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TATTLING LINKS

~ ISHLT Members in the News ~



FROM AUSTRALIA:


Peter MacDonald, MD, PhD
St. Vincent's Hospital
Sydney


Advancements made in treatment for heart disease

sbs.com.au, 21 Nov, 2013

links imageOrgan-donation rates have increased dramatically over the past few years but there simply aren't enough to meet a growing demand. For every 1000 people in this country, only one is a potential donor and only 30 per cent of that one per cent will become a successful donor.

But new technology looks set to change these odds. Cardiologist Peter Macdonald has created a way to reduce that damage once the heart is removed from the donor by keeping it working while waiting to be transplanted. "The heart just isn't able to withstand the insults that occur during the withdrawal of life support and just isn't usable, Dr MacDonald said. Read full article →


Allan Glanville, MBBS, MD, FRACP
St. Vincent's Hospital
Sydney


Australia ranks 21st for organ donation

Herald Sun News, 12 Nov, 2013

links imageSpain is the world leader, and France, the US, UK, Belgium and Norway are among the countries with higher proportions of donors than Australia. The figures compiled by Sharelife Australia draw on international donor data published by the Council of Europe. The data shows hundreds of Australians are missing out on life-saving transplants every year. This is because a $151 million, four-year package announced by the federal government in 2008 has failed to achieve its goal of establishing Australia as a world leader.

There has been an improvement, says ShareLife spokesperson Sara Irvine, but Australia's progress is slower than many other countries. Australia's rate of organ donation is half that of the leading countries, and 1000 more transplants could be performed a year if it reaches the level of the top five countries. "We are still not in the top 20 nations and have long way to go," says ShareLife director Professor Allan Glanville, medical director of lung transplantation at St Vincent's Hospital in Sydney. "Organ donation saves lives, saves money and improves quality of life. "You only need to talk to people who have been on kidney dialysis to see how well and productive they are after a kidney transplant." Read full article →


FROM CANADA:


Shaf Keshavjee, MD
Toronto General Hospital
Toronto, Ontario


# 45 - World's First Successful Single Lung Transplant

YouTube, 4 Nov, 2013

links imageEarly in the morning of Nov. 7, 1983, a team of Toronto General Hospital surgeons began a surgery that would make medical history. It was an experimental human procedure ... a single lung transplant. The patient was Tom Hall, the 45th patient worldwide to undergo the risky procedure — risky because none of the previous 44 attempts had been successful. This is the story of a world first ... the story of a courageous patient and medical staff, and, how the legacy of their achievement lives on today at UHN's world leading Toronto Lung Transplant Program, led by Dr. Shaf Keshavjee, who is also Surgeon-in-Chief at UHN's Sprott Department of Surgery. Watch video →


Lori J West, MD, DPhil
University of Alberta
Edmonton, Alberta


Alberta MLAs approve bill to boost organ donations

EdmontonJournal.com, 31 Oct, 2013

links imageTransplant advocates, doctors and patients are hailing the approval of new legislation designed to improve Alberta's abysmal organ donation rates. The Human Tissue and Organ Donation Amendment Act, which will create a new provincial agency to oversee donations, passed third reading in the legislature late Tuesday after receiving support from all parties.

"Alberta has not only failed to move forward with the rest of the world, but we have actually fallen behind," said Dr. Lori West, an Edmonton cardiologist serving as director of the Canadian National Transplant Research Program. "So this is a real step forward to helping hundreds of patients who are waiting on transplant lists." Read full article →


FROM UNITED STATES:


Thomas M. Egan, MD, MSC
University of North Carolina School of Medicine
Chapel Hill, NC, USA


'Lungs don't die when you do': New transplant program might ease shortages

NBC News, 17 Nov, 2013

links imageThe pair of lungs sits inside a clear dome, gently inflating as doctors measure how well they'll breathe if implanted into a patient who desperately needs a new set. It's a little-known twist of nature—your lungs can live on for a while after you die. The air left inside keeps them from deteriorating right away as other organs do.

