Organ transplants linked to higher skin cancer risk – UPI.com

This was originally published on this site

WEDNESDAY, Sept. 21, 2016 — People who have an organ transplant may be more likely to develop skin cancer, new research suggests.
The finding applies to all transplant patients, even those who are nonwhite and dark-skinned, according to Dr. Christina Lee Chung, an associate professor of dermatology at Drexel University in Philadelphia, and colleagues.

The researchers said the risk increases over time with ongoing exposure to medications that suppress the immune system to prevent organ rejection.

Total-body skin exams should be a routine part of care after transplant surgery, the study authors advised.

For the study, the researchers analyzed medical records of 413 organ transplant recipients, 63 percent of whom were not white.

The investigators found 19 new skin cancers in 15 of the nonwhite patients. That group included six black patients, five Asians and four Hispanics. Among the black patients, all of the skin cancers were caught early on.

Most of the Asian patients developed skin cancers in areas that had been exposed to the sun. Skin cancers were also found on sun-exposed areas and lower legs of the Hispanic patients.

The researchers noted, however, that their ability to draw firm conclusions was limited by the small number of skin cancer patients. And the study did not prove a cause-and-effect link.

“Nonwhite organ transplant patients represent a unique group with specialized medical needs; thus, more knowledge on risk factors, appropriate screening methods and counseling points are essential for providing comprehensive dermatologic care for these patients,” the study authors concluded.

The study was published online Sept. 21 in JAMA Dermatology.
More information
The U.S. National Library of Medicine has more about organ transplantation.

Copyright © 2016 HealthDay. All rights reserved.

Robin Roberts Celebrates 4th ‘Birthday’ of Bone Marrow Transplant With Podcast Launch – ABC News

This was originally published on this site

Good Morning America” co-anchor Robin Roberts is celebrating her fourth “birthday,” as she likes to say.

It’s been four years since Roberts received a life-saving bone marrow transplant to treat myelodysplastic syndrome or MDS, a rare blood disorder.

Throughout her difficult journey, Roberts remained resilient thanks to her beloved mother’s refrain, “Everybody’s got something.” She held onto that phrase like a mantra.

Now, Roberts, who started her career in the radio booth at WFPR in Hammond, Louisiana, is coming full circle to launch an intimate and compelling podcast called “Everybody’s Got Something.”

The podcast spotlights true stories of redemption, recovery, and how to discover inner strength even in the most difficult of times.

“It’s all about honest and important conversations with everyday heroes and celebrities … and some laughter too,” Roberts said.

Check out the podcast interviews at RobinPodcast.com.

In every interview, Roberts has candid conversations with her guests, who offer unfiltered admissions to obstacles they’ve faced, and moving descriptions of unexpected journeys of self-discovery.

Food Network superstar Giada De Laurentiis opened up about her unbearable grief in the wake of her brother’s death. “I think I shut down for quite some time, several years,” she told Roberts. “And it wasn’t really until I had my daughter that I realized, ‘Okay, I think I can love like this again.'”

Radio host Delilah, with her famous edge of ironic humor, confessed to Roberts that she has wrestled with her own ghosts and demons, including a six week marriage gone wrong.

“You know my six week failed marriage probably was more life changing -– except for having my children. That incident probably blessed me and helped me more than anything else in my life…that was such a defining thing in my journey, in my path of life. I thank God for that six week marriage,” she explained.

Roberts also reunited with her friend, award-winning singer-songwriter India Arie. The two women collaborated on a theme song for “Good Morning America” in 2008 and worked together again on an original song for the podcast.

Arie also shared her own story of resilience. After a crippling loss of self-confidence, she disappeared from the public eye for four years in order to find herself.

“I was broken. I knew no one was going to be able to put me back together but me…and I didn’t want to die….and I felt like I was in danger of dying,” Arie said.

“I knew that I couldn’t live that way. … I did the work to actually heal myself. And in hindsight, I realized that is courageous. At the time it just felt like survival — like I’m just trying to survive.”

To listen to these revealing and intimate interviews in Robin Roberts’ podcast, visit RobinPodcast.com.

Download the “Everybody’s Got Something” podcast on iTunes or Google Play, and learn more at RobinPodcast.com.

Family Rallies Behind Infant In Desperate Need Of Liver Transplant – CBS Local

This was originally published on this site

BOSTON (CBS) — At Boston Children’s Hospital organ transplant floor, 7-month-old Gabriella puts on a brave smile even though she’s fighting for her life.

