Tag Archives: Liver

3-year-old girl with rare disease gets liver transplant – NY Daily News

BY CORINNE LESTCH NEW YORK DAILY NEWS Wednesday, November 12, 2014, 11:33 AM A A A

A 3-year-old girl was the first to receive a liver transplant to treat an extremely rare metabolic disease that has been diagnosed in only eight people.

Donya McCoy’s daughter, Kennedy, received the transplant on Tuesday after months of waiting and being turned down by several doctors, according to Yahoo! News.

McCoy was alerted to her daughter’s condition after she had a seizure at just 8 months old.

A doctor near where McCoy lives in Elizabethtown, Penn., did an MRI on the girl and was stumped.

“He came out to talk to us and told us the white matter in her brain looked like nothing he’d ever seen before,” said McCoy.

After several doctors turned her down for treatment, since it was unclear what Kennedy was suffering from, a retired 86-year-old metabolic specialist named Dr. S. Harvey Mudd decided to come out of retirement to lend his knowledge.

Donya McCoy set up a Facebook page to attract donors for her daughter.

He diagnosed Kennedy with a rare metabolic disorder called S-adenosylhomocysteine hydrolase deficiency — a condition that only eight people have been identified as having. Just six of those are alive today, according to Yahoo! News.

The agonizing wait continued when Mudd died 11 months later. At his memorial, McCoy begged Kevin Strauss, the medical director of the Clinic for Special Children, to take over for Mudd and treat her daughter. He said yes.

“He made her a priority and within a month, he figured out that a liver transplant was her best shot at survival,” McCoy said. “So she’s the first in the world to have a liver transplant for her disease.”

Kennedy received the life-saving transplant from her mother’s high school classmate, Michael Thompson.

“A guy I went to high school with messaged me and said, ‘I have O positive blood,'” McCoy recalled.

Michael Thompson responded to the Facebook post.

Thompson spotted his old classmate McCoy’s desperate plea for a liver donor on her Facebook page — and decided to help.

“One of the greatest things I will probably do in my life, give more life to another human,” Thompson, who donated 25% of his liver, wrote on his Facebook page in October. “Thank you, Donya McCoy, for letting me.”

The surgery at Children’s Hospital of Pittsburgh lasted eight hours and required the skills of four surgeons, two anesthesiologists and two nurses.

She will remain in the hospital for a few months, McCoy said, but she’s “tough.”

via 3-year-old girl with rare disease gets liver transplant – NY Daily News.

Pennsylvania mother finds transplant donor for daughter on Facebook | Fox News

Published November 11, 2014

FoxNews.com

Staying in touch with old friends on Facebook proved more than a little fruitful for a Pennsylvania mom who updated her status in hopes of recruiting a liver donor, CBS Pittsburgh reported.

Donya McCoy’s daughter, 3-year-old Kennedy Stevenson, has a rare metabolic disease and is only one of eight people in the world to be diagnosed with the condition.

Kennedy will also be one of the first people in the world with the condition to undergo a liver transplant operation that doctors hope will save her life.

Michael Thompson, who went to high school with McCoy, is going to help make that happen.

“I think I asked him five or six times if he was serious, if that was a serious response,” McCoy told CBS Pittsburgh of Thompson’s reply on Facebook.

Thompson was serious, pointing out that he didn’t think the reality had sunk in for McCoy until they started the steps. During the testing process, Thompson turned out to be a match, qualifying him as a liver donor.

While surgeons remove Kennedy’s liver at Children’s Hospital of Pittsburgh, doctors at UPMC Montefiore will remove up to 25 percent of Thompson’s liver, which will be donated to Kennedy.

“They think this is going to cure her,” McCoy said. “And if it does, it gives me so much comfort that maybe another mom doesn’t have to walk the same path that I did. They’ll figure things out sooner, and know how to intervene and do a transplant, and life goes on.”

via Pennsylvania mother finds transplant donor for daughter on Facebook | Fox News.