An innovative experiment now aims to use that hour or more window of time to boost lung transplants by allowing donations from people who suddenly collapse and die at home instead of in a hospital.

"There aren't enough lungs. We're burying them," said Dr. Thomas Egan of the University of North Carolina, Chapel Hill, who is leading the project. "It turns out your lungs don't die when you do." Read full article →


Julia Klesney-Tait and Kalpaj R. Parekh, MD
University of Iowa Hospitals and Clinics
Iowa City, IA, USA


Breathing new life

Iowa Now, 22 Nov, 2013

links imageOn Thanksgiving Day 2011, the Nacks found hope. It came in an email—from Iowa. For Dennis Nack of Nelson, MN, the previous two decades had not been easy. Since his mid-40s, his health had been in a slow, steady decline. He'd spent nearly 20 years working with industrial chemicals, inhaling noxious fumes daily. He'd also smoked for a number of years before quitting in 2011.

"It was from the University of Iowa," Sharon Nack says. "They asked us to send his medical records." The request for Dennis' medical records was only a requisite first step and not a guarantee, but for Sharon, it was a glimmer of hope. "It was all I had to go on," she says, "and I believe in miracles."

A few weeks later, gathered around the table for Thanksgiving dinner, Sharon asked the Nacks' son-in-law, Bill, to read Beaver's email to the family, which included Dennis' 90-year-old mother. "No one knew what to say at first," Sharon says. "And then one of the kids asked, 'What does this mean, Mom?' I said, 'It means we're going to Iowa.' "It was a ray of light, and we aimed right for it." Read full article →


Gabriel Loor, MD
University of Minnesota
Minneapolis, MN, USA


New Transplant Tech Keeps Lungs Warm, Ready To Work Immediately

CBS Minnesota, 21 Nov, 2013

links imageLast week, a new lung transplant procedure was performed at the University of Minnesota, and for the first time in the Midwest. The new technology keeps the lungs warm and breathing from the time they leave the donor. Common practice has been to keep the organs on ice before transplant. We spoke with the doctor who performed the new procedure, using the Tans Medics Organ Care System. "It's almost like landing on Mars," Dr. Gabriel Loor said.

On Nov. 13, a 50-year-old man received two transplanted lungs. And those organs were never put on ice for the two hours they were outside a human body. The lungs were kept sterile, perfused with blood, and breathing inside the portable machine. "Before this, we relied on ice, so we'd bring a cooler out to a donor hospital, and after the procurement, we would place the lungs on ice," Loor said. Read full article →


John M Stulak, MD
Mayo Clinic
Rochester, MN, USA

Randall C Starling, MD, MPH
The Cleveland Clinic
Cleveland, OH, USA


Mechanical hearts hold death at bay for patients on transplant list

The Chicago Tribune, 4 Nov 2013

There were 5,500 machines, known as left ventricular assist devices, implanted worldwide last year, said Doug Godshall, chief executive officer of Framingham, Mass.-based Heartware. The benefits of the pump are clear, said John Stulak, a cardiovascular surgeon at the Mayo Clinic in Rochester, Minn., who studies and implants the devices. Every trial comparing them with the best drug therapy, often the only treatment available, shows they lengthen and improve lives, he said.

"As we are learning more about LVADs, and we're getting more experience and people are living longer, we are starting to see it's not completely a walk in the park," said Randy Starling, head of heart failure and cardiac transplant medicine at the Cleveland Clinic in Ohio. "We are starting to see some of the other potential complications," including bleeding in the stomach, infections and erratic heart rates. Read full article →


Michael Hess, MD
Virginia Commonwealth University Medical Center
Richmond, VA, USA

Nelson A Burton, MD
Cardiac Vascular Thoracic Surgical Associates
Falls Church, VA, USA

Devices have changed heart transplants

Milwaukee Wisconsin Journal Sentinel, 11 Nov 2013

links imageAs many as 500,000 people suffer heart failure in the United States each year. Yet the number of hearts available for transplant plateaued at around 2,500 in 1995. Medicine is getting better at transplanting hearts and the need for them is growing larger, but the number of organs available is static. So devices are filling some of that gap. "The whole field is being dominated today and tomorrow by LVAD and artificial hearts, and is becoming a problem of engineering, miniaturization and, believe it or not, batteries," says cardiologist Michael Hess, who directs the Pauley Heart Center's heart transplantation program—one of the world's oldest—at the Medical College of Virginia in Richmond. "The next big breakthrough is going to come out of engineering schools such as MIT and not medicine."

