Canadian children receive organ transplants

Organ Transplants in U.S. is a Problem that Canadians Solved a While Ago

Canadians didn´t invent the wheel, but occasionally they are in the right path in terms of health care measures.

In Philadelphia, two terminally-children need to receive a lung transplant that would save their lives.

Javier Acosta is a boy of 12-years-old who has cystic fibrosis. And Sarah Murnaghan is a 11 year old girl. Both have Cystic fibrosis, which is a genetic disorder that affects the lungs.

According with National organ donor policy the priority of the system is for people of 12 and older. And Javier is 12 and Sarah is 10. Javier´s brother died two years ago of the same disease.

The debate is about the fairness of transplant policies. Some specialists said that this is fair, because is equal for everyone. For instance, secretary Kathleen Sebelius, Health and human services, didn´t want to intervene in Sarah´s case because other 40 children in Pennsylvania over 12 were waiting for a lung transplant.

The Canadian system is different, and is also much more fair. Such case would never occur in Canada. There is a single list and children are on top of that list.

CTV news Canada informed, that Ronnie Gavsie, president of the Trillium Gift of Lfe Network said that Canadian system is working, “we have a list where the most medically needy person, who has been on the wait list the longest, will be the first to get the organ, regardless of age”.

And Dr Gary Levy, director of the multi-organ transplant program at Toronto´s University Health Network said, “We believe children come first. We consulted widely… we believe children are a priority”.

On another hand back in United States, Lawrence O. Gostin, health law professor, said “People who have privilege or people who complain more loudly or have political voice shouldn´t be able to claim special treatment”.

Dr. John Roberts, Organ Procurement and Transplantation said, “ under-12 year old policy for lungs accounts for younger children´s different medical needs. They are particular hard to transplant, children don´t tend to fare as well and adults lungs not always fit them”.

However, Canadian Dr, Levy, said otherwise, “age should not be a factor, as adults lungs can be modified to fit smaller child´s body”.

The organization that decides the organ transplant policy will have an emergency meeting next week. A big discussion is ahead between the federal court, desperate parents and the Obama administration.

This is not a game, the life of many innocent children is at risk. Canada has a fair system and it might be the time to learn something from them.

By Oskasr Guzman, The Guardian Express
SOURCE: CTV news, Fox news, ABC news

“You Have the Power to Donate Life – Sign-up today! Tell Your Loved Ones of Your Decision”

Donor Registration Links Worldwide

Older Age limits viable in lung transplantation

Doctors told Peter Nicosia, 81, who was suffering from pulmonary fibrosis, he was too old for lung replacement. That was in 2009 at the age of 78.

Tampa-area lung transplant patients, past and future, celebrate life

Christina Mabe, lead nurse in the T.G.H. Lung Transplant Unit, gives a hug to transplant recipient Derek Goody and his wife Rose Marie as Mabe sells raffle tickets at the annual One Breath at a Time Lung Transplant Support Group holiday party. The event helps to raise money for the Butterfly House, a place where patients and their families can stay while undergoing the months long procedure.

By EDDIE DANIELS | Tbo.com" 

Doctors told Peter Nicosia, who was suffering from pulmonary fibrosis, he was too old for lung replacement.

That was in 2009.

Sunday, the 81-year-old joined fellow lung-transplant survivors and others waiting for transplants in The Regent ballroom for the ninth One Breath at a Time Holiday Party, which drew about 250 people.

"Something like this is very encouraging, very strengthening," said Nicosia, of Most Holy Redeemer Catholic Church in Tampa. "You also feel that you're not by yourself. You realize that you're not on an island independent of others.

"You exchange ideas, learn from others, what they do during their time of suffering. The suffering is not only physical, it's psychological and emotional."

This was Nicosia's fourth party.

Sunday night was one of several fundraisers the nonprofit One Breath at a Time organization hosts throughout the year. The goal is to fund its Butterfly House, a two-story home just off the Hillsborough River in Tampa, renovated to serve three patients and some family members before, during and after transplants. The house allows people to stay within a seven-minute drive to Tampa General Hospital during treatment, rent-free.

Mark Rolfe and his medical staff deep-fried six turkeys, while guests provided the side dishes. Later, items ranging from wine to an iPod speaker system were auctioned off.

"It's great to see the people," Rolfe said. "We see them when they're sick. [At the party], we see them with their families and dressed up. They're not patients. They're more friends. It's nice because they get to interact with each other."