General Health Surveillance, Screening Important for Long-Term Liver Transplant Survival – HCPLive

Originally posted by HCPLive

By Kari Oakes, PA-C | November 10, 2014

Outcomes for liver transplant recipients have never been better, and long-term survival will depend on a holistic approach to optimizing screening and primary prevention in this population, says the Mayo Clinic’s Kymberly Watt, MD. She spoke to the need for both hepatologists and primary care providers to adopt evidence-based health surveillance for long-term survivors of liver transplant on November 9, 2014 at The Liver Meeting in Boston, MA.

For liver transplant recipients who die more than one year after surgery, almost two-thirds (63.8%) will die of nonhepatic causes, while only about a quarter (23.9%) die of hepatic causes (the remainders are unknown). Liver disease recurrence rates vary by type of disease; HCV recurrence, which had been near-universal, will likely plummet as new treatments are introduced. This will result in fewer allograft failures and a likely increase in long-term post-transplant survivors.

The three most common nonhepatic causes of death are malignancy, infection, and cardiovascular disease. Screening for malignancy should be dictated by the underlying pathology that prompted transplant, as well as by the post-transplant immunosuppressive regime and the relative increased risk of particular malignancies with immunosuppressive use. Primary sclerosing cholangitis and alcoholic liver disease each carry nearly a 25% risk of non-skin malignancies post-transplant, so screening vigilance must be high in these populations. Smokers and former smokers (defined as having smoked within the past 15 years) should be screened according to guidelines for the general population, which now would include annual surveillance lung CT. Liver transplant recipients do not seem to be at greater risk for prostate and breast cancers than the general population.

Cardiovascular disease is a common cause of morbidity and mortality in the post-transplant population. The basics of lifestyle and diet intervention as both primary and secondary prevention strategies apply equally to this group. Care providers should bear in mind, however, that the post-transplant population is more likely to have a number of cardiovascular risk factors, which will raise the risk of cardiac events. According to treatment guidelines, this will change target blood lipid goals and may require more intensive therapy.

Hypertension, common post-transplant, should be addressed first by recommending a low sodium diet, increased exercise, and weight management. Providers should consider screening for obstructive sleep apnea, a frequent contributor to hypertension, and remind patients to abstain from alcohol use. Hypertensive liver transplant patients must be watched closely for proteinuria and renal function as well; hazard ratio for death climbs precipitously as estimated GFR rises in this population.

The weight gain and increased adiposity seen over time in the post-liver transplant population, in addition to contributing to risk for cardiovascular disease and hypertension, also increase the risk for metabolic syndrome and type 2 diabetes mellitus (T2DM). As for the general population, metformin is the mainstay of treatment, and treatment recommendations should follow guidelines of use of hypoglycemic agents.

The rate of osteoporosis and osteopenia is already increased pre-liver transplant, and the risk of osteopenic or osteoporotic fratures is greatest at 6-12 months after transplant. Bone density tends to rise slowly over time; however, bone density screening, with consideration for vitamin D and bisphosphonate therapy, should be part of post-transplant surveillance.

Turning to women’s health issues, Watt noted that women may use hormonal contraceptives post-transplant, with some caveats. Online resources are available to guide contraceptive prescribing. All pregnancies post-transplant are considered high risk, with documented increased risks for hypertension, pre-eclampsia, caesarian sections; however, an increased risk of birth defects has not been seen. Immunosuppressive regimes may continue with close coordination between hepatologist and obstetrician. Watt noted, though, that although some pregnancy category C immunosuppressives may be continued, the antiproliferative effects of the mTOR inhibitors create a contraindication to use in pregnancy.

Finally, Watt reviewed immunization recommendations for liver transplant recipients. Ideally, patients would be fully vaccinated prior to transplant, with special focus on bringing the patient up to date on live attenuated viruses, which should be avoided when taking immunosuppressives. These include the measles, mumps and rubella vaccine as well as varicella zoster vaccination. Family members should also be fully vaccinated and should give thought to avoiding close contact themselves after receiving live virus vaccines.

via General Health Surveillance, Screening Important for Long-Term Liver Transplant Survival.

Philadelphia baby with rare disease receives liver transplant | Fox News

Photo courtesy of My Fox Philly

Published October 14,
2014FoxNews.com

An 8-month-old Philadelphia baby is recovering after becoming the one of the smallest ever to receive a liver transplant at the Children’s Hospital of Philadelphia.

