs available for transplant, not only in Toronto, Canada but worldwide as other centers adopt the technique.

Canadian Institutes of Health Research (CHIR)

Research Profile July 2009

In a room at the Toronto General Hospital (TGH), a pair of human lungs is breathing inside a glass dome. As they breathe in and out, fed by a supply of gases and nutrients, the lungs are healing themselves from injury. This revolutionary technology promises to improve the fate of many patients waiting for lung transplants in Canada.

In Canada, nearly 300 patients with lung disease died between 1997 and 2006. These patients died because of a shortage of suitable lungs available for transplant. In fact, as few as one in 10 donated lungs available can be used. The new technology at TGH may allow doctors to more than double the number of lung transplants done worldwide, according to Dr. Shaf Keshavjee of TGH's Division of Thoracic Surgery.

"Lungs are very fragile as organs," says Dr. Keshavjee, who directs the Toronto Lung Transplant Program. "This new system allows you to assess the lungs, to diagnose what's wrong with them, and then repair them."

Dr. Keshavjee's team worked for years studying lung transplant and repair experiments on animal models. In December 2008 they announced a successful first use of the system in transplanting a pair of lungs into a patient. They have since completed twelve other successful transplants with the system, called The Toronto XVIVO System.

The work is being funded by the Canadian Institutes of Health Research's CIHR/Rx&D Collaborative Research Program, a partnership of CIHR and Canada's Research-Based Pharmaceutical Companies. Other collaborative partners include Astellas Canada, Wyeth Pharmaceuticals and Vitrolife Inc.

The Toronto XVIVO Lung Perfusion System was developed by Dr. Keshavjee's team and Virolife Inc., which specializes in lung preservation. The technique allows lungs to be kept at body temperature, outside the body. Fed with a bloodless solution containing nutrients, proteins and other medications, the organs exchange oxygen and carbon dioxide through a ventilator and can repair themselves while the researchers facilitate the recovery and check them. The lungs can be kept inside the device for up to 18 hours, though 12 hours is the current routine limit. A similar blood perfusion system developed in Sweden for short term assessment only works for about an hour before the lung becomes damaged.

"We've already successfully transplanted twelve* patients now using the XVIVO System, so those patients received lungs that couldn't have been used before," says Dr. Keshavjee. "They've all done superbly, every single one of them. We're now able to use lungs that we couldn't use before."

*As of today, Dr. Keshavjee tells me that 14 patients have now been transplanted - Merv.

The Canadian Institutes of Health Research (CIHR) is the Government of Canada's agency responsible for funding health research in Canada.

NOTE: Also read the article at physorg.com.

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