"Mechanical circulatory support has been a real game-changer," says Nelson Burton, chief of heart and lung surgery at Inova Fairfax. He says he implants twice as many LVADs as hearts these days, and "I'm sure that ratio will increase as the technology improves. We'll be putting in more and more of them." Read full article →


Frank Smart, MD
LSU School of Medicine
New Orleans, LA, USA


Frank Smart, MD: Bringing engineering know-how to HF care

healio.com, Nov 2013

links imageFrank Smart, MD, always had a fascination with technology, so cardiology—and mechanical circulatory support systems for HF patients, in particular—was a natural focus when he decided to switch his course of study from engineering to medicine.

A prominent transplant cardiologist, he has been a lead researcher on studies of immunosuppression in transplantation and in transplant CAD. He has advised many medical device companies on how to support device design. His passion for engineering and building systems extends to his free time as well, in the form of refurbishing cars and welding.

What else sparks his interest? Mark Twain, Abe Lincoln and Clancy's restaurant in New Orleans—all subjects near and dear to the heart of our Links editor! Read full article →



Alfred Asante-Korang, MD
Pediatric Cardiology Associates
St. Petersburg, FL, USA


Young heart transplant patient faces rejection with a smile

ABC Action News, 4 Nov 2013

links imageAsk 9-year-old Jayden Langan why he's in the hospital, and he doesn't really know, but his father does. Will Langan is Jayden's father. "It scared me to death. It's, I mean, since he had his heart transplant we knew at any time he could go into rejection."

But the fact is, heart transplant surgery is still relatively new and no one knows how long these unique kids will survive. So when Jayden came in Friday in stage 3 rejection, his parents feared it was life threatening. Dr. Alfred Asante-Korang is the Medical Director of the Heart Transplant Program at All Children's Hospital. "If the heart function is severely affected, then it can be life threatening." Read full article →


Mariell Jessup, MD
University of Pennsylvania
Philadelphia, PA, USA


Derek Fitzgerald: Cancer, Heart Transplant, IRONMAN

phillymag.com, 6 Nov, 2013

links imageIn 2003, Fitzgerald was your typical 30-year-old, focused more on his career than his health. His perspective quickly changed when doctors found a large, grapefruit-sized tumor in his stomach and, after removing it surgically, diagnosed him with non-Hodgkin's lymphoma. Fitzgerald immediately underwent several rounds of chemotherapy. The treatment destroyed the cancer and Derek was given a second chance at life. However, the treatment had also destroyed his heart.

In his many trips to the ER for shortness of breath and suspected pneumonia, Fitzgerald learned that he had dilated cardiomyopathy and heart failure. His ejection fraction—the levels at which the heart pumps oxygenated blood through your body—was at 18 percent. The ejection fraction for the average healthy person is between 55 and 70 percent, according to the American Heart Association.

After completing the compatibility process for the heart transplant, Dr. Jessup met with Fitzgerald and explained that the healthy organs surrounding his damaged heart were compensating well now, but that would soon change. He recalls her explaining that when that happened it would be like falling off a cliff. "But don't worry," she added. "When that happens, we'll be there to catch you." Read full article →


Joseph M Pilewski, MD
University of Pittsburgh Medical Center
Pittsburgh, PA, USA


Double lung transplant gives cystic fibrosis patient second chance at life

AltoonaMirror.com, 10 Nov, 2013

Proud parents watch as 4-year-old Gavin carefully writes first his name on lined paper in marker, and then his dad's name, Jeremy, and finally, his mom's name, Joy. Such simple things for a family of three, except for this Altoona family, nothing is taken for granted anymore. Jeremy Weyandt, Gavin's father, almost lost everything when Jeremy came as close to death as anyone could come, his doctor said. Jeremy doesn't remember anything of that harrowing time, he said. "The last thing I remember is the nurse saying I think we need to talk about a transplant," Weyandt said.