Annalise Suthers was born with a rare disease that flushed her skin in a yellow hue and caused her liver to swell, MyFoxPhilly.com reported.

Doctors diagnosed Annalise with Biliary atresia, a rare disease that occurs in about 1 in 5,000 babies. The condition occurs when a bile duct is blocked between the small intestine and the liver.

When Annalise was just 3 months old her liver failed. She was rushed to the emergency room, where doctors found that her organ had swelled three times its normal size, MyFoxPhilly.com reported.

Annalise— weighing only 6 pounds at the time— immediately underwent liver repair surgery, but the corrective procedure was not successful.

Through the “The Gift of Life”  donor program, Annalise found a match for a liver donor quickly.

Annalise will have to take medication twice a day for the rest of her life, and she currently is not up to speed on her motor and cognitive skills, MyFoxPhilly.com reported.

But, she’s celebrating milestones similar to others her age and has doubled in weight and is even rolling over.

Annalise’s parents, who call their daughter a fighter, are working to raise awareness about the rare disease and becoming a donor.

via Philadelphia baby with rare disease receives liver transplant | Fox News.

Mississauga girl lucky to find liver donor, recovering from re-transplant

Mississauga News

By Nouman Khalil

MISSISSAUGA – No one can better understand the importance and value of organ donations than Mississauga’s Baig family.

Fatima Baig, 21, the youngest member of the Erindale family, was waiting for a liver donation for more than three years and eight months.

Her long wait finally comes to an end as she found a perfect match – a deceased donor of complete liver.

Fatima underwent an eight-hour long liver re-transplantation on Tuesday, Sept. 23, and is currently recovering from the surgery at Toronto General Hospital’s Acute Care Unit.

Baig’s story is one of many examples showing the importance of organ donations in saving lives within our communities.

“I couldn’t believe, it’s a miracle,” said Afia Baig, Fatima’s mother. “We’re grateful to whoever has donated the liver. I’m just thinking what could have happened … my daughter was at the (final) stage of liver failure.

“It’s a big thing. Who can think of donating an organ of a dying family member? We learnt the importance of organ donation,” said Baig.

Liver disease followed Fatima throughout her life as she was born with it in Pakistan in 1993.

When she was mere 11 years old in 2004, she had to undergo her first liver transplant at Toronto’s SickKids Hospital and received a piece of liver from a living donor – no other than her own mom.

But, unfortunately, the liver failed within six years and Fatima was relisted for a second transplant in 2010.

“We feel that a second liver transplant using a live donor would be extraordinary difficult,” said Dr. Les Lilly, medical director of Liver Transplantation at the University of Health Network. “For all technical reasons that the liver needs to work right away and partial liver takes time for some regrowth, we felt in general that re-transplantation can only be done with a full liver.”

Lilly has more 20 years of experience looking after some 2,000 liver transplant patients at the Toronto General Hospital. Fatima has been his patient since she turned 18.

Based on the life-threatening nature of the disease, Fatima has been on the organ recipients’ waiting list since 2010, but her health further deteriorated in the past few weeks and time was running out.

“It does not always happen because of the shortage of organs but Fatima was fortunate to receive a second liver,” said Lilly. “The surgery went better than expected, but we are cautiously optimistic because prior to surgery she was very week due to illness.”

Life expectancy

Commenting on life expectancy of a liver re-transplant patient, Lilly said so far they (at Toronto General Hospital) have performed more than 2,500 liver transplants, with just over 4 per cent, or 100, were second transplants.

“Liver re-transplant is fairly uncommon and personally I can’t recall a person who is young and have ever undergone a second liver transplant,” said Lilly.

Fatima completed her grade 10 at John Fraser Secondary School, but could not continue her education due to illness.

Lilly said once she recovers from the sickness, she will be able to do normal routine work such as going to school or playing sports with her friends.

“It’s of course a huge operation, it has blood transfusion, high doses of medication to help liver work. These medications also have side affects, but ‘age’ is in Fatima’s favour. She is quite young and young people do tend to recover more quickly,” said Lilly.

In liver transplant, finding a right size as well as blood group is necessary.

“If you have a donor that weighs 120kg, we would not likely be able to fit that liver into a 50kg recipient. Similarly, if you want to fit a 50kg donor’s liver into 120kg recipient, the liver may not be large enough to do the job,” said Lilly.