Robyn Dekeyser, now 43, was diagnosed with cystic fibrosis just 21 days after being born. She said it never hindered her everyday life, just fast-tracked things. She's an accomplished ballet performer and for 10 years was an administrative assistant at the U.S. Attorney's Office in Tampa.

On July 23, 2012, Dekeyser underwent a double lung transplant.

Now, she doesn't worry about breathing anymore.

"It's an involuntary thing that you do, but for [cystic fibrosis] patients waiting for a double lung transplant, it's not so voluntary," said Dekeyser, who was attending her first party. "Every breath is labored and very executed. To not have to worry about that is amazing."

The annual party allows the doctors and patients to move beyond numbers, said Tarik Haddad, a doctor who began working with Rolfe four years ago.

"A lot of times, that personal touch in medicine is lost," Haddad said. "You're just a patient, a number. This brings it to now you're a family. Patients can share stories of been there and done that."

When potential transplant patients see those who have already experienced the process and are on their way to a new sense of normalcy, it makes the journey easier, Haddad said.

"It's a rewarding experience for the fact that we can take our patients who have been through the process of a transplant and get them to meet patients who are just starting that process," Haddad said. "A lot of times the patients are facing the daunting thought of transplant and breathing with someone else's lungs; it's a huge surgical procedure, and it's a scary task."

“You Have the Power to Donate Life – Sign-up today! Tell Your Loved Ones of Your Decision”

Donor Registration Links  

Dick Cheney's Heart Transplant At 71 Spurs Age Debate

I don't believe that age should be the only criteria when assessing a potential candidate for an organ transplant. Some people are more fit at age 70 than others at age 50. Each individual should be considered on his or her physical fitness and the probability of having an optimal outcome of the transplant.


More than 3,100 Americans are waiting now for a new heart, and about 330 die each year before one becomes available.

Reporter: CBS/AP (Posted by Melissa Brunner wibw.com)

(CBS/AP) Did former Vice President Dick Cheney get special treatment when the 71-year-old got a heart transplant on Saturday? Doctors are saying it's unlikely the Republican septuagenarian was bumped ahead of thousands of younger people who were also in line to get a new heart.

"You can't leapfrog the system," said Dr. Allen Taylor, cardiology chief at MedStar Georgetown University Hospital. "It's a very regimented and fair process and heavily policed."

More than 3,100 Americans are waiting now for a new heart, and about 330 die each year before one becomes available. When one does, doctors check to see who is a good match and in highest medical need. The heart is offered locally, then regionally and finally nationally until a match is made.

Cheney's case reopens debate about whether rules should be changed to favor youth over age in giving out scarce organs. As it stands now, time on the waiting list, medical need and where you live determine the odds of scoring a new heart - not how many years you'll live to make use of it.

"The ethical issues are not that he had a transplant, but who didn't?" Dr. Eric Topol, a cardiologist at Scripps Health in La Jolla, Calif., wrote on Twitter.

Cheney received the new heart Saturday at Inova Fairfax Hospital in Falls Church, Va., the same place where he received an implanted heart pump that has kept him alive since July 2010. It appears he went on the transplant wait list around that time, 20 months ago.

Cheney had severe congestive heart failure and had suffered five heart attacks over the past 25 years. He's had countless procedures to keep him going - bypasses, artery-opening angioplasty, pacemakers and surgery on his legs. Yet he must have had a healthy liver and kidneys to qualify for a new heart, doctors said.

"We have done several patients hovering around age 70" although that's about "the upper limit" for a transplant, said Dr. Mariell Jessup, a University of Pennsylvania heart failure specialist and American Heart Association spokeswoman. "The fact he waited such a long time shows he didn't get any favors."

Jessup and Taylor spoke Sunday from the American College of Cardiology's annual conference in Chicago, where Cheney's treatment was a hot topic.

Patients can get on more than one transplant list if they can afford the medical tests that each center requires to ensure eligibility, and can afford to fly there on short notice if an organ becomes available. For example, the late Apple chief Steve Jobs was on a transplant list in Tennessee and received a new liver at a hospital there in 2009 even though he lived in California.

That's not done nearly as often with hearts as it is for livers or kidneys, said Dr. Samer Najjar, heart transplant chief at MedStar Washington Hospital Center. Each transplant center decides for itself how old a patient it will accept, he said.