“We are trying to keep hope. We are doing our best for her,” her mother Meghan Stuart said.

Gabby has Biliary Atresia, a liver disease that develops shortly after birth. Gabby’s is now advanced and she’s in desperate need of a liver transplant.

“Unfortunately, this is a disease if it gets to this point can be fatal for her if it progresses any longer without a liver transplant,” Boston Children’s Hospital Liver Specialist Dr. Maureen Jonas said.

The family made a Facebook page called “Gabriella Quinn’s Journey.”  It’s to let people know how she’s doing but also to spread awareness about the importance of organ donation. In Gabby’s case, she doesn’t even need a full liver.

“We are now lucky that these procedures have been perfected we can take part of a liver or from a living donor and go into Gabby and grow as she grows,” Dr. Jonas said.

7-month-old Gabriella Quinn is in desperate need of a liver transplant (WBZ)

7-month-old Gabriella Quinn is in desperate need of a liver transplant (WBZ)

Gabriella’s family is very thankful for all the love and support but their precious child needs a liver transplant within a year. And while the family remains hopeful they know the road for this child is going to get tougher.

“It’s overwhelming. I am only 30 this is my first baby and you think you’re going to have a newborn and take them home but you mourn the fact you can’t do that,” Stuart said.

The family is very thankful for support at Boston Children’s Hospital as they hope for a miracle.

“In reality she may not get one before she needs one. The doctors here have been unbelievable to us and we trust in them,” Stuart said.

Until then, Gabby will smile, fight and wait for a transplant.

Doctors say Gabby needs an O positive or O negative blood type.

For more information go to her Facebook page where you can apply to be a donor.

Computer algorithm shows need of standard care for transplant patients Johns Hopkins Medicine – EurekAlert (press release)

This was originally published on this site
Using the results from a computerized mathematical model, Johns Hopkins researchers investigated whether they could improve heart and lung transplantation procedures by transferring patients from low-volume to high-volume transplant centers.

Investigators have long observed a positive relationship between a high operative volume and improved patient outcomes across a variety of surgical procedures, meaning that the more times a medical center does a particular surgery, the better its patients do overall. The new study, published in the American Journal of Transplantation on September 12, was the first to investigate this trend for heart and lung transplant patients on a national level, the Johns Hopkins team says.

“The reason we did the simulation is because there is a lot of uncertainty in predicting post-transplantation outcomes,” says Trent Magruder, M.D., a surgery resident and fellow in the Division of Cardiac Surgery at the Johns Hopkins University School of Medicine. “We hope our model will help illuminate areas for improvement and bring better and more predictable outcomes to doctors and patients.”

Past research showed that centers performing less than 14 heart transplants or 20 lung transplants each year have been associated with increased patient mortality. The new simulation drew on information from 12,594 heart transplant patients from 135 medical centers and 12,300 lung transplant patients from 67 centers in the U.S. The researchers define low-volume centers as those performing less than an average of 5.9 heart transplants or 11.9 lung transplants per year — both below the threshold for low-volume centers, as defined by past studies by other researchers.

The algorithm divided the continental United States into 11 regions, as defined by the United Network for Organ Sharing, which controls the allocation of donor organs, and began figuratively “closing” the center with the lowest number of transplants per year in each region. The algorithm essentially referred all patients from the “closed” low-volume center to the largest one in that region and assigned those patients the largest center’s reported mortality rate. This process was repeated until either five centers had been closed or only one transplant center in a given region was left.

For heart transplant patients, the first, second, third, fourth and fifth closings were associated with saving 10.1, 37.5, 76.6, 120 and 240.3 lives, respectively, at one year post-transplant. Lung transplant patients saw similar benefits, with 29.2, 78.2, 124.6, 202.5 and 240 lives saved at one year post-transplant for each successive closing.

“The goal of this study is not to say we need to close small centers,” says Christian Merlo, M.D., M.P.H., associate professor of medicine at Johns Hopkins. “We used this algorithm as a tool to see if we can limit some of the heterogeneity between centers and find out if this improves outcomes for our patients. It is food for thought that we hope will spark conversation among our colleagues about the need for a set of best practices and ways to share that information across centers,” he adds.

While other countries, like the U.K., have nationalized, single-payer health care, a similar system may not be practical in the U.S. because of its size. For example, patients’ average travel distances for heart and lung transplantation exceed 300 miles in parts of the Pacific Northwest, and center closure would undoubtedly increase these distances. As such, regionalization could limit access to care to those who can’t afford to travel, in addition to the cost of the procedure. The authors emphasize that their algorithm, for the time being, can’t quantify the socioeconomic costs regionalization of care would create.