In 95 per cent of liver transplant cases, he said, the first liver carries the patients through the rest of their lives, but in some cases, the first graft fails for a list of reasons which vary from patient to patient.

Shortage of donors

In Ontario, currently more than 1,500 people are waiting for life-saving transplants while, out of an eligible 11.74 million population, only 2.98 million (25 per cent) are registered life-saving donors.

The shortage is particularly acute in the South Asian community because of blood group difference and variety of other reasons.

Since 2003, some 10,344 Ontarians have received a life-saving organ transplant.

Ontario’s goal is to register 275,000 new donors by March 2015 and it has already reached 22 per cent of the target with 60,868 registrants.

Lilly said anybody who is 16 and older can be a donor, but it all depends on the circumstances of the donor’s death.

“Everybody is a potential donor, but if someone dies of cancer or of overwhelming infection, doctors wouldn’t be able to use the organs. The decision is made at the time of donor’s death,” said Lilly.

To be a donor, visit www.beadonor.ca.

via Mississauga girl lucky to find liver donor, recovering from re-transplant.

Liver Transplant Reallocation Plan On Hold | KCUR

By ANDY MARSO

Dr. Timothy Schmitt, left, and Dr. Sean Kumer perform a liver transplant at the University of Kansas Hospital in Kansas City, Kan.
Credit Courtesy / University of Kansas Hospital
A plan to redistribute donor livers from areas where donor numbers are higher, like Kansas City and the South, to organ-needy coastal areas is on hold after protests from members of Congress representing the areas that would have seen transplant wait times increase.

That group included U.S. Rep. Kevin Yoder, a Republican who serves the Kansas City area. Yoder said last week’s meeting of the United Network for Organ Sharing’s Liver and Intestinal Organ Transplantation Committee resulted in tabling a proposal to change to the way the organs are distributed.

“It’s my understanding the result of last week’s UNOS forum was to further review the process, and no changes will be made in the immediate future,” Yoder said in an emailed statement. “I still believe the best solution moving forward is to work to increase organ donor rates across the country and ultimately save more lives. I would like to see other states replicate the processes used by Kansas organizations such as the Midwest Transplant Network and Gift of Life.”

Richard Gilroy, a University of Kansas Hospital physician who sits on the liver transplant committee, confirmed that after a series of votes the committee decided it was not ready to recommend a change to the way organs are distributed.

“What the ultimate decision was is that we are currently still looking at redistricting, but the model that was proposed in its current form isn’t moving forward,” Gilroy said.

Regional variation

There are 11 regions for organ sharing in the United States, and the amount of time a person in need of a liver transplant might wait varies widely from region to region.

In the Kansas City area, it might be a matter of months, while on the coasts wait times can run five years or longer. According to Yoder’s office, about 6,000 liver transplants are performed annually and about 12,000 Americans await a liver transplant.

According to a UNOS concept paper on the proposed reallocation, 1,523 patients died while awaiting a liver transplant in 2013 and another 1,552 were removed from the transplant eligibility lists because they had become too sick for a transplant to have a high likelihood of success.

The proposed realignment was developed through a computer-generated algorithm that projected about 500 fewer deaths per year by evening the wait times nationwide. Those who currently have short wait times could survive longer before their transplant, according to the projections, allowing those who currently have longer wait times and greater risk of death to receive organs sooner.

But Gilroy said some on the committee had serious questions about the algorithm’s limitations in predicting continued organ donation patterns.

“People change their behaviors,” Gilroy said. “The model, which is fragile, fails to predict what’s going to happen, and you could see the opposite happen. You could see more deaths.”

Gilroy said some on the committee also had concerns about the cost and risks of waiting longer for transplants and the cost and risks of transporting organs farther. When an organ has to travel by plane, the transplant teams “fly in any weather,” he said, and in recent years nine people on those teams have died in two crashes.

“So if we have three times the number of flights, we have three times the possibility of transplant teams going down,” Gilroy said.

Gilroy said the committee is looking at other organ distribution models, including one based on concentric circles or geographic radius from the donation site. But he said it would be months before it had anything to present publicly.