"Most centers wouldn't put somebody on" at Cheney's age, said University of Pennsylvania bioethicist Art Caplan, who has testified before many panels on organ sharing issues.

"I've been arguing for a long time that the system should pay more attention to age because you'll get a better return on the gift" because younger people are more likely to live longer with a donor organ, Caplan said.

There have been other recent reports of successful heart transplants in septuagenarians.
In Canada, a man described as a home builder and philanthropist received a heart transplant when he was 79 at the University Hospital in Edmonton, Alberta, Canada. He lived for more than a decade with the organ, dying in 2010 at age 90.

In Texas, a 75-year-old retired veterinarian received a heart last year from a 61-year-old donor, but he had been a marathon runner and was presumably healthier than many of his peers.

Cheney will have to take daily medicines to prevent rejection of his new heart and go through rehabilitation to walk and return to normal living. He was former President George W. Bush's vice president for eight years, from 2001 until 2009.

About 5.8 million Americans suffer from heart failure and other 57,000 will die of it this year.

“You Have the Power to Donate Life – to become an organ and tissue donor Sign-up today!
Tell Your Loved Ones of Your Decision”

Australia, register at Australian Organ Donor Register

New Zealand, register at Organ Donation New Zealand

Canada - Ontario beadonor.ca
other Canadian provinces

South Africa, http://www.odf.org.za/

United States, donatelife.net

United Kingdom, register at NHS Organ Donor Register

Your generosity can save or enhance the lives of up to fifty people with heart, kidneys, liver, lungs, pancreas and small intestine transplants (see allotransplantation). One tissue donor can help 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 or tissue transplant. Organs can save lives, corneas renew vision, and tissue may help to restore someone's ability to walk, run or move freely without pain. Life Begins with You.

U.K. Member of Parliament helping 66 year-old man denied lung transplant because of age

MP takes Bill Clark’s fight for lung transplant to the top

See my Previous post about Bill Clark, who has pulmonary fibrosis, being denied a lung transplant. Now it's great to see that others have taken up his fight.

The Bolton News

A BOLTON MP fighting to help a man who claims he has been handed a “death sentence” by a hospital has demanded a meeting with Health Secretary Andrew Lansley over the issue.

Bill Clark, aged 66, has been taken off the waiting list for a double lung transplant, claiming doctors told him he is too old for the operation.

Bosses at Wythenshawe Hospital have said they take a range of factors into account, including age, and he is no longer suitable.

Now Yasmin Qureshi, who represents the south east of the town, has taken up his case.

Ms Qureshi wrote to Mr Lansley highlighting Mr Clark’s case but is unhappy with the response she received.

A letter from minister Anne Milton explains there is an acute shortage of organs donated leading to difficult decisions.

It goes on to say this would be down to a multi-disciplinary team adding she is unable to comment or intervene in individual cases.

Ms Qureshi has replied asking to meet with Mr Lansley, saying: “I am afraid that I am not happy with the contents of this letter and I wish to speak to you in person about Mr Clark’s case.”

Her office is now waiting to hear when a meeting can be arranged.

Grandfather Mr Clark, of Duchy Avenue, Over Hulton, who is married to Barbara, said: “It was good to meet Ms Qureshi and I am pleased she is helping me.

“She is really having a go and I have my fingers crossed that if we keep going we will get a result. I feel more positive and hope to get back on the list. I would tell Andrew Lansley to get up-to-date with the times, people might be working until they are 70 or older but apparently 66 is too old for an operation.”

“You Have the Power to Save Lives – Register to be an organ and tissue donor & Tell Your Loved Ones of Your Decision”

Register to be a donor in Ontario at 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 or enhance the lives of up to fifty people with heart, kidneys, liver, lungs, pancreas and small intestine transplants (see allotransplantation). One tissue donor can help 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 or tissue transplant. Organs can save lives, corneas renew vision, and tissue may help to restore someone's ability to walk, run or move freely without pain. Life Begins with You

When Will Dick Cheney Be Too Old for a Heart Transplant?

The question of age affecting eligibility for an organ transplant arises frequently and this article addresses the issues physicians must consider when listing a candidate for a heart transplant.

By Katherine Hobson Wall Street Journal Health Blog

Former Vice President Dick Cheney said earlier this week, in an interview on the Today Show, that at some point he’ll have to make a decision about whether to seek a heart transplant.

