Professor, Heart Recipient,
Will Decide To Be Organ Donors
Patrica L. Pastore
Robert Clouse goes about his duties in the history department
of Indiana State University like hes never had a sick day
in his l(fe.
He is a
vibrant contributor to society who actively pursues his job with
more zeal than many much younger
68, is grateful for every beat of his heart, a heart that was transplanted
into his body more than 15 years ago when a virus in his heart muscle
nearly killed him.
first strongly rejected the idea of a transplant. Only after doctors
told him he was dying did he agree to be out on a list for a heart.
Id never known anyone that had a cornea transplant,
let alone a major organ, he said. Not too many organ
recipients survived then.
his quality of life is good and hes grateful to those who
made the choice to donate a loved ones organs so he could
survive, he said.
a strong advocate of organ transplants, he said. I hope
more people will donate. Donating a brain-dead loved ones
organs is one of the toughest decisions family members can make.
president of the Organ Donation Awareness Council, got involved
26 years ago when she started her nursing career in a critical care
unit at a Terre Haute hospital.
saw young patients die who were declared brain-dead and whose family
agreed to donate the youngsters organs, Girton said.
Later; those family members told me they were glad they chose
to donate their loved ones organs. Other families who made
a different choice have told me they are sorry they didn 't
choose organ donation. Heart, lung and liver transplant recipients
pass you on the street everyday, and the other pedestrians have
no idea this persons life was extended by the gift of an organ
a Terre Haute attorney, is among those who keep making a daily contribution
to his community. He too received a heart when his nearly stopped,
Twelve years later; hes still working and enjoying a rich,
people and more than 30 others I know wouldn t
have had this second chance at life if people hadn t
agreed to donate, Girton said.
organization is attempting to reach as many people in the community
as possible to help them understand the need for donations and also
to show them how transplant patients, much like the Energizer Bunny,
just keep giving and giving and giving, she said.
high school students are made aware of the importance of organ donations
by a presentation Girton makes in health classes. We are now
talking to those kids for an hour about organ procurement and tissue
donation, she said. "I go at it from a medical aspect
and take a recipient with me.
people don t realize only
brain-dead individuals can be organ donors because organs require
oxygen, Girton said. She said others who die natural deaths can
be tissue donors.
is a need for corneas, bone tissue, skin, ligaments and tendons,
arteries and veins and human heart valves, she said. If
human heart valves are used instead of manufactured ones, the patient
doesnt need blood thinners
R.N., the local coordinator for the Indiana Organ Procurement Organization
Inc. (IOPO) works closely with the Organ Donation Awareness Council.
are in the recovery business, he said. Our job is to
obtain organs from families who wish to donate them.
indicate that 80 Indiana residents as of March 7, are awaiting heart
transplants, 75 lung transplants, 205 liver transplants, 397 kidney
transplants and 2.3 pancreas transplants.
donated organ stays in this state, Zindren said. He said the individual
with the greatest need and the closest blood and tissue match is
given the organ. If the donors blood and tissue are a close
match to the recipient, the chances for success are increased, he
organ and tissue donor may enhance the lives of up to 50 people,
an important step in becoming an organ and tissue donor is talking
to your family about your decision.
is not only beneficial for the recipients, it helps the donors
family with death by understanding that something positive came
from a personal tragedy.
Donation Awareness Council also offers support for donor families
Clouse is certainly one of the very first sufferers, ah, readers
of UpBeat. He s also among the group of long-term heart recipient
readers, with Marjorie Rorabough leading the group with some
22 or 23 years, but who s counting? Ed.
To Keep Selling Capsule Form Of SangCy...
YORK (Dow Jones 7/11/00) SangStat Medical Corp. (SANG) will
continue to market the capsule formulation of SangCya, a drug used
for the prevention of organ rejection in transplants, Chief Executive
Jean-Jacques Bienaime said Tuesday.
Monday the company voluntarily recalled the liquid version of the
drug, a generic version of Novartis Neoral, after a study
showed that it wasn t
equivalent to Neoral.
recall has absolutely no impact on the capsule formulation, Bienaime
said in a CNBC interview
accounts for less that 4% of the companys revenues, he said.
