Oriented to Thoracic Transplant Recipients -- March 1997
Outcomes of Patients Undergoing Transplantation with Older Donor
By Davis C. Drinkwater, MD, et al UCLA, Cardiothoracic Surgery & Cardiology
Background: The limited number of donor hearts relative to the number of waiting
recipients is the major determinate of a growing inequity. Although a number of potential
options are being vigorously pursued, the most effective immediate solution is to
expand acceptance criteria for donor age and medical condition. This report is a
review of our early and late results with the use of older donors, including simultaneously
"bypassed" donor hearts.
Methods: Between April 1987 and September 1994, 52 patients received older
donor hearts (older than 45 years) with a mean donor age of 51 years. Ten patients
in this group received hearts simultaneously bypassed with from 1 to 4 grafts per
patient. Donor and recipient age, diagnosis, and HLA match were compared between
the older donor group and a contemporaneous younger (younger than 45) donor group
(N = 324). Also compared was actuarial survival at up to 5 years of follow-up in
addition to graft function, bypass graft patency, infection and rejection incidence
at 1 year, and the prevalence of transplant-associated coronary artery disease in
the two groups. Echocardiography, coronary angiography, and intravascular coronary
ultrasonography were used for this assessment.
Results: One-year actuarial survival was 84'W for the older donor group, which
included 19 status 1 patients (survival 76%) and 23 status II patients (survival
90%). In the bypassed donor subgroup there was a 60% @-year actuarial survival with
5 status 1 patients (survival 80%) and 5 status II patients (survival 40%). At 1
year, left ventricular function and the incidence of infection and rejection were
equal between these two donor groups.
Five-year actuarial survivals were the same between the overall older and younger
donor groups. Finally, the development of transplant-associated coronary disease
was similar in both groups up to 5 years after transplantation.
Conclusions: This initial review of heart transplantation with older donor
hearts, including bypassed hearts, demonstrates similar early and late survival outcomes
as compared with those of a contemporaneous younger donor group. Significantly, there
appears to be no difference in the development of transplant-associated coronary
artery disease during the follow-up period. The older donor represents a potential
immediate increase in the number of suitable hearts for transplantation. Bypassed
donor hearts represent a small but potentially significant subgroup that may be safely
and effectively used when appropriately matched to the recipient by age and medical
Greater experience, particularly with this bypassed group, will help determine optimal
donor-to-recipient matching in the future.
J Heart Lung Transplant 1996;15:684-91
NEED FOR HEARTS WILL GROW AS BOOMERS AGE
By Marilyn Elias, USA Today
George Balding, owner of a thriving electronics firm in Salt Lake City and inventor
of 27 products, refused to accept the verdict at his local hospital: Go home and
die because you are too old for a heart transplant.
Balding had just turned 65, the cutoff age at the Utah Cardiac Transplant Program.
Doctors gave him six months to live. But a later marriage had left him with five
children at home, "and there was no way I'd just roll over and die. I was healthy
in every way except for my heart."
So Balding sent a 40-page "resume" of his medical records to 10 hospitals.
The news back was mostly bad until he got a unique offer from the University of California,
Los Angeles. Wait on an alternate list for older patients willing to take hearts
from donors over 50, which usually are not transplanted, or in need of repairs such
as coronary bypass.
He jumped at the chance for a "retread." "It sure beat the alternative,"
says Balding, a healthy 68-year-old with a different heart. He works, parents and,
he says, "appreciates every day I have."
UCLA's pioneering program, launched five years ago, is gathering impressive survival
data on patients over 65 given hearts consigned to the "reject' bin elsewhere.
Critics doubt the bold gamble taken by program director Hillel Laks will pay off
in enough added survival time to justify the cost of a heart transplant $150,000
to $250,000. But a handful of other centers are beginning or expanding similar alternate
programs. They're betting on a worsening shortage of hearts as baby boomers swarm
into the age bracket when the transplant need is greatest but the fewest donor hears
Adults over 50 already are the majority of patients awaiting hearts and the number
on waiting lists surged from 1,722 to 3,693 between 1988 and 1994. Only 9% of donor
hearts are from people over 50. "In the long term, death is simply more cost
effective (than transplant) in the older age groups," Laks wryly observes "because
they may come back with longer-term complications."