Cheney has in the past experienced atrial fibrillation, an irregular rhythm of the upper chambers of the heart. And last summer he received a left ventricular assist device to help him regain function he’d lost due to congestive heart failure. LVADs are approved both as a stopgap measure for people waiting for a transplant and for those who don’t intend to seek a transplant.

To find out more about heart-transplant eligibility, we chatted with Jon Kobashigawa, director of the heart transplant program at the Cedars-Sinai Heart Institute. Kobashigawa, who isn’t involved in Cheney’s care, was one of the authors of the transplant guidelines developed by the International Society for Heart and Lung Transplantation.

Most of the guidelines deal with the clinical factors that make someone eligible for a transplant — normally end-stage heart failure with a high chance of death within a year. Potential recipients have poor scores on measures of heart-pumping efficiency and the ability to consume oxygen during an exercise session, for example.

But age is also a factor. The guidelines say that generally speaking, heart transplants are considered an option for eligible patients aged 70 and under. Cheney turns 70 on Jan. 30, but that doesn’t necessarily mean he has to make a decision in the next year, because the guidelines also say that “carefully selected” older patients may also be considered.

“Older patients in general can do as well as the younger patients at least in the short term,” says Kobashigawa, who wrote the section of the guidelines pertaining to age. But over time, obviously, they are more likely than young ones to experience other diseases that may kill them, he says.

There are more patients requiring heart transplants than there are donors, and some people do die while awaiting a donor organ. So the committees at transplant centers that decide how to allocate organs have to consider the ethics of taking, say, a 26-year-old’s heart and implanting it into someone who is not likely to live for another two decades rather than someone with a much longer life expectancy, Kobashigawa says.

One way to manage the ethical issue is through the “use of an alternate list or strategy where organs from donors (usually older donors) that would otherwise remain unused are allocated to older recipients,” the guidelines say.

At Cedars-Sinai, the oldest patient was a 77-year-old, says Kobashigawa. (There’s no lower bound; infants can have heart transplants, he says.)

“You Have the Power to Save Lives – Register to be an organ and tissue donor & Tell Your Loved Ones of Your Decision”

Register to be a donor in Ontario at 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 or enhance the lives of up to fifty people with heart, kidneys, liver, lungs, pancreas and small intestine transplants (see allotransplantation). One tissue donor can help 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 or tissue transplant. Organs can save lives, corneas renew vision, and tissue may help to restore someone's ability to walk, run or move freely without pain. Life Begins with You

UK man, 66 "too old’ for a life-saving transplant"

This story got my attention immediately because I personally know quite a few patients who received lung transplants in their 70's and have done quite well. Most centers have stopped using age as a criteria but rather assess each individual on their physical condition and the potential for an optimal outcome to a lung transplant.

from This Is Lancashire
A MAN claims he has been handed a “death sentence” after health chiefs took him off the waiting list for a double lung transplant.

Bill Clark, aged 66, has been told he has between 12 and 18 months to live without the procedure.

The grandfather-of-two, who is seriously ill with lung fibrosis, claims doctors told him he is too old for the operation.

Bosses at Wythenshawe Hospital, which cares for him along with the Royal Bolton Hospital, say they take a range of factors, including age, into account and Mr Clark is no longer suitable for surgery.

Mr Clark, who is married to Barbara, said: “They have given me a death sentence and I am devastated.

I don’t think 66 is old, I’m a fit person and someone at 40 might not do as well as me, everyone is an individual and it shouldn’t be about age.

They don’t seem to care and they’re not giving me a chance. I feel like I am just waiting to die.”

The retired employee of Bury’s primary care trust has been on the transplant list for three years, after developing lung fibrosis in 2004. He is now housebound, uses a wheelchair and is hooked up to oxygen 24 hours a day.

The family, of Duchy Avenue, Over Hulton, has already suffered tragedy, after the couple’s daughter, Gail, died at the age of five in 1976. She suffered a massive brain haemorrhage and her parents donated her kidneys.

Mr Clark, who also has a son, Paul, said: “I am prepared to take any chance to have a normal life. I put into the NHS for 48 years and this is the first thing I have wanted, I feel let down.

“They wanted me to lose weight which is difficult on steroids. I have, and I can get down more given time, I’ll do anything. We’re all upset and there’s nothing we can do.”