SangStat Medical has two other products on the market.
said he doesn t
think improvements to date in transplant technology
will affect his companys business. For the foreseeable future,
he said, transplant patients will need to take medication
on a daily basis to prevent organ rejection. As a consequence,
our business will continue to grow
(AP 7/11/00) A generic
version of a drug used to prevent organ buns-plant rejection is
being recalled because of an unusual problem: Patients may not absorb
enough of the SangCya oral solution if they swallow
it with apple juice.
and Drug Administration announced the nationwide recall of SangCya,
a generic version of liquid cyclosporine, on Monday.
brand-name version, Neoral, isnt
affected; nor are cyclosporine capsules.
urged patients not to alter how they take SangCya until contacting
a doctor for advice on switching to another cyclosporine product.
should not panic. Transplant recipients have cyclosporine levels
in their blood checked frequently, so people who regularly took
SangCya with apple juice would have had their doses increased if
doc tors spotted too-low drug levels, said FDA generic drugs chi
ef Gary Buehler
the latest controversy over SangCya. Neoral manufacturer Novartis
Inc. already has sued the FDA, claiming the government improperly
approved the generic drug, and said Mondays recall bolsters
instructions suggest patients mix it in apple juice or orange juice
to disguise the bad taste. But a study found volunteers who took
SangCya mixed in apple juice absorbed about 20 percent to 30 percent
less of the drug than people absorb when taking Neoral with apple
juice, Buehler said.
drugs are supposed to be equivalent to their brand-name competitors;
hence Mondays recall.
Ceilcept Approved For Liver Transplants
NJ (Reuters 8/9/00) - Hoffmann
La Roche Inc. said Wednesday that it has received marketing clearance
from US. federal regulators for expanded use of CellCept to prevent
organ rejection in liver transplant patients.
was originally approved by the U.S. Food and Drug Administration
in 1995 for use with cyclosporine and corticosteroids, to prevent
organ rejection in kidney transplant patients. The drug is also
used in heart transplant patients.
are more than 16,000 people on the waiting list for a liver transplant,
and numbers are increasing rapidly, said Dr EddyAnglade, Medical
Director; Transplantation, Roche Laboratories. Having another
drug in the liver transplant arsenal is important news for the transplant
Open Letter: What one heart recipient feels about the retirement
of his initial Transplant Coordinator.
have delayed responding to your kind note regarding your new life
and semiretirement situation. I say kind because you were
very thoughtful to think of us. My delay was caused by a visit
from our daughter-in-law and two granddaughters, while their father
is away being Air Boss pilot on a Navy Cruiser.
had eleven and a half years now to assemble my thoughts on transplant
patient and staff relationships. I think the overriding factor
is the almost unacceptable bonding that occurs between patient
and staff over time. I say unacceptable because supposedly the
worst thing that a professional medical clinician can allow to
happen is establishment of an emotional bond concerning the patients
well being. Conversely, it is only normal for the patient to try
and maintain an informal communication with their following transplant
staff, which can make it very difficult for the individual staff
person to always maintain a medically honest professional decorum.
am I leading, only really to say a rather embellished Thanks.
Without your self, many other members of your staff, and your
team surgeons at the time, I would never even have met the daughter-in-law
mentioned above. With your help I was able to see two sons through
college and to actually return to work and then retire. Talk about
transplantation permitting a return to normal life, there can
be no question. Sure there have been some nasty side trips definitely
traceable to the required drugs, but that is not an exposure unique
to being a transplant recipient.
most significantly to me, on all of these sometimes very fearful
adventures in undesirable medicine, you have been there both formally
to assist in getting second opinions and informally as a firm
rational information base without any attempt to make situations
nicer than reality. Now that type of person and we all know you
arent the only one, is as close as anyone wants to get to
a friend in the medical profession.
for myself and for all others, the transplant field seems to draw
the cream of professional people. I have been under the care of
others since leaving California, who have instilled in me the
same high level of confidence and willingness to accept their
decisions unquestioningly. However, in the trauma of a heart transplant,
particularly when the procedure was as tentative as it was in
January of '88, the staff whos persona are maintained with
the highest esteem are those such as yourself, who took the patient
from sure death, to close to a normal life. At the
time most laymen regarded it as a miracle. I know it was not,
it was talent and hard work on the part of many people.
am now approaching old age, so closely that my former concerns
about being retransplanted if necessary are not gone, but fading.