Proposal generated concern

U.S. Rep. Kevin Yoder in February 2011.
Credit file photo
Concern about the proposed computer-algorithm model caused an unusual amount of interest in UNOS. More than 300 people registered for a public forum on the liver transplant idea Sept. 16 in Chicago. Others listened online.

Before that forum and the committee meeting that followed the next day, Yoder and about 50 of his congressional colleagues took the rare step of writing a letter protesting the proposed reallocation to Mary Wakefield of the Health Resources and Services Administration. UNOS is a nonprofit, but Wakefield’s agency, under the U.S. Department for Health and Human Services, administers the UNOS contract to manage the nation’s organ transplant system.

In the letter, Yoder acknowledged the “large geographic disparity in the rates of organ donation,” but said regions with high donation rates should not be punished by seeing their organs go to others.

“Kansans, and the Midwest as a whole, are historically generous organ donors and UNOS should not adopt proposals that punish successful programs and decrease access to organs where donation rates are highest,” Yoder said. “We must implement programs that raise the organ donor consent rate in the areas of the country where disparities in wait times are the greatest.”

To increase donation rates elsewhere, Yoder and others are encouraging other regions to adopt grassroots donor education programs, like one promoted by Overland Park-based Gift of Life. That nonprofit organization, with four employees, was formed by families with children in need of transplants.

KC program plays a role

Keith Anderson, executive director of Gift of Life, said its signature outreach program, Lifesavers, has reached more than 200,000 people in the Kansas City area by sending speakers to 90 area high schools and talking to students about what it means to sign up to be an organ donor when they get their driver’s licenses. The students are then encouraged to talk with their parents about organ donation.

Gift of Life uses surveys to track the effectiveness of the program, he said, and about 74 percent of the students reached say they want to become donors.

Anderson said most cities have organ transplant hospitals and an “organ procurement organization” responsible for the logistics of transporting organs from donors to those hospitals. But few have organizations like Gift of Life, dedicated solely to organ donation education.

“Those three things together are really what make it work,” Anderson said. “Most cities only have two of the three.”

Anderson said Yoder “did step up to the plate” in encouraging further review of the proposed reallocation plan, and Gilroy played a key role as a member of the UNOS liver committee.

“His message as a member of the committee has been you can look at the mathematical models, but if the other states are not doing anything for community education, they’re not doing anything to increase organ donations,” Anderson said.

This story originally appeared on khi.org.

Liver Transplant Reallocation Plan On Hold | KCUR.

Mortality, transplant rates greater in patients with liver injury from nonbodybuilding supplements | Hepatology

Navarro VJ. Hepatology. 2014;60:1399-1408.
September 25, 2014

Patients with liver injury attributed to ingesting nonbodybuilding herbal and dietary supplements had greater mortality and liver transplantation rates compared with patients taking bodybuilding supplements, according to new study data.

Patients with hepatoxicity were recruited from eight referral centers in the Drug-Induced Liver Injury Network (DILIN) to evaluate liver injury due to herbal and dietary supplements (HDS). Among 839 patients enrolled, 709 had injury caused by medications, 45 by bodybuilding HDS and 85 by nonbodybuilding HDS. All bodybuilding HDS cases occurred among young men, while nonbodybuilding HDS cases were more frequent in middle-aged women.

During the study (2004-2013), liver injury caused by HDS increased from 7% to 20% (P<.001), and was attributed to bodybuilding HDS cases growing from 2% in 2004-2005 to 8% in 2010-2012 (P=.007). During the same period, nonbodybuilding HDS incidence of liver injury grew from 5% to 12% (P=.05).

Bodybuilding HDS caused prolonged jaundice, but did not lead to mortality or liver transplant. Nonbodybuilding HDS cases had an increased rate for both death and transplantation compared with cases of injury from medications (13% vs. 3%; P<.05). Thirteen nonbodybuilding HDS patients died or underwent transplantation. Overall, the HDS liver injury group had a greater number of severe cases based on DILIN severity score compared with the group with liver injury due to medications (P=.02).

“The proportion of liver injury cases attributed to HDS in DILIN has increased significantly,” the researchers wrote. “Liver injury from nonbodybuilding HDS is more severe than from bodybuilding HDS or medications, as evidenced by differences in unfavorable outcomes (death and transplantation).”

via Mortality, transplant rates greater in patients with liver injury from nonbodybuilding supplements | Hepatology.