But are boomers apt to "go gentle into that good night'"?
The generation isn't famous for stoic acceptance of aging and decline. After setting
records for facelifts rummy tucks, hair transplants and hip replacements why would
bionic boomers draw the line at a heart'?
"Thirty years ago you'd reach 70 and the prevailing philosophy was 'now you're
old and you can expect to die. Now people at 70 are saying 'I want to travel I want
to play golf, I want to get married again,' says Laks.
Regardless of what they want not everyone with terminal heart disease should get
a new heart Laks says. The UCLA program only transplants in older patients who have
no other serious organ damage or diseases.
"You have to pick candidates carefully or you'll have high mortality,"
says transplant surgeon Robert Kormos whose University of Pittsburgh alternate program
started six months ago. It was prompted by UCLA's success rate.
In five years UCLA has transplanted 27 .... retread'" hearts in older patients
11 in 1996 alone. Doctors only have three-year survival data so far. At 78%, it's
equal to survival of younger patients given prime hearts Laks says. Excellent survival
also is reported for older patients of the Northern Indiana Heart Institute at Lutheran
Hospital, Fort Wayne.
Critics say that too many usable hearts are being discarded from donors older than
50. Some people over 50 hike in the Alps, play tennis stay sexually active and keep
their cholesterol low. If they die in an accident why discard their adequately '
functioning hearts they ask.
"Our clinical experience is that 20% to 40% of hearts traditionally considered
unusable can be used or fixed to be functional, says cardiologist Gregg Fonarow of
UCLA's center. On the national level this means more than 1,000 additional hearts
would be available per year he says.
But some experts
think this is a dangerous route to take particularly at a fast pace. "Using
older or repaired hearts is still experimental. We have to do it slowly carefully.
Only a few questionable deaths could bring the whole thing to a screeching halt,
says Arthur Caplan director of University of Pennsylvania's Center for Bioethics.
Older people are more apt to have many health problems says surgeon David Taylor
of the Utah Cardiac Transplant Program. Patients over 65 aren't transplanted there,
and even 60-year-olds are scrutinized carefully.
Despite UCLA's short-term high success rate, heart recipients over 65 in international
registries have lower long-term survival says Taylor. The American Heart Association
(AHA), in a 1995 scientific consensus paper even questions transplants in patients
over 55. Though these surgeries can work medically they're ethically debatable AHA
But right now older heart patients are far more likely to never make it onto a transplant
list than to take a heart from a younger person says Caplan. He favors potential
quality of life "not any age cutoff written in stone,' as the key criterion.
And that sounds fine to UCLA's Laks whose book-lined office displays photos of transplanted
patients playing baseball at "reunion" picnics. His older patients aren't
James Shirley 67, fits right in. He rides horses and ropes steers as a hobby. Heart
disease forced his retirement from contracting work. Since the transplant last June,
"my energy is coming back, says Shirley "and I'm getting just as ornery
as I used to be ..... I plan to start working again soon I can't sit around. This
sitting around drives me crazy."
James Taylor, 73 the program's oldest alumnus is five years post-transplant. A retired
engineer he's lay pastor at a nearby Hispanic church. Taylor is designing and marketing
a camper/trailer that folds electrically.
Despite good news so far UCLA's program is still "an experiment in progress,'
says cardiologist Jon Kobashigawa, who treats the post-transplant patients for the
rest of their lives.
Meaningful five-year survival rates will be out in two years he says, "and we'll
know a lot more then ."
The jury is definitely in, though for many touched by UCLA's program. Virginia Balding,
52, works beside her husband George in the family business. She doesn't have any
illusions about George.
"George's problem," she coilfides, "is he thinks he's 40 years old.
He can't figure out why he can't do 14-hour days, even with his new heart. He can
only work 9 hours. He thinks, "What's the problem? But you know, that's the
reason he deserved to get a heart. My Lord, he had so much life left in him."