I can delightedly inform you that retirement is the best of all
worlds. As active intellectually and physically as you have been,
Im positive you will open a whole new era of success.
know that a simple Thank you will be more than enough
to happily send you on your way. And better for me, I accept with
honor and pleasure your offer to stay in touch as
a friend. As they say, youve got it!
Revise Medicare Standards for Transplant Centers
(AP 8/2/00) Medical
centers that perform heart, liver and lung transplants for only
one year can serve Medicare
patients under revised federal standards issued Wednesday.
transplant programs had to perform procedures on patients not
entitled to Medicare for two years before applying for government
benefits, said Nancy-Ann DeParle, head of the Health Care Financing
Administration, the Health and Human Resources agency that administers
studies conclude that the num of transplants performed by a center
is re important in predicting successful surgeries than the number
of years of expe ice, DeParle said in a statement.
centers still must meet other dicare standards including those
con ning patient selection policies, ility resources and survival
Surgeons Implant Breakthrough
(Reuters 7/30/00) - Israeli
surgeons said on Sunday they had broken medical ground by implanting
an experimental device in a 64-year-old man which could enable
people dying of heart failure to live normally without a transplant.
Dr Jacob Lavee, head of the transplant unit at Sheba Medical
Center near TelAviv, said the battery-powered electric pump
weighed about 350 grams and did most of the work of the left
ventricle, the hearts main pump ing chamber
the first time it has been planted in a human being, Lavee
said the device, HeartMate 2, made by Massachusetts-based Thermo
Cardio systems Inc, was a smaller and more effective version
of the companys original left ventricle assist device,
original HeartMate was designed only as a temporary solution
while a patient waited for a heart transplant, but the new device
whose price has
yet to be set would
2 is meant to be an alternative to human heart transplants,
the new technology is proven to be successful, and it will take
another year; it has the potential of solving the problem of
many thousands of patients waiting for heart transplants around
the world, he added.
device was installed in the patient, identified only as A.S,
during a 14-hour operation Thursday at Sheba Medical Center.
Lavee said the man, who was on the verge of dying before the
operation, was in critical condition after the procedure.
tests after the surgery showed that HeartMate 2 was working
well, he added.
HeartMate 2, Lavee said, the patient could look forward to a
normal lifespan assuming he was able to overcome the damage
done to his organs from months of heart failure.
said that before Thermo Cardiosystems Inc sought the US. Food
and Drug Administration s approval for HeartMate 2, it
would be tested on other patients who, like A.S., were dying
disease and deemed unsuitable for transplants.
FDA approved HeartMate in 1998 for dying patients waiting for
major benefit of HeartMate 2 is that patients do not need to
take anti-rejection drugs which often cause organ damage and
lower the immune system, making them susceptible to illness.
Lavee said patients with HeartMate 2 would need to take aspirin
and other anti-clotting medication.
number of hearts available for transplants is usually a fraction
of the number of people waiting for heart donations. In the
United State an estimated 15,000 to 20,000 people need heart
transplants each year, but there are only enough hearts for
about 2,000 people.
said the problem was particularly severe in Israel, which had
a very low rate of heart donations compared with other countries
due to religious beliefs that made people less likely to donate
by Tx David Cannavo
the patient died about 5 days later due to causes unrelated
to the artificial heart. Ed.)