Skating dream-come-true for girl awaiting transplant | KSL.com

By Dave McCannSeptember 3rd, 2014 @ 10:36am

SALT LAKE CITY — Sophie Hansen is a bashful 12-year-old girl. But get her on ice, and that shyness melts away.

She has been ice skating for five years despite what she’s bravely faced for much longer.

“Sophie has been a patient at Primary (Children’s Hospital) since she was 3,” said her mother, Jill Hansen.

Doctors diagnosed Sophie with an auto-immune liver disease. She’s waiting for a liver transplant.

When the team at Primary Children’s heard Sophie was heading to Sun Valley to watch her idols skate, they made a few calls and everything came together.

“I saw Sophie a few days before they went,” said Barbie Robinson of Primary Chidren’s. “I said, ‘This is going to happen. You’re going to meet them. But I think you should take your skates.’ ”

It’s a good thing she listened, because Sophie took to the ice to skate with the stars — Charlie White and Meryl Davis.

“I’ve been watching them skate for a long time,” Sophie said.

First it was a few laps around the rink and a little chit chat. But then, White asked Sophie to skate with him.

Hands linked, arms stretched wide, they glided into a lift.

Credit: KSL TV screen shot

“He just picked me up, flipped me around and put me on his shoulder,” she explained.

It was just a few minutes on the ice, but a memory Sophie will never let go.

“It was awesome,” she said.

“Just watching her get that chance to skate with them, she was all smiles,” Jill Hansen said. “It was fun.”

Then the ice cleared, and it was Sophie’s time to shine.

“Hopefully it gives her something to carry with her while she waits,” Robinson said.

Sophie has been on the transplant list for a year and probably has another year to wait.

via Skating dream-come-true for girl awaiting transplant | KSL.com.

Liver transplant donor fight is brewing – CNN.com

By Jen Christensen, CNN

updated 12:27 PM EDT, Wed September 3, 2014

(CNN) — Dr. Sean Kumer is actually happy when a call from work wakes him from a deep sleep.

A call means the transplant surgeon at The University of Kansas Hospital can save another life. He worries, though, about possible changes being discussed regarding the way donated organs are distributed; if they go into effect, he may not be able to save so many lives.

“I worry (the possible changes) will harm my patients,” Kumer
said.

On September 16, the United Network for Organ Sharing, the nonprofit that manages the nation’s transplant system, will hold a public hearing to discuss ways to “increase equity” in how organs are assigned to patients across the country. Each organ has a different system for handling its waiting list, and the network has seen a particular problem with donated livers.

Currently, a donated liver is supposed to go first to the person who is most likely to die without a transplant, but the system also takes geographic factors into consideration. That means the sickest person in the country doesn’t always get dibs. Instead, the system uses a “local, regional and national” algorithm.

Transplant saves Olympic snowboarder Mom hears son’s heartbeat in recipient Mom saves daughter by donating liver Six-organ transplant patient goes home

There are wide disparities in the number of organs available in the country’s 11 regions. In the South and Midwest, donations are high. Donations on the coasts are low.
So if you live in California, an area that has one of the lowest liver donation rates, you would probably wait longer to qualify for a transplant than someone who lives in Tennessee, in a region where the donation rates are much higher. That’s why Apple co-founder Steve Jobs flew to Tennessee to get his liver transplant, even though he lived thousands of miles away in California.

These are disparities the organ network considers “unacceptably high.” (PDF)

The biggest problem is a serious shortage of donated livers. Although about 6,000 liver transplant operations happen each year, that’s only a fraction of those who need them. There are 15,600 people on the waiting list right now.

An average of 1,500 people die each year while waiting for a liver transplant across all regions, whether there is a generous donor community or not. And the number of people needing liver transplants is expected to rise. With the nation’s obesity epidemic, fatty liver disease has become a growing problem with more patients needing transplants.
“We lose someone every week who never got a shot at a lifesaving liver transplant because of where they live,” said Dr. David Mulligan, chief of transplantation and immunology at Yale and chairman of the United Network for Organ Sharing committee considering the change. “That same person would have had a shot if they lived in Kansas or Georgia or Louisiana.”
To address this disparity, Mulligan says, his committee is open to ideas. Right now, it is considering a variety of mathematical models. One would reduce the 11 U.S. transplant regions to four or eight. Centers on the West and East coasts could see a 40% to 50% increase in volume with this shift, according to some estimates.