USA Today, February 10, 1997
UpBeat is delighted to report that recent contact with Cal Miller at
his vacation golfing retreat in Florida reveals that his condition is very stable
and he is in "full operating condition." As will be remembered two years
ago Cal was the first heart transplant recipient to undergo the laser cardiac revascularization
procedure called TMR for transmyocardial revascularization. This is the promising
procedure where a grid of small holes are fired into the heart muscle by a highly
technical laser. The heart muscle there after is able to become oxygenated via direct
contact with blood, very similar to the heart of a frog. Cal says his ejection fraction
is holding steady at about 45% and he has no symptoms of any heart problems. He still
feels it is a very worthy treatment for consideration by heart transplant recipients
with TCAD, but not in a position for retransplant or other treatment. See below:
PLC Sys Sees FDA Approval Of Heart Laser This Summer
By Louis Hau
NEW YORK (Dow Jones 3/4/97)-PLC Systems Inc. (PLC) expects the Food and Drug Administration
to approve its Heart Laser this summer for use in the treatment of late-stage coronary
artery disease, Chairman Robert Rudko said. "We really think we're in the final
stages," he told Dow Jones.
PLC's carbon-dioxide laser zaps channels into the heart to enable blood tO reach
tissue that has been deprived of sufficient oxygen because of coronary artery blockages.
The procedure is known as transmyocardial revascularization, or TMR. Other TMR laser
manufacturers include CardioGenesis Corp. (CGCP) and Eclipse Surgical Technologies
Inc. (ESTI), both of which are conducting U.S. clinical trials on their respective
PLC's application to the FDA asks for approval of the Heart Laser for use in patients
for whom angioplasty or bypass surgery is not an option. Market observers expect
TMR to be used eventually in conjunction with a bypass to move blood more effectively
into oxygen-starved heart muscle.
Somehow right after my heart transplant, I came into ownership of a
paper poster with the heading, "Look at Cyndi! Thanks to Heart and Blood Donors."
It showed a pretty young lady happily dancing and said at the bottom that Cyndi
Jeikmann received a heart transplant at Stanford University in 1977. It was sponsored
in those very early days by the American Red Cross and the Anatomical Transplant
Association of California. It made me feel good just looking at it from time to time.
A couple of weeks ago I stumbled across the same poster, now not in very good shape,
jammed behind a cabinet. Just about the same day I read about the death of Cyndi
Jelkmann Bock at age 40. She had undergone a 2nd transplant and married both about
5 years ago. As Peter Rauch of the Los Angeles area TRIO put it: "She
was a pioneer who lighted the way for all of us to follow. It was my privilege to
know her. She will be missed by all who knew her and by the "world of transplantation
"for her courage and her dedication to the cause which gave her another 20 years."
I think I'll still keep the poster around for those days when I need a little boost.
Gosh, I'm just plain tired of hearing about the organ donation non-stamp!
The late Ed Heyn of Michigan worked hard on that campaign and gathering supporting
signatures and requesting letters be written for several long years before his death.
Then it was taken over by the Southwestern Michigan Transplant Association and they
are still very much at it with still more of the same. After all this action, nothing
has happened at all. The Stamp Selection Committee has met and literally done no
more than chosen not to put out an organ donor stamp in 1998. Obviously we're doing
something wrong, or at best we're not doing anything that works. Maybe we should
suggest a stamp portraying the agony of a family who lost a loved one because organs
weren't available. No, not a good idea. Well, how about a stamp that just says "Thanks"
and has the portrait of one of the better know recipients on it - Mantle, Hagman,
Casey, Coleman, Lewis? The weakness seems to be the approach we're taking and the
stamp concept being put forth, not really the idea of organ donation. We've got the
donor cards now with the tax refunds and astronauts signing their cards in space,
so Uncle isn't against donation. We just haven't sold the idea for a good stamp.
UpBeat received the following note from author/writer Tx A.C.
