Thursday, April 03, 2014

Donor organs kept viable for transplant longer


'Cold' Carriers to up travel time for transplant hearts



You cannot blame transplant surgeons for having high BP. After all, speeding in an ambulance across the city, removing a beating heart (or liver or lung) from a brain-dead patient, putting it in a box of saline and rushing back before the organ gets infected or stops beating... and then operating for 6-12 hours,  cannot be good for the nerves.
The heart transplant team at Global Health City may be able to breathe a little easier soon, when they procure new organ transportation cases that are equipped with cold perfusion technology. “Right now, the organs are carried in sterilized boxes with ice and saline, which keep the organ usable for up to four hours. But the battle against time is a constant worry,” said Dr R Ravi Kumar, senior interventional cardiologist at the hospital.
Despite its having the best organ transplant programme in the country, at least a 100 harvested organs go to waste every year, rued cardiologist Dr Nandkishore Kapadia at the inauguration of Global’s Heart Failure Clinic on Wednesday. Most of it is because the organ gets infected before it reaches the recipient.
In contrast, the cold perfusion boxes will keep feeding the heart cold nutrients that circulate inside the blood-pumping organ, allowing it to stay alive and fresh for longer. “Studies have indicated that these cases will be able to keep harvested cadaver hearts alive for up to nine hours,” he added about the boxes which have been procured at a cost of `60 lakh. (more than $100,000 U.S.)
While the additional time will make it easier for ambulance drivers who battle the city’s traffic every day, what it really does is open up the possibility of procuring organs from further south. “At the moment, we struggle to procure organs from Tiruchy, which is about three hours away through our ‘green corridor’. With the advantage of these boxes, we may be able to receive organs from places like Coimbatore soon,” said Dr Ravi.
Global’s Heart Failure Clinic brings together the whole gamut of heart services from elective surgeries to emergencies in one department and is among the few of its kind in the country.
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Wednesday, March 12, 2014

New Smaller SynCardia Artificial Heart waiting FDA approval

Press Release

New Smaller SynCardia Total Artificial Heart

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

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

The 70cc SynCardia Total Artificial Heart, left, has been implanted in nearly 1,300 patients world-wide. The smaller 50cc SynCardia Heart, right, which could go to clinical trials this year pending FDA approval, is designed to fit in heart failure patients of smaller stature, including most women and many adolescents.The 70cc SynCardia Total Artificial Heart, left, has been implanted in nearly 1,300 patients world-wide. The smaller 50cc SynCardia Heart, right, which could go to clinical trials this year pending FDA approval, is designed to fit in heart failure patients of smaller stature, including most women and many adolescents.
TUCSON, Ariz. – March 11, 2014 –Recent developments surrounding the SynCardia temporary Total Artificial Heart will make the life-saving device available to three times the number of people suffering from end-stage biventricular heart failure. Over 300 SynCardia Hearts have been implanted worldwide since 2012.
Clinical trials awaiting FDA approval will document the use of a new smaller 50cc version of the SynCardia Total Artificial Heart, making it available to people of smaller size, including most women, men and many adolescents.
The current 70cc SynCardia Total Artificial Heart, the world's first and only FDA, Health Canada and CE approved Total Artificial Heart, is approved as a bridge to transplant. It has been implanted in nearly 1,300 people worldwide.
Once approved by the FDA, the studies are expected to launch later this year. They will also investigate using the SynCardia Heart for permanent use (also known as destination therapy). This allows patients who do not qualify for a donor heart transplant — because of other health conditions or age — to receive a SynCardia Heart.
About 3,800 people wait for a heart transplant on any given day, according to the U.S. Department of Health & Human Services. The need for donor hearts is increasing, however. For over 20 years, the supply of approximately 2,300 donor hearts annually has been flat in the U.S. and the supply has generally been declining in Europe. Approximately 16% of people on the heart transplant list become too ill or die each year.
Many patients have lived with the SynCardia Heart for months or years while waiting for a matching donor heart. Thelongest a patient has lived with a SynCardia Heart was nearly four years before receiving a successful donor heart transplant. The SynCardia Total Artificial Heart is one of the most reliable approved heart devices. The valves in the heart have never failed and the diaphragms that pump the blood have a failure rate of less than 1% for nearly 1,300 implanted hearts, accounting for 2,600 ventricles.
Once the clinical trials are underway, both the 50cc and 70cc SynCardia Total Artificial Heart will be available as both destination therapy and bridge to transplant at study sites. The 70cc SynCardia Heart as a bridge to transplant is available at all SynCardia Certified Centers. Like a human heart transplant, the SynCardia Heart eliminates the symptoms and source of end-stage biventricular heart failure, when the left and right ventricles can no longer pump enough blood for the patient to survive.
SynCardia CEO and President Michael P. Garippa and Chief Technology Officer Rich Smith detailed these developments in a March 4, 2014 segment of “AZ Illustrated Science,” a Tucson Arizona news and public affairs show that airs on Public Broadcasting. They also provided an update about the Freedom® portable driver, which powers the SynCardia Heart.
The Freedom® portable driver, at only 13.5 pounds, provides patients with almost unlimited mobility. It is pending FDA approval and is approved by Health Canada and the CE Mark for Europe. A majority of clinically stable patients are discharged with the Freedom portable driver to recover at home and in their communities. At home, patients are able to sleep in their own beds, eat out, socialize and be part of their communities. Most patients exercise, helping them become stronger for their donor heart transplant.
“Freedom patients have proven that many activities and daily living are possible, including activities that we don’t necessarily endorse,” Garippa says of some patients. “We’ve had people go four-wheeling. We’ve had people doing tai chi. We’ve had people cycle, run, take driving vacations through many states and countries and do everything but swim.”
The 50cc Total Artificial Heart is designed for use as a bridge to transplant in patients of smaller stature, including women and adolescents. It has been designated as a Humanitarian Use Device (HUD) by the FDA for destination therapy in adults and as a bridge to transplant in pediatric patients. Prior to clinical study, an Investigational Device Exemption (IDE) application that includes each indication must be approved by the FDA.
CAUTION – The Freedom portable driver is an investigational device, limited by United States law to investigational use.
###
About the SynCardia temporary Total Artificial HeartSynCardia Systems, Inc. (Tucson, AZ) is the privately-held manufacturer of the world's first and only FDA, Health Canada and CE approved Total Artificial Heart. Originally used as a permanent replacement heart, the SynCardia Total Artificial Heart is currently approved as a bridge to transplant for people suffering from end stage heart failure affecting both sides of the heart (biventricular failure). There have been more than 1,250 implants of the Total Artificial Heart, accounting for more than 350 patient years of life on the device.
Similar to a heart transplant, the SynCardia Total Artificial Heart replaces both failing heart ventricles and the four heart valves. It is the only device that eliminates the symptoms and source of end stage biventricular failure. Unlike a donor heart, the Total Artificial Heart is immediately available at 97 SynCardia Certified Centers worldwide with 39 others in the process of certification.
The Total Artificial Heart provides immediate, safe blood flow of up to 9.5 liters per minute through each ventricle. This high volume of blood flow helps speed the recovery of vital organs, helping make the patient a better transplant candidate.
For up-to-date information, please visit: http://www.syncardia.com
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Cystic Fibrosis patient runs marathon after double lung transplant