Catheter May Permit New Transplant Biopsy Procedure
B. C., (Business Wire 7/13/ 00)
Biomax Technologies Inc. is pleased to announce that
it has received an Office Action from the United States patent
& Trademark Office that indicates that least
13 claims in its primary US. patent application related to the
Companys Optical Catheter technology will be allowable
if the Company makes some minor formal amendments to the claims.
is an important milestone for Biomax, as it will enable the
Company to maintain strong patent protection for its primary
addition, the Company announces that it has completed its final
large Animal study using the Optical Catheter. The study involved
the in vivo analysis of 8 pigs in corporating anti-rejection
therapy. Over 4,100 optical spectra were obtained during 83
biopsy sessions: three to four days before transplant, at the
time of transplant, and every three to four days over the next
two weeks as anti-rejection therapy was modified.
with previous studies, the results demonstrated a correlation
between autofluorescence response and the degree of rejection
as determined by pathological observations. Based on these positive
results, the Company has determined that it has obtained sufficient
animal data for it to make application to the United States
Food & Drug Administration for an Investigational Device
Exemption (IDE). The IDE, once obtained, will enable the Company
to commence a human clinical trial utilizing the Optical Catheter;
which is currently forecast to commence prior to the end of
human clinical trial of the Optical Catheter will be led by
James B. Young, MD, FACC, Head, Section of Heart Failure and
Cardiac Transplant Medicine and Medi cal Director; Kaufman Center
For Heart Failure at the Cleveland Clinic Foundation, Cleveland,
Ohio. In addition, Howard J. Eisen, MD, FACC, FACP, Medical
Direc tor; Heart Transplant and Director of Heart Failure Intensive
Care Unit at Temple University
School of Medicine, Temple University Hospital, Philadelphia,
Pennsylvania will also be a US Investigator The Cleveland Clinic
Foundation and Temple University are two of the five largest
heart transplant centers in the world. The trial will also be
conducted at St. Pauls Hospital, Vancouver; BC and one
other site yet to be determined.
for Rare Lung Condition Found
(Reuters 7/27/00) -
Several teams of researchers say
they have identified a gene involved in primary pulmonary hypertension,
a rare but serious lung condition that can kill.
about the gene did not offer any immediate hope for treatment,
but could help scientists understand the condition, which can
cause patients to need a lung transplant and which can kill
within 5 years, the researchers said.
is characterized by uncontrolled proliferation of cells in the
blood vessels of the lungs. They block the vessels, forcing
the heart to pump harder and raising blood although
a lung transplant or a continuous intravenous
dosing of the drug prostacyclin can
researchers found that defects in a single gene, the bone morphogenetic
protein receptor!! (BMPR2) gene, were associated with PPH. The
gene regulates growth and development of the lung, they reported
in two separate reports, published in the journals Nature Genetics
and the American Journal of Human Genetics.
that we have pinpointed a gene, we can focus on learning how
it works, Dr Claude Lenfant, director of the National
Heart, Lung, and Blood Institute, which funded both studies,
said Wednesday in a statement.
information should enable us to devise better treatments and
perhaps eventually a preventive therapy or cure.
are more at risk of PPH than men and several conditions are
associated with its development, including pregnancy, underactive
thyroid, the use of oral contraceptives, cocaine, or the banned
appetite suppressant drug combination ofphentermine and fenfluramine
Jarvik 2000 Heart
Joel Anderson - Associated
(AP 7/21/00) The
first person to have a new type of miniature heart pump successfully
implanted to keep her blood flowing while doctors searched for
a replacement is back home after undergoing a heart transplant.
Spiller; a 52-year-old retired financial analyst, spoke between
tears Thursday as she described her joy over her improved health.
just real happy to be here today she said. !just
knew I had to come through this after all
the support my family and the doc- tors had given me.”
To keep her alive until her transplant, the Jarvik 2000 left
ventricular assist device was implanted in Spiller ‘s failing
heart on April 10,
after her physicians gained approval from the US. Food and
Drug Administration to begin clinical trials with the device.
The battery-operated device is about the size of a wine cork
and ftts directly into the heart’s left ventricle. When the
heart can no longer pump properly, the tiny turbine pushes
oxygenated blood throughout the body.
The implantation of the device brings scientists closer to
the goal of finding an alternative to a heart transplant.