Green of Salado, Texas: "Want to thank you for the 10-year piece in the January
UpBeat. It sure makes me, coming up on nine (June) feel a little better about
things; not full of false hope or optimism, but just seeing statistics about people
who have made it beyond five, which is where most of those stats. have ended. I've
managed to fight off a nerve cancer, although not some of its after effects, and
my case has fit most of the "good" profile for possibility: no smoke, no
rejection episodes of any kind, no cardiomyopathy nor disease, and ability to continue
working so my mind ain't wore out! May not make 10, but at least I now know it can
Help may have arrived for those males who have had sexual performance
problems since transplantation for many reasons, but mostly basically due to medications.
There is a new drug system recently approved by the FDA called Muse, manufactured
by Vivus. The drug is available in four dosage levels and is directly inserted into
the end of the male organ with the goal of making it functional for a portion of
an hour. Those who desire to pursue the matter further should discuss the situation
with their transplant physician, who would then refer them to a urologist for examination
and establishment of the proper dosage. Now, without overly dampening the optimism
that this new drug may offer, it also must be reported that some very preliminary
reports indicate a lack of success on certain individual transplant recipients, most
likely due to unknown interactions of certain drug combinations. The only way to
determine individual reaction is to have a urologist perform a trial dose.
In acknowledgment of the many comments made on the recent questionnaire
about the problem of the seemingly constant need urinate during the night, here's
a restatement of the best explanation yet put forth as to the reasons why, as first
published in UpBeat October of 1996.
At long last, here's a rather neat theory to explain all the night-time trips to
the "john" by heart transplant recipients. Accept as a given that cyclosporine
is at minimum rough on kidney function. Thus during the active hours of the day when
the body is attempting to regulate all its needs using a minimally fixed heart rate
controlled only by catacholamines, kidney function is minimal, or even suppressed.
However, at night when the body is in a supine position, the heart doesn't need to
work as hard, yet it's resting beats per minute are still fixed at a significantly
higher rate than that of a "normal." Thus with extra circulatory volume
that is not really needed by other areas of the body, the kidneys are in a situation
where they can function more efficiently, and we all know the result, clockwork trips
to get rid of their successful efforts to clean up the blood.
Going one step further, if one checks the PDR it will show that two out of the three
heavy hitter "standard transplant drugs", cyclosporine and prednisone,
have listed as "less common" side effects "frequent urge to urinate"
and "frequent urination" respectively.
I guess the best solution is don't be leaving your foot stool in the middle of your
route to the facility.
IMMUNITY RESPONDS TO DANGER, NOT INVASION
By Elizabeth Manning - UPI Science
Seattle, (UPI 2/15/97)- Proposing a new view of how the immune system works, a National
Institutes of Health researcher says her model may better explain a range of biological
mysteries: why mothers do not reject their unborn babies, how tumors gain a foothold,
and why the body continues to reject transplanted organs.
Contrary to traditional belief, NIH immunologist Polly Matzinger says, the immune
system responds to danger -- not necessarily battling every foreign invaders.
In a presentation at the annual meeting of the American Association for the Advancement
of Science in Seattle, she noted traditional thinking holds the immune system does
not attack cells of its own body because it learns early in life to recognize what
native tissues look like. So anything it does not recognize must be a new arrival
-an invader to be destroyed.
But Matzinger says this thinking does not explain several common situations.
For example, a woman who was not breast-fed as a child would not be able to recognize
human milk. Yet this same woman can breast-feed her own child, and her immune system
will not attack her milkproducing cells.
Matzinger's theory explains this mystery simply: the milk cells pose no danger to
the body, so the immune system leaves them alone.
The same is true for tumor cells, at least at first. Matzinger says, "After
all, what's a tumor cell but a normal cell that has lost its growth control'?"
Transplanted organs would seem to benefit, not threaten, the body. But an organ can
sense the stress of removal and transportation from donor to recipient. Its cells
send out distress signals to warn its host of injury. Matzinger says it is these
signals, not the organ itselK that triggers rejection.
Furthermore, Matzinger points out, current anti-rejection drugs also suppress the
signal that would teach the body to accept its new organ. Thus transplant patients
must take them for life, or risk rejection even years later. The new view could alter
the way drugs for transplant patients are developed to more accurately target the
immune system's rejection response.
ORGAN DONOR BILL BLOCKS FAMILY OVERRIDE
Columbus, Ohio, (UPI 2/26/97) -State Rep. William Schuck, R- Columbus, has introduced
legislation aimed at increasing organ donation by prohibiting families of organ donors
from overriding a family member's donation wishes.
Transplant experts said such a law would be the first of its kind in the nation.
Schuck, who introduced his bill Wednesday, said, "A mentally competent person
should have a right to make binding decisions about donating his or her organs. This
bill ensures that a donor's wishes are respected and takes several steps to promote
The bill, among other things, provides that a hospital need not consult with the
family of a deceased person before removing tissue for an anatomical gift, as stipulated
by the deceased person.
Schuck's legislation also would require Ohio high school health and driver education
classes to include information on anatomical gifts. It also authorizes declarations
of such gifts to be filed with county recorders for a maximum fee of $5.
Although courts have ruled that the organ donor cards that people sign when renewing
their driver's license are legal documents, organ banks and hospitals always ask
families to consent to a donation.
BOLIVAR, Tenn. (AP 3/3/97) -- A fatal bullet has kept 18-year-old Clay Burford from
joining his high school buddies at graduation this spring -- but his heart will be
there, donated to a classmate who needed a transplant.
Police said Bufford was shot in the head Feb. 23 while trying to protect a child
from a teen who was flashing a handgun. The teen was arrested and charged with murder.
Bufford, of Bolivar Central High School, was placed on life support. Doctors later
told his mother that he was brain-dead and that there was nothing they could do for
Ms. Bufford then remembered 17-year-old Ameanna Turner, who had been hospitalized
since December after doctors discovered a leaking valve in her heart. The mother
decided to donate her son's heart to the girl the next day.
Ms. Turner had been told that Bufford was shot and that a donor had been found for
her, but she didn't know he had died. Alter the operation, she figured out it was
Bufford's heart before doctors could talk to her.
"She named his name," said hospital psychologist Glenn Ann Martin. "She
smiled. She's OK with it."
Doctors expect Turner to go home in a few weeks. By April, they believe she should
be marching in her graduation line to get her diploma.
Ms. Bufford said the only thing that mattered to her son was graduation, which is
why she wanted Ms. Turner to have his heart. The family of an organ donor can designate
a recipient under certain conditions, said Gary Hall of the Mid-South Transplant
Foundation. The recipient must already be accepted by a transplant program and be
on the national list for patients awaiting donor organs. The donated organ must also
be acceptable medically for the designated recipient. with matching blood types and
other such factors, Hall said.
SOME ORGANS GO UNUSED FOR NON-MEDICAL REASONS
Cleveland (AP 2/3/97) -- Patients awaiting transplants should be told how often hospitals
turn away potential donor organs for administrative rather than medical reasons,
medical ethics leaders say.
Twenty-eight of the nation's 167 hearttransplant centers refused donor hearts for
nonmedical reasons 20 percent of the time or more during a seven-month period in
1994, The Plain Dealer reported today. The period is the only one in which complete
data are available.
Of those 806 hearts rejected for administrative reasons, 97 percent eventually were
accepted and transplanted by other hospitals, the newspaper said in the second part
of a series on the organ transplant industry.
Many of the nonmedical rejections were made by smaller programs which often had only
one transplant team, the newspaper said. That means the team might be unable to accept
a donor organ if doctors were out of town or involved in other surgeries. The newspaper
did not give examples of other nonmedical reasons.
Patients should be given information about a hospital' s nonmedical rejection rate
while they are deciding where to have a transplant, not after they are hospitalized,
said Jeffrey M. Prottas, an ethics committee member of the government's organ allocation
contractor, United Network for Organ Sharing.
"Whenever I have my say on this issue, I say that UNOS ought to be publishing
all of this," said Prottas, who teaches health politics at Brandeis University
in Waltham, Mass. "It's really unfair. Everybody should know these sorts of
"I'm surprised that the numbers are that high," said Thomas H. Murray,
director of the Center of Biomedical Ethics at Case Western Reserve University and
one of several ethicists and doctors who said they were unaware of the practice.
"You'd like to know what the circumstances were ... but if they can' t give
good reasons, it' s troubling."
Every transplant center turns down some donor organs for nonmedical reasons, said
Dr. John R. Wilson of Vanderbilt University.
"There is no program in this country that can guarantee that every organ that's
acceptable is taken," Wilson said.
Medical reasons for rejecting an organ range from issues related to the quality of
the organ or a donor's social history, such as drug or alcohol use, to the recipient'
s immediate need for a multiple organ transplant. Sometimes a recipient was too ill
to accept a transplant, or the donor's size or weight was incompatible with the recipient.
Judith B. Braslow, who heads the U.S. Department of Health and Human Services' Division
of Organ Transplantation, said the number of hospitals that regularly refuse donor
organs for nonmedical reasons is small.
"We do 19,000 to 20,000 transplants a year. We're talking about very small numbers,"
But when it comes to withholding such data from patients, "That's not to say
patients should have been treated this way," she said.
The number of people nationwide awaiting an organ transplant has tripled to more
than 50,000 since 1988, with more than 3,700 waiting for heart transplants. During
1994, a total of 2,361 received heart transplants and 770 people died waiting, the
PROTESTS AS INDIA PIG HEART TRANSPLANT DOCTORS FREED
Guwahati, India (Reuter 2/19/97) - Three doctors charged with homicide for transplanting
a pig's heart into a man who later died were released from prison Wednesday and promptly
faced protests from local residents.
Witnesses said a crowd of over 100 people gathered outside a jail in the northeastern
state of Assam, shouting "killers," "butchers" and "murderers"
at the three doctors as they stepped out of the prison.
There was no violence, the witnesses said.
Hong Kong-based surgeon Jonathan Ho and two Indian doctors were arrested in Assam
Jan. 8, a day after a 30-year-old heart patient was declared dead.
The doctors had transplanted the pig's heart into Purna Saikia Dec. 15 in a private
clinic 20-miles west of the state capital Guwahati. The transplant attracted international
attention and widespread criticism on ethical grounds.
After Saikia died the three surgeons were charged with homicide and violation of
a three-year-old law governing organ transplants. The maximum punishment under the
law is five years in prison or a $280 fine, officials said.
Tuesday a two-judge bench of the Guwahati High Court ordered the three doctors released
on bail, but impounded their passports and told them to report to police twice a
The judges also barred the doctors from performing any organ transplants without
federal authorization. No trial date has been set.
PIG CLONES, TRANSPLANTS NOT IN IMMEDIATE FUTURE
By Maggie Fox
London, (Reuter 2/27/97)- Pigs will not be immediately cloned for organ transplants
to people, and the technology for such transplants is some way off still, experts
said on Thursday.
David White, a co-founder of Cambridge-based Imutran, said he was intrigued by news
that Scottish scientists had cloned an adult sheep but would have no immediate use
for the technology.
"We are not planning to clone our pigs at this stage," he told a London
conference on transplants which ends on Thursday.
News about the cloning technique, developed by the Roslin Institute and biotechnology
company PPL Therapeutics Plc, alarmed many and prompted a call for worldwide examination
of the research and its implications.
There has been equal anxiety about the prospect of transplanting animal organs into
humans. In January, a government-appointed committee of experts advised further studies
before passing laws on xenotransplantation.
The government agreed.
White, whose company has been producing genetically engineered pigs for transplant
experiments, said the possibility of trying out pig transplants in humans was a long
They were currently testing the organs in monkeys, but the best survival was just
over 40 days and that was not being achieved all the time.
It would not be possible to go to clinical trials until scientists were routinely
getting 30-day survival in monkeys, he said.
Currently the problem was getting the balance of drugs right. For an organ transplant
to work, the recipient's immune system must be suppressed so the body does not reject
"We're busy working our way through a list of immunosuppressive drugs,"
White told the Royal Society of Medicine conference.