"They almost ran out of time," said Dr. Joseph Pilewski, medical director for the UPMC lung transplant program in Pittsburgh. "There's a limit to how long people can be on the ECMO machine and Jeremy had almost reached that limit," he said. Read full article →


Cesar A Keller, MD
Mayo Clinic Transplant Center
Jacksonville, FL, USA


Pulmonary rehab: Healing with music

MySunCoast.com (Ivanhoe newswire), 11 Nov, 2013

links imagePlaying a musical instrument can be fun, but for people with lung problems it can also offer a health benefit. Music has always been a huge part of Larry Rawdon's life. "I think it transports people to a different, a better place," Larry Rawdon told Ivanhoe. Larry was a professional cellist for 30 years. More recently, he took up the harmonica. "I love playing the harmonica. It's a great outlet," Larry said. However, for Larry, it's been much more than that. After surviving two lung transplants, he noticed that his passion could also be a form of therapy. "My scores were always substantially elevated after playing the harmonica," Larry said.

Larry told his doctor about what he observed on his lung tests. "I knew I could not just ignore what he was saying because this guy knows what he's talking about," Cesar Keller, MD, Professor of Medicine Medical Director, Lung Transplant Program, Mayo Clinic Florida, told Ivanhoe. Read full article →


Dr Ali Nsair, MD
David Geffen School of Medicine at UCLA
Los Angeles, CA, USA


UCLA doctors test stem-cell therapy to improve blood flow in angina patients

HealthCanal.com, 13 Nov, 2013

links imageMarty Greenfield lives with crushing pain every day due to angina, a condition that is caused by an inadequate supply of blood to the heart. He has suffered a heart attack, and a coronary bypass procedure and angioplasty have provided little relief. His doctor referred him to UCLA to be considered for a heart transplant. Dr. Jonathan Tobis, a UCLA clinical professor of cardiology, performed an angiogram and angioplasty on Greenfield, 64, but found that the patient was not a candidate for a heart transplant because his heart muscle function was still good. Instead, Tobis suggested that Greenfield consider participating in a Phase 3 clinical trial that uses a patient's own blood-derived stem cells to try to restore circulation to the heart.

"We're hoping to offer patients who have no other options a treatment that will alleviate their severe chest pain and improve their quality of life," said Dr. Ali Nsair, an assistant professor in residence of cardiology at the David Geffen School of Medicine at UCLA and the study's co-principal investigator. Read full article →


Michael M. Givertz, MD
Brigham & Women's Hospital
Boston, MA, USA


Tethered to a machine, R.I. man awaits a new heart

Providence Journal, 11 Nov, 2013

links imageTo save Steve DiSumma's life, doctors had to remove his heart. The surgery was in July, and since then the 44-year-old husband and father has been connected to a machine that keeps him alive at Brigham and Women's Hospital in Boston. He is waiting for a donor heart. He says he's at the top of the list, but his wait could be as long as eight months.

His doctor, Michael M. Givertz, said some patients can leave the hospital with the device, but DiSumma's condition keeps him tied to Brigham and Women's. Steve was born with transposition of the great arteries, a type of congenital heart defect in which the two main arteries going out of the heart—the pulmonary artery and the aorta—are switched in position. Instead of pumping oxygen-rich blood from his lungs to his body, his heart pumped oxygen-depleted blood from his body back into his body. Oxygen-rich blood, meanwhile, was cycled in and out of his lungs. If he hadn't had holes between the chambers of his heart, he could not have survived, Givertz said. Read full article →



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