For now, the FDA has approved study of the pump only as a
bridge to transplant.
Two other patients with end-stage heart failure have been
implanted with the device and are waiting for donor hearts
to become available. Another two had the device implanted
on an emergency basis; both died shortly after the surgery.
Spiller. whose heart trouble dates back to 1987, had the implant
in her enlarged heart for 79 days. She received her heart
transplant three weeks ago and was released from the hospital
Spiller said she is getting around just fine, and has even
cooked breakfast and washed dishes since leaving the hospital.
Before the artifìcial pump was transplanted, she was so weak
that she struggled to even talk.
According to the Texas Heart Institute, about 5 million Americans
suffer from heart failure. The ideal therapy is a transplant,
but there are only about 2,500 donor hearts available each
year About 6,000 patients annually die before receiving a
following article is a hold-over from last month’s UpBeat
Pacemaker-Like Device Tested
WASHINGTON (AP 5/2 WOO) —
Jim Kent was the most avid of outdoorsmen, constantly golfing
or fishing or hunting. Then a mountain hike left him gasping
for air Heart failure, doctors said. Within a few years Kent’s
heart was so weak he was housebound and on the waiting list
for a transplant.
Almost 5 million Americans have congestive heart failure,
where their hearts gradually lose the ability to pump blood.
Drugs help many, but those like Kent whose hearts worsen despite
medication have few options.
Now scientists are experimenting with a new pacemaker-like
device called a "ventricular resynchronizer” that promises
help these struggling hearts beat more normally.
Kent is one of the few Americans to try one —
and today the 60-year-old Louisiana man is back on the golf
course and off the heart transplant list. Prompted by such
early promising results, scientists are hunting 2,000 more
heart failure patients for a study to prove how well the experimental
treatment, made by Guidant Inc., really works.
now there’s not a lot you can do for these patients,” said
Dr Eric Prystowsky, electrophysiology director at St Vincent
Hospital in Indianapolis. “This is very exciting.”
Heart failure is not a heart attack Nor does it mean the heart
Instead, a heart weakened by age, damage from a survived heart
attack or some other disease gets flabbier as
struggles to push blood out to the rest of the body. Lacking
oxygen, patients feel dizzy or faint. Eventually, they’re
pressed even to walk across a room. Their legs swell. Fluid
seeps into their lungs, blocking breathing.
Just half of victims survive five years. When medications
fail, they have few options.
Enter the ventricular resynchronizer.
It’s basically a souped-up and redesigned pacemaker But it
doesn’t speed up a sluggish heartbeat like regular pacemakers
do. Heartfailure causes the opposite problem
the struggling heart beats faster to compensate for weakened
pumping. And the heart’s two bottom chambers, the ventricles,
don ‘t pump together in rhythm like they’re supposed to.
The idea: Resynchronize the right and left ventricles so they
pump at the same time, making that pumping more forcefuL Then
the heart might not wear itself out pumping so fast.
Doctors thread three separate pacemaker wires, “leads
that deliver electricity, into a vein near the collarbone.
Two leads are popped down to the heart’s right side, just
like a routine pacemaker implantation. The breakthrough came
when scientists figured out how to put a third lead on the
more vulnerable left ventricle, so both sides can be sparked
to pump together It’s tricky, requiring threading into just
the right spot in a vein lying on the ventricle’s walL
It’s not a cure. But early results are promising, German scientist
Dr Angelo Auricchio told a recent meeting of the North American
Society of Pacing and Electrophysiology. In a study of 42
severely ill Europeans, a single month’s use of the device
improved the heart’s pumping efficiency by 15 percent, and
significantly increased patients’ ability to walk Longer use
seems to be reducing hospitalizations.
Dr Scott Higgins of Scripps Memorial Hospital in San Diego
has implanted 60 Americans with the Guidant device.
The devices long-term impact isn ‘t proven. But Kent
Port Allen, La., man, calls his implant life-changing. “It’s
nothing worse in the world than not being able to breathe
But right now, nothing’s too strenuous.”