Other obstacles also remained, White. whose company is owned by Novartis, said.
These included public acceptance of the idea of xenotransplantation.
Questions were still being raised as to whether it was ethical, what the psychological
effects would be and whether there were concerns for animal welfare.
Imutran is creating transgenie pigs whose organs can trick the human immune system
into accepting them. Pig cells are injected with genes instructing for human proteins
to be produced on the surface of certain organs.
The immune system tends to see such organs as human.
The issue of disease transmission had still not been dealt with, either. Experts
had found satisfactory ways to eliminate bacteria such as salmonella, viruses such
as influenza and parasites such as the one causing toxoplasmosis from the pigs and
But one known pig virus, porcine endogenous retrovirus, was proving stubborn and
there was still no way of being certain that unidentified viruses were not going
to be passed on.
"Clearly there are things we cannot give a clear guarantee on," White said.
"The regulatory authorities will have to be reasonable."
Ian Kennedy, who chaired the committee reporting on xenotransplantation to the government,
said the issue of passing on animal diseases to people was a major one.
"Things like viruses do not carry passports," he said. "The risks
we are talking about are not risks to the patient only, but also to the community
that might be coming in contact with that patient."
Many doctors believe AIDS originated in monkeys, and say once infected, a transplant
patient could infect many others.
PIG VIRUS COULD INFECT HUMANS
Washington, (UPI 2/27/97) -- A study appearing in the March issue of Nature Medicine
found a certain strain of a pig virus could infect human cells in a laboratory and
then replicate itself.
In recent years medical researchers have expressed optimism for using pig and other
animal tissues to meet the growing need of humans awaiting organ transplants -- but
the new study adds to other research suggesting animal transplants possibly could
infect humans with other species' viruses.
San Antonio virologist Jon Allan, of Southwest Foundation for Biomedical Research,
wrote an accompanying opinion article in the same issue. In the opinion piece, Allan
says, "The real question is can you make this safe? Safe enough to not introduce
a new infectious disease into the population'?"
British researchers found that after several rounds of replication, the virus was
no longer susceptible to the immunities of the host cells.
Several animal-to-human transplants, or xenotransplants ("ZENO-transplants"),
have already taken place in the United States. Perhaps the most famous was a baboon
bone marrow transplant to a San Francisco HIV patient in 1995. A pig liver has also
been transplanted, as have fetal pig cells for Parkinson's disease patients.
The Food and Drug Administration must approve all xenotransplants. An FDA spokeswoman
told United Press International studies like the one conducted in Britain may lead
to a series of medical workshops before the practice becomes more widespread.
Mandatory FDA xenotransplant guidelines were first set up in 1996 to protect the
public from health risks while not impeding medical innovation, FDA officials say.
But Allan says now that several transplants have already been done, the FDA will
likely continue to approve xenotransplant requests.
Allan says, "There needs to be more vigilance on the part of public health agencies."
TRANSPLANT FUNDS ALLEGEDLY MISHANDLED
Dallas, (UPI 2/25/97) -- A Dallas federal grand jury today (Wednesday) indicted a
former Seagoville, Texas couple for mishandling funds intended to help children seeking
The 22-count indictment names Jack and Bettie B radberry, managers and controllers
of Children's Transplant Association. The U.S. attorney's office says the Bradberry'
s are expected to turn themselves in Friday.
Prosecutors say the Bradberry's, who now live iri Tulsa, Okla., are charged with
conspiracy, wirefraud, interstate transportation of money taken by fraud, mail fraud
and money laundering.
From July 1988 until May 1993, the indictment alleges the Bradberry's induced persons
across the nation to place trust funds with the CTA and then diverted some of those
funds to their own use and the use of others.
U.S. Attorney Paul Coggins says the mishandling of the funds "added to the burdens
of families already stressed to the breaking point."
A spokeswoman for the U.S. attorney says the alleged wrongdoing never actually prevented
a child from getting an organ.
FBI Agent Jim Adams-says, "We hope this case does not create a chilling effect
on charitable contributions as most charities perform just as they say they will."
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