The researchers say that the next steps will include studying the best performing centers to see what they are doing differently from smaller centers to save more lives. Using this information, transplant physicians and surgeons can develop guidelines for best practices to share across the country. “The limitation of this study is that it is a black box,” says Magruder. “I can tell you that this algorithm appears to save lives, but I can’t tell you what the high-volume centers are doing, which makes more detailed research an important next step.”

###

In this year alone, 16,000 transplants have been performed in the U.S. Of those, 1,577 have been heart, 1,199 have been lung, and four have been heart and lung. However, all transplant patients can benefit from the improved care and collaboration across institutions that the researchers in this study wish to bring about.

Additional authors include Ashish Shah of the Department of Cardiac Surgery at Vanderbilt University School of Medicine; Bo Kim and Jonathan Orens of the Division of Pulmonary and Critical Care Medicine at the Johns Hopkins University School of Medicine; and Todd Crawford, Joshua Grimm, Errol Bush, and Robert Higgins of the Division of Cardiac Surgery at the Johns Hopkins University School of Medicine.

The authors of this manuscript have no conflicts of interest to disclose as described by the American Journal of Transplantation.

Click for raw video footage featuring Dr. Robert Higgins, MD, surgeon-and-chief at Johns Hopkins.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

‘Liver in a Box’ could be game-changer in organ transplant process – WCVB Boston

This was originally published on this site
A local company has created a high-tech upgrade for organ transplants, and doctors believe it could help save more lives as the use grows.

The portable device, known simply as “liver in a box,” is made by TransMedics in Andover.

It lets doctors keep a donated liver operating and functioning just like it is in the body, rather than the traditional process of putting it on ice once it is removed.

Massachusetts General Hospital recently became the first hospital in the country to perform a liver transplant using the “box.”

“I think it’s a major advance,” said Dr. James Markmann, of the MGH Liver Transplant program.

“We try to keep it as it would be in the body, so we give it oxygen and blood and nutrients to allow it to function physiologically,” said Dr. Markmann. “We think that keeping it on the pump for a period may actually improve the organ before we put it in.”

Markman said that, among other things, the device makes it possible for surgeons to monitor the quality of the organ and ensure that it is viable.

Right now, doctors typically discard a liver if they can’t be sure it will function when transplanted. This device takes away that uncertainty, and therefore could make more organs available for people on long waiting lists.

Since the device keeps the liver functioning, it could also allow for longer transportation of the organ when it is moved from donor to recipient.

Lloyd Matsumoto, a professor of biology at Rhode Island College, became a candidate for a liver transplant after 30 years of fatty liver disease that led to cirrhosis and liver cancer.

“I was completely jaundiced. Even the whites of my eyes were yellow,” said Matsumoto. “You know, I was pretty close to checking out of here.”

Surgeons removed three tumors from Matsumoto’s liver and he eventually became the third local patient to undergo transplant surgery using “liver in a box.”

He and the other patients are doing very well.

“We won’t know until many of these are done how great a benefit there is, but I think this is probably the biggest innovative step in many years,” said Dr. Markmann.

Matsumoto said he feels like a lucky man, not only for being able to take part in the new process, but also that he was able to receive a donated kidney.

“I wouldn’t be here if it was not for the generosity of the donor’s family,” said Matsumoto.

The device is currently undergoing clinical trials before it can receive full approval from the U.S. Food and Drug Administration. 

Recommended

Cobb races raise money for heart transplant patients – Atlanta Journal Constitution

This was originally published on this site

Cobb races raise money for heart transplant patients

Runners hit the trail in Powder Springs for the Achy Breaky 5K to support Enduring Hearts, a nonprofit that supports research for pediatric heart transplants. Photo courtesy of Enduring Hearts.

Who’s doing good?Each Tuesday, we write about charity events such as fun-runs, volunteer projects and other community gatherings that benefit a good cause. To suggest an event for us to cover, contact Devika Rao at doing.goodAJC@gmail.com

Information: volunteer@enduringhearts.org, enduringhearts.org

More Cobb coverage

Cord-blood transplants show promise in leukemia treatment – WDEF News 12

This was originally published on this site
Bone marrow or stem cell transplants can save the lives of adults and children with leukemia, but an ideal donor often isn’t available. In those cases, umbilical cord blood may work as well as current alternatives — or even better in some cases, a new study suggests.