Brighton jewellery designer runs marathon 

The Argus: Amanda Chalmers gearing up for the marathon
Amanda Chalmers gearing up for the marathon

A jewellery designer born with cystic fibrosis will run a marathon less than two years after undergoing a double lung transplant.
Amanda Chalmers, 26, could hardly walk up the stairs and was reliant on oxygen therapy 24 hours a day before her life-saving operation in September 2012.
The University of Brighton graduate will run the Brighton Marathon with six of her friends next month, raising money for the Cystic Fibrosis Trust.
Miss Chalmers, who won gold for archery in the British Transplant Games, said: “I initially signed up for the marathon in 2011 after seeing my friends complete it.
“I had just come out of hospital and for the first time needed to use oxygen therapy at home, but I was determined that by the following year, I would get myself back on track and healthy enough to run the marathon.
“That didn’t happen as I became completely reliant on oxygen 24/7 and my health deteriorated.
“By May 2012, I was on the list for a life-saving double-lung transplant and in September that year I was lucky enough to receive one.”
She said that after her surgery she knew she no longer had an excuse not to run the marathon and that completing it will be a huge achievement.
“Going from hardly being able to walk up my stairs to being able to run – and a bit of walking – in a marathon is something I’m so glad to have the chance to do,” she said.
Miss Chalmers, from Brighton, said that basic care for cystic fibrosis sufferers to maintain life and keep as healthy as possible was improving, but that many people are not lucky enough to receive a transplant.
She said: “Thanks to the Trust putting money into care and gene therapy research, a major trial of new drugs is now under way.
“This work is only possible through the generosity and support of very kind people, so when it came to picking a charity to run for it was an easy choice.”
Ed Bending, the university’s environmental communications officer, who is running the marathon with his friend, said: “Amanda’s life-saving operation and her amazing recovery are just fantastic and we are all so proud of the resilience she has shown and the can-do attitude that has led her to this point.”
Jennifer Westmoreland, head of the Cystic Fibrosis Trust’s community and fundraising events, said: “Amanda is a brilliant example of what people with cystic fibrosis can achieve when they are given the opportunity. I’m sure her story will inspire others waiting for organ transplants.”
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Poor immigrants targeted in illegal organ sale

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


According to the police report, the suspects were caught while they were trying their luck with impoverished immigrants in Spain's eastern region of Valencia.
An NGO worker working with migrants in the region was the one who took the matter to local police.
The Lebanese man and his four associates had already covered the cost of several candidates’ medical check-ups to determine their organ compatibility.
Spain has been the world leader in organ transplants for the past 22 years, with 35 out of every million people donating their organs.
A national record was set last February, when 45 organ transplants were performed in a single day.
According to several Spanish media sources, this was the first attempt to carry out an unregulated organ transplant on Spanish soil.

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Sunday, February 02, 2014

Couple pulling out all the stops in search for a kidney

jeff and kathy

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

Photograph by: Nick Procaylo, Nick Procaylo


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

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

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

But in McIntee’s mind, her life-saving work is far from over.
“I’m doing everything I can think of to find him a kidney donor,” she said. “We’re trying to keep our faith and hope up.”

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

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

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

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

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

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

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

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

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

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

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

In fact, Vanderveen was contacted by B.C. Transplant about a possible anonymous donor last week. It’s unclear if the person will be a match, but he’s hopeful, while trying to remain realistic. There have been times when he’s thought there was a match in the past.
“We’re not giving up the search until I actually receive a kidney,” he said. “For everyone on the transplant list, this is their only chance.”

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

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

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

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

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

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

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