The hospital says the decision is not made by one person but a team of experts, who look at a number of factors.

A spokesman said: “He wasn’t taken off the register purely because of his age, his risk profile was considered to be quite high.

“We consider a number of things, age, weight, lack of mobilisation and the particular disease. There are national and international guidelines that anyone over 65 is at higher risk but it’s not always what we stand by, we have done a transplant on a 67-year-old.

“For this particular gentleman there were a number of reasons his risk profile was too high.”

“You Have the Power to Save Lives – Register to be an organ and tissue donor & Tell Your Loved Ones of Your Decision”

Register to be a donor in Ontario at 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 or enhance the lives of up to fifty people with heart, kidneys, liver, lungs, pancreas and small intestine transplants (see allotransplantation). One tissue donor can help 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 or tissue transplant. Organs can save lives, corneas renew vision, and tissue may help to restore someone's ability to walk, run or move freely without pain. Life Begins with You

Journal of American College of Surgeons finds lung transplantation should be used in older patients

The traditional protocol has been no lung transplants for patients older than 65, but as this study shows, there's no reason to deny potential transplant candidates a second chance at life just because they're older. Many centers now assess each potential candidate on an individual basis and I know several older recipients who were given a "second chance" and they're doing just fine. Thanks go to those transplant centers who are willing to raise the bar and save more lives.

(Have an opinion on this article? Please enter your comments at the end of the post)

Study supports use in appropriate candidates under the age of 70

EurekAlert!

CHICAGO (March 10, 2009) – New research published in the March issue of the Journal of the American College of Surgeons suggests that lung transplantation should be used with caution in patients older than 60 years and that the procedure is associated with high rates of mortality after one year in patients 70 and older.

Lung transplantation has been the gold-standard treatment for a variety of end-stage lung diseases, but candidate selection varies greatly among transplantation centers. The International Society for Heart and Lung Transplantation (ISHLT) reports that since 1985 the percentage of older patients receiving lung transplantation has increased steadily, with 24 percent of recipients in 2006 being older than age 60. This trend has raised concerns among transplant centers, since there is no consensus on potential age limits for the operation.

"These data underscore the importance of carefully considering age among potential lung transplantation recipients," said Eric S. Weiss, MD, division of cardiac surgery, The John Hopkins Hospital, Baltimore, MD. "Although age is only one of many important criteria, advanced age appears to have a major impact on post-surgical mortality. Our findings suggest that lung transplantation remains a viable option for appropriate candidates younger than age 70."

This new research study in JACS expands on previous findings reported by Dr. Weiss and colleagues. In October 2007 (93rd annual Clinical Congress Congress of the American College of Surgeons), Dr. Weiss reported that lung transplants improved survival rates in patients over 60 years of age. In this previous study the Johns Hopkins researchers looked at factors that create positive results in a 60-plus patient population, which has typically been regarded as not being the best candidates for lung transplantation. Upon analyzing patient outcomes, the researchers found that the survival rates between older and young patients were not all that different, especially at the 30-day survival period, and they concluded that this elderly patient population should not be categorically excluded from being offered the procedure as a treatment option. In the study just released in JACS, the researchers are able to make more specific recommendations for patients in the 60 to 70-years of age range, and beyond.

This new retrospective study examined 8,363 adult patients who underwent lung transplantation between 1999 and 2006. The United Network for Organ Sharing (UNOS) database provided the data, which was stratified into four quartiles (Q) of age: Q1, 18 to 45 years; Q2, 46 to 55 years; Q3, 56 to 60 years; Q4, 61 to 79 years. Patients in Q4 were further examined in smaller increments of age to assess differences in outcomes among the oldest groups of transplant recipients.

Patients in all four age quartiles had similar 30-day and 90-day mortality rates, but patients in Q4 experienced the highest mortality rates at 1-year post-transplant (21.4 percent, p=0.002). Of the 57 patients identified as 70 or older, 34 percent of the patients died during the study period. Additionally, both the 90-day and the 1-year mortality rates of the 70 years or older cohort was significantly higher than those patients under 70 (27 percent versus 9 percent for 90 day; and 42 percent versus 18 percent for 1 year; p<0.001 for both comparisons).

About the American College of Surgeons

The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and to improve the care of the surgical patient. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 74,000 members and is the largest organization of surgeons in the world. For more information, visit http://www.facs.org.

“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
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