“Often, cord-blood transplant is thought to be only as the last resource for patients without donors. But cord blood does not have to be considered only an alternative donor source,” said study lead author Dr. Filippo Milano.

“In centers with experience, it can yield to great outcomes,” said Milano, an assistant member of the Clinical Research Division at Fred Hutchinson Cancer Research Center in Seattle.

At issue: How best to treat the blood cancer leukemia and a related condition called myelodysplastic syndrome? One approach replaces a patient’s blood-producing bone marrow through a transplant. The “gold standard” is to find a relative who can donate bone marrow or stem cells, preferably a “matched” sibling whose blood is compatible with the patient’s, Milano said. But for 70 percent of patients, this ideal fit doesn’t occur, the study authors noted.

Physicians then might recommend a transplant from a compatible donor unrelated to the patient or an unrelated donor who’s mostly (but not entirely) compatible.

This new study considers another option: A donation of cord blood from the placenta​ and umbilical cord of newborn babies. Like bone marrow or stem cell transplants, a cord-blood transplant can produce stem cells that create new blood.

“However, cord-blood donors and recipients don’t need to be a perfect match,” Milano said.

To compare the success of the different options, researchers looked at 582 patients with leukemia or myelodysplastic syndrome. If a compatible bone marrow or stem cell transplant from an unrelated donor wasn’t available, the patients got either a cord-blood transplant or an incompatible bone marrow or stem cell transplant from an unrelated donor, Milano said.

“Our study showed that overall survival after cord-blood transplantation was comparable to the one observed after matched unrelated transplants,” Milano said. And patients who got cord-blood transplants seemed to live longer than those who got non-matching bone marrow or stem cell transplants from unrelated donors, he noted.

The cord blood approach appeared especially beneficial for a subset of patients with what’s known as “minimal residual disease.” This means small amounts of cancer cells remained after the chemotherapy that is required before transplant.

“The risk of relapse is very high for them,” Milano said. But “the risk of relapse was significantly lower in patients receiving cord-blood transplants,” Milano said.

What about cost?

Milano said cord-blood transplants require more blood, potentially increasing the cost. But, he said, prices may drop thanks to technological advances that could allow less blood to be used.

Dr. Marcos de Lima, a bone marrow transplant specialist, said the study results are surprising.

“This validates the idea that cord blood is a very strong alternative to bone marrow as a source of stem cells for a transplant,” said de Lima, a professor of medicine at Case Western Reserve University School of Medicine in Cleveland. Even so, “one would not go as far as saying cord blood should replace the fully matched donors,” added de Lima, who wasn’t involved in the study.

Another expert agreed.

Cord blood “is a very good option particularly in terms of high survival and low risks of relapse, and should be considered in a patient who does not have a fully matched family donor,” said Dr. Vinod Prasad, who played no role in the study. He specializes in pediatric blood and marrow transplantation at Duke University Medical Center in Durham, N.C.

Questions remain, however, de Lima said. Why does cord blood seem better at vanquishing leftover cancer in some situations? It’s not clear, he said. But it does seem that “cord blood is more tolerant of mismatches” between the donor and the patient who gets the transplant, he said.

The study was published in the Sept. 8 issue of the New England Journal of Medicine.

Robot carries out its first kidney transplant on two Britons – International Business Times UK

This was originally published on this site

Two Britons have left hospital just four days following a kidney transplant after it was successfully carried out by a robot. Siobhan Morris, 42, and Andy Brooks, 58, who had transplants within a day of one another, are the first patients in Britain to undergo the procedure performed by a non-human.

According to the Sunday Times, the transplants were so accurate and caused such limited damage that only paracetamol was required for pain relief.

In comparison, patients who undergo traditional open surgery often require a morphine infusion for pain control.

Morris – who previously received a kidney from her mother in 2007 – said: “I was amazed. The pain is probably 80% less than it was first time round because they cut through all the muscles before and they didn’t do any of that this time. It is so much easier.”

She received the kidney transplant on 4 September.

Brooks was given strong painkillers at first before switching to paracetamol after a couple of days.

“The post-operative recovery was much shorter than it would have been under the conventional transplant,” he told the newspaper. “I was operated on on Saturday [10 September]. I was hopping out of bed on Sunday and walking about. It was an amazing experience.”

A traditional kidney transplant procedure using open surgery consists of three stages.