These models worry doctors who live in the regions where the supply of donated organs is better. Doctors in Kansas benefit from a highly successful donor outreach program and don’t want their region to be an “organ farm” for the parts of the country where not as many donate, Kumer says.

“What they are attempting to do is say, ‘Hey, those guys have all the organs. Let’s go over and poach those’ instead of having their own grass-roots campaign to identify new donors,” Kumer said.

Dr. Tim Schmitt, director of transplantation at The University of Kansas Hospital, thinks the organ network’s committee is looking at the problem the wrong way. Instead of shifting regions, he believes, it should focus on signing up more organ donors.

“That’s where we should devote all our energy, rather than just shuffle the organs around the country,” Schmitt said. “I think everyone in UNOS and in the transplant community wants to save more lives; that is a no-brainer. But we feel that geographic disparity is more a reflection of other broader problems.”

This week, Schmitt and doctors at dozens of transplant centers in the Midwest and the South sent a letter of protest to the organ network, urging the committee not to make any changes until all available data are considered.

If the network implements the “concept” proposal and broadens the geographic boundaries for sharing donor livers, it would “represent the most drastic change in liver allocation ever,” the authors wrote, and “would significantly disadvantage many areas of the country currently able to serve their patient populations.”

A congressional delegation from Georgia also sent a letter in April, asking the network to put a hold on the remapping process. Their letter argues that the changes could reduce the “number of liver transplants performed in Georgia by 25%” and “inevitably drive up costs, decrease survival rates, and waste precious resources in an already constrained sector of healthcare.”

Transporting organs longer distances could cost health care centers $30 million more annually, according to some estimates. Mulligan argues that cost would be offset when doctors have to take care of fewer people with end-stage liver failure.

Mulligan says his committee will make sure it does not “hurt the regions that have been successful” with organ donation. He believes that ultimately, a new system will save hundreds of lives every year.

“We are totally aware that there are certain parts of the country that will see big shifts, and that will be scary to them, but we have to take off our hats that represent our individual centers and think about what is best for patients all across the country,” Mulligan said.

Both sides of the debate agree though, that no matter how the system will change, it is only a temporary fix akin to “rearranging the deck chairs on a sinking ship,” Mulligan said. “We are going to continue to have this problem if people don’t donate.”

To become an organ donor, register at OrganDonor.gov.

via Liver transplant donor fight is brewing – CNN.com.

Student Survives Liver Failure Without Transplant – The New Indian Express

By Express News Service Published: 30th August 2014 06:00 AM Last Updated: 30th August 2014 01:57 PM

CHENNAI: Mohana Prasanna, a 20-year-old engineering student from Tiruvannamalai, was advised to undergo a transplant after he was diagnosed with liver cell failure at a private hospital in Vellore. Never had Mohana imagined that he would be able to recover without a complex transplant surgery. But thanks to the efforts of doctors at Government Stanley Medical College Hospital, it only took a 45-day blood component therapy for Mohana to recover.

Dr Sundaramurthy, professor of Medicine, and Dr Venkateswaran, HOD, Medical Gastroenterology, diagnosed that the student suffered from liver cell failure that manifested from failure of clotting. They were alarmed when they took a blood test called Prothrombin Time — a test to measure the time blood takes to clot. They found that it took about 114 seconds for his blood to clot while the normal time is 13 seconds.

“He was referred to us because he could not afford `50 lakh for the transplant surgery. Here, we decided that we could treat him without the surgery,” said Dr AL Meenakshi Sundaram, dean, Government Stanley Medical College and Hospital.

Mohana underwent the 45-day therapy where he was given blood components including fresh frozen plasma, albumin, which is the protein found in blood plasma, and cryoprecipitate, a blood component made from plasma.

Mohana’s liver function is now restored. He has been discharged and is now back to college.

via Student Survives Liver Failure Without Transplant – The New Indian Express.