First, an incision is made to the lower abdomen where the donated organ is put into place. Nearby blood vessels are then attached to those from the donated kidney to maintain blood supply. Finally, the ureter of the donated kidney is connected to the patient’s bladder.

Surgery via India

Transplant surgeons at Guy’s and St Thomas’ NHS Foundation Trust controlled the robot with assistance from Professor Pranjal Modi of the Institute of Kidney Diseases and Research Centre located in India’s westernmost state of Gujarat. Modi is credited with pioneering robotic transplants.

“We have been incredibly impressed with the difference in recovery. Normally these patients would be on morphine infusions for two to three days,” Nizam Mamode, a consultant transplant surgeon at the hospital said.

“We think [using the robot] they will require little or no morphine. That means they mobilise quicker, and if they mobilise quicker and they feel better, then we would expect their overall recovery to be better.

“The first patient didn’t require any morphine at all and wanted to go home on day three,” Mamode added. “Normally, in an [open surgery] transplant, you make a big incision and you cut muscle to go in, which is then painful. Potentially it is going to revolutionise transplantation.”

Kidney donors don’t always get priority when they need a transplant – Yahoo – Yahoo News

This was originally published on this site

By Andrew M. Seaman

Living kidney donors are supposed to get priority on the waiting list if they ever need a transplant themselves, and when a recent study found that wasn’t always happening, regulators put new policies and programs in place to reduce delays.

“We were surprised to find that some donors did not immediately receive their (prior living donor) priority on the waiting list,” said Jennifer Wainright, of the United Network for Organ Sharing (UNOS) in Richmond, Virginia. “We found this while we were working on another project. It wasn’t something we expected to find, and it was a serious problem. We immediately put the original project on hold to address it,” she added.

“Potential living donors should know that in the rare case where they would later need a transplant themselves, policy gives them very high priority on the kidney waiting list and most prior living donors receive a kidney very quickly,” Wainright said.

However, her team discovered, about a third of prior donors who needed a new kidney waited days to months before receiving their priority designation.

Wainright and colleagues say a number of factors can keep a prior living donor from quickly getting an organ, including delays in being added to the waiting list, not being listed as “active” (that is, eligible to receive a kidney) and not being designated as a past donor.

For the new study, scheduled for online publication September 1st in the Clinical Journal of the American Society of Nephrology, the researchers used Organ Procurement and Transplantation Network data collected from January 2010 through July 2015.

During that time, 210 prior living donors were added to the waiting list. By September 2015, 167 had received a kidney from a deceased donor, six had received a kidney from a living donor and seven had died or become too sick to undergo a transplant.

About half the prior living donors received a deceased donor’s kidney after 98 days on the list.

About 68 percent of the prior living donors had been listed as “inactive” for up to 90 days. Being inactive means that you’re on the list, but – for some reason – can’t accept a new organ at that time. About 18 percent were inactive for 90 days to a year, and about 14 percent were inactive for more than two years.

After being activated on the list, about two thirds received their prior living donor priority status within seven days. About 15 percent waited eight days to a month and about 17 percent waited longer than a month.

About half of those who were active on the list, with prior living donor status, received a kidney from a deceased donor within 23 days, the researchers found.

Based on the findings, UNOS implemented new policies and programs. “We think UNOS’s new processes will help transplant programs prevent this type of delay in the future,” said Wainright.

Her team is currently evaluating data to see if prior living donors have benefited from those new policies and programs.

“We are just finishing up those analyses, but the preliminary findings have been positive for prior living donors, and we plan to continue monitoring results to make sure they continue to receive transplants quickly,” said Wainright.

SOURCE: http://bit.ly/2bMxHQ1

Clin J Am Soc Nephrol 2016.

(This version of the story corrects study author’s name in paragraph five.)

Son of Miami-Dade Police Officer Battling Leukemia, Needs Bone Marrow Transplant – NBC 6 South Florida

This was originally published on this site

Members of the community came out Thursday to help the son of a Miami-Dade Police officer who’s battling Leukemia.

Two-year-old Alex needs a bone marrow transplant and is looking for a potential donor who is a match.

Looking to help, people filed into the Miami Beach Police Department Thursday to get tested by OneBlood, to see if they could be a match for Alex.

OneBlood will be looking for donors for Alex all month. If you are between the ages of 18 and 44, get tested and see if you can help. Click here for more info on donating.

Inspiration + Education : . . . . for parents of children who are going through transplant

%d bloggers like this: