Oriented to Thoracic Transplant Recipients -- September 1999

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Another viewpoint of "piece work"- But no real solution ....

At the Heart of an Uneasy Commerce

By Rick Weiss

Remember that scene in Fellini's "Satyricon," where the guy gets his hand chopped off? I heard that it was real: The man was some poor Italian farmer, or baker, who really needed the money. Fellini gave him maybe $1,000. Good deal for both of them. (Now if the UpBeat reader has gotten this far and said to themselves, "I haven't a clue what you're discussing." Consider yourself at one with the Editor If you fully understand what ~ been discussed, you are definitely reading below your level. However, let's plough forward, it does become comprehensible.)

Apocryphal stories like this one, which circulated on my college campus after the movie was released in 1969, abound in American popular culture. Rod Serling worked a similar theme in his pilot for "Night Gallery" in the same year. Joan Crawford played a rich, blind art collector who saves a gambler's life by paying off his debts to the Mob, in return for his agreeing to submit to a radical operation that would give her his eyes.

We find these stories disturbing because there is a deep, if somewhat vague, presumption in our culture that the body and its parts are scared and shouldn't be subject to the standard economic laws of supply and demand. To the extent that body parts find themselves in the market place at all, there is usually a message - overt or covert - that altruism ought to be at the heart of the transaction. We donate rather than sell our blood, bone marrow and kidneys because we believe it's wrong to engage in cold-blooded commerce in corporeal components.

Yet the buying, selling and even renting of body parts does happen outside the bounds of television and the movies. Many people routinely sell their plasma to companies that extract from the strawcolored fluid therapeutic proteins worth far more than their weight in gold. Young women can, and increasingly do, sell clutches of their ripened eggs for $5,000 or more. And in many states, women rent their wombs for nine months at a time, charging whatever fee the market will bear.

In fact the more you look into the issue of what is allowed and not allowed in the trafficking of body parts and bodily fluids in this country, the more inconsistencies you find. Buying and selling organs such as kidneys and livers is illegal under the National Organ Transplant Act of 1984. But sperm can be sold (though on a per capita basis they have a tiny fraction of the value of human eggs). And you can sell your hair to the neighborhood wigmaker. It's illegal, however, to sell a lobe of your liver to someone in liver failure, even though your body would regenerate the missing lobe at least as quickly as your hair would grow back.

Moreover, restrictions on the sale of body parts, where they exist, generally don't apply to third-party profiteers. In the most famous legal case to deal with the question, the California Supreme Court ruled in 1990 that a patient did not hold property rights to his cells and tissues removed during surgery. But the court said the surgeon and biotechnology company that sought to make those cells into a blockbuster drug were entitled to keep the billions of dollars in profits they projected would come from the uncompensated man's tissues.

The economic system, which some critics have likened to legalized biological pillaging, is about to become federal policy in the emerging arena of human embryo research. Federal guidelines now being devised by the National Institutes of Health would preclude women undergoing fertility treatments from selling their leftover embryos to federally funded scientists wishing to do research on those embryos. Only donation would be allowed a reflection of the discomfort many people feel about the prospect of parents selling their offspring. (It's already illegal, of course, to sell a child, but in another example of our inconsistencies, price controls on private adoptions in some states are so loose that the result is virtually indistinguishable from child selling.) Yet the scientists who gain access to these freebie embryos would explicitly be allowed to patent and profit from cell lines or other biological products they might derive from them.

Because we're so confused and conflicted about the market valuation of our bodies and their parts, and in particular our reproductive tissues, wouldn't it make sense to come up with a consistent approach to regulating commerce in body parts? Especially 'given that today, as never before, the body is valued not simply as the vessel within which we each enjoy the brief privilege of personal existence but also as a biological resource that can be cultivated, propagated, farmed, mined, extracted and transformed into value-added commodities.

Placentas are being whisked from delivery rooms for sale to companies that make shampoos. Foreskins are passed from the circumcision table to the ice bucket for shipment to scientists who want to experiment with the easily cultured cells. Even cancerous lumps once destined for the surgical ashcan are now coddled and preserved for stock-optioned researchers who hope to turn the tissue into a cancer vaccine.

With improved immune system suppressing drugs and better surgical techniques, pancreases, hearts, lungs and other internal organs are becoming more transplantable - and therefore more valuable. And most recently, as scientists have learned to master the tools of biotechnology, the market for individual genes and even fragments of genes has begun to expand. A brain cancer gene might, if tamed a bit, hold the secret to regenerating neurons in patients with Alzheimer's or other neurodegenerative diseases. A gene that makes the clotting protein that hemophiliacs lack is no longer a mere product of nature but a potentially curative molecular therapy.

In short, as biomedical science has progressed during the past few years, the market value of our bodies has pretty much tracked the Dow. Which means that, to the extent that we are willing to put our bodies on the block, each of us is probably a bit richer than we think.

So why shouldn't we be allowed to freely dispose of ourselves - or at least the more fungible parts of ourselves - and trade our natural endowments for cash or some other form of spendable wealth? If everyone is really so proud these days that capitalism has proven so globally victorious, why not let it strut its stuff and let folks profit from the one thing we each most definitely own - our bodies?

Consider the rules for participating in medical research. The government allows perfectly healthy people to participate in risky medical research - and be financially compensated - even when the research has no promise of benefiting them personally, as long as they have willingly consented. The same rules could apply to giving up a kidney - or the hand in Fellini's movie. Just five months ago, surgeons in Kentucky did this country's first hand transplant. Other transplants are planned. Donors will be needed!

A few brave souls have seriously suggested that market forces should reign in the arena of organ transplants. An article in the Fall 1997 Cato Journal, known for its free-market orientation, argued that the U.S. ban on buying and selling organs is causing today's massive shortages, which leave thousands waiting for transplant.

The need for organs grows every year, but donation rates have long remained almost flat. Let's face it, the Cato authors say, lots of people are not crazy about giving up their organs, even after they die. A little cash incentive may well grease the gears. What's more, they argue, a payment system could lessen the waiting time disparity that exists between blacks and whites, since payments would probably encourage people of lower income, including blacks, to donate more organs.

But that potential for attracting donations from the neediest members of society is one of the big problems. A policy that allows the wealthy as well as the desperate to sell themselves piecemeal brings to mind Anatole France's famous 1894 observation that "The law, in its majestic equality, forbids the rich as well as the poor to sleep under bridges, to beg in the streets, and to steal bread."

Rather than reducing disparities between the rich and the poor, compensation for organs might exacerbate the differences, turning the poor into surgical ward slaves or feudal donors for the rich.

Some also warn that by encouraging organ donations from the poor, a payment system might inadvertently boost donations for the least healthy organs. That was certainly one of the reasons the nation's blood banks switched to an all-volunteer system for blood donors in the early 1970s. Donors who gave their blood for cash were often poor alcoholics and intravenous drug users; many infected with the hepatitis virus. By switching to volunteers, the blood supply got an instant cleanup.

And, at the risk of sounding old-fashioned, there is still the argument that our bodies and their components are not simply economic units of trade: That even though they are worth more, monetarily, than ever before, they also have special personal and cultural meaning, and by putting too much emphasis on the money side we actually cheapen ourselves. "The problem," as Jane Arson, a law professor at the University of Wisconsin says, "is how to value these things without destroying or diminishing their value."

Surely there is room for a Third Way of dealing with this special segment of the global economy. Something between the harsh and potentially enslaving laws of pure capitalism and the current system of not compensating people at all for "donations" of raw materials that in many cases promise to reap enormous profits for others.

To find such a way would require some legal and ethical trailblazing. "We are constrained by existing legal categories," says Lori Knolls, an associate at the Castings Center, a bioethics think tank in Garrison, N.Y. "In law, all is either person or property. There are very few things that are not one or the other. But embryos outside the body, embryonic stem cells, organs removed from a person before they're transplanted - they have connections with both. They are inanimate but also are derived from human beings, and we're not sure where to draw the line."

Pennsylvania is about to try one novel approach: An experimental program that will allow payments of $300 to aid families of deceased organ donors. The money would be available not as a direct payment for the organs, but to offset funeral expenses.

Another plan, floated by Cato authors Charles Carlstrom and Christy Rollow, would create, in effect, a barter system for patients who are in need of a kidney but whose willing relatives turn out to be a bad match for transplantation. A relative could donate a kidney to someone who is a good match, in return for someone else donating a kidney to their family member.

Neither of these approaches deals directly, however, with the fastest growing class of trade in body parts: the burgeoning quasi-marketplace in genes, cells, tissues and yes, embryos and fetuses. Here more than with organs for transplantation, some legal heavy lifting is going to be needed.

Specific models are still wanting, but many experts believe that it's time to consider allowing for some modest, non-coercive and properly regulated payments for people who give up their personal cache of biological resources to for-profit entities. A properly drawn system would protect people in the same way labor agreements protect people from slavery.

"We say you cannot sell all of yourself unconditionally, 24 hours of the day, but you can sell yourself eight hours a day at a fair wage with a set of controls that gives you some autonomy and that allows you, for example, to quit," Larson says. "Under those conditions, you are allowed to sell an important aspect of yourself: the best that you have in mind and body. So I think there is also the possibility of selling parts of yourself with similar controls over the action."

Alternatively, says E. Richard Gold, a professor of law at the University of Western Ontario and author of "Body Parts" (Georgetown University Press), perhaps companies should have free access to volunteers' tissues for free but should be granted only limited patent rights over products they make from those materials. The remaining rights could be passed to a non-profit foundation whose mandate would be to ensure that any medical benefits derived from those human tissues eventually are made available to everyone equally.

No doubt there are other ways to compensate people willing to share their biological resources. But we'll have to be sure the pendulum does not swing too far: There's always the risk that in an effort to protect ourselves from plundering biotech buccaneers we will grow greedy ourselves and forget that, in the long run, even we don't necessarily own our own biological wealth.

Rod Serling, for one, recognized the universe's perverse propensity to punish those who forget such humility. The blind dowager in his story, desperate for even a fleeting tryst with vision, saves the gambler's life and arranges for the surgery, knowing that she'll get just a few hours of sight before the transplanted eyes will fail.

The episode ends with the removal of her bandages one night-just as New York experiences the great blackout of 1965.

Washington Post, Sunday June 27, 1999
Contributed by Myrna Porter, Woodbridge, VA


A Heart Recipient's Favorite Web Sites

By Tx Jim Gleason - Collegeville, PA

Newest unique site:
the Heart Failure Hotel at: http://www.homestead.com/alouso
This is the web site for a local (they don't publicize that its Temple Hospital) heart transplant unit. With over 20 patients hospitalized for upwards of 9 months waiting for life saving heart transplants, this unique service developed by Ted, a nurse in the unit, provides for most welcome virtual visitations via their guest book. The patients themselves develop material and maintain the site, but like college students, hopefully they will graduate and leave, leaving Ted as the site's continuing mentor. For patients waiting in other heart transplant units, as well as post transplant patients and family and friends, it offers a unique insight into the heart failure world that is saving so many lives these days.

Transplant Recipients International (TRIO) offers a unique legislative advocacy service at their http://www.trioweb.org for members and friends to easily write their congressmen. Clicking to the support legislation link, one enters their zip code to get a photo and info on their congressional representatives. Another click and an emailable letter (which can also be printed out for snail mailing to non-emailable reps), formatted with the sender's name and address, is generated in support of important legislation TRIO is trying to advocate on behalf of their membership, transplant patients and other professionals in the transplant network. Writing to your reps was never so easy.

At http://www.donors1.org, Gift of Life Donor Program is using their redesigned (and very aesthetically pleasing - designed by local artist, web designer and kidney transplant, Charley Parker - who also did the design work for the TRiO site) web site to announce that name change (from Delaware Valley Transplant Program) with a unique "magical" name changing logo on the home page. Along with a "Tour of the site" there are many photos of local transplant people to give the professionally done site the home spun feel that goes along with their life saving mission here in the Delaware Valley (including NJ and Dela). The site also serves as a source of event and news information for it's many volunteers and visitors.

http://transweb.org is, of course the world of transplantation's main resource rich site is the famous, out at the Univ. of Michigan. Everything anyone ever wanted to know about the process, the patients, the resources, the world of organ transplants can be found here. While I don't care for the recent redesign that tries to make navigation easier (it just doesn't look attractive in its black and white menu starkness), it contains some of the most emotion filled stories of recipients and donors you will find anywhere on the web.

http://members.aol.com/gleasonjim is my own simple web site which serves the purpose of introducing my own heart transplant experience (locally at Hosp. of the Univ. of Penn in '94) and links to the full virtually published version of my book, A GIFT FROM THE HEART (over 45 chapters and 300 pages of story, advice, inspiration and reference for transplant patients around the world). This gift (also mailed in hard copy free for the asking, but viewers are encouraged to print out their own copy or read it on line) is my response to the anonymous gift of this new heart by giving back to those who follow in these transplant footsteps. Over 10,000 copies have been distributed in this virtually publishing form, something not affordable to me if I had to use "normal" print publishing methods. The web has generated requests for this book from as far away as a medical library in India and friends in Australia (a US company manager stuck there with heart failure unable to return until he got his own new heart - then he stopped by my office here in PA to say thanks upon his return, new heart and all). The book is hosted at the Transweb site at the Univ. of Michigan.

(Ed. Note.' For those of you uninitiated to the Web, the paragraph above is what is called blatant "Spam ", the use of legitimate network band width for the purpose of nonpaying advertising. (G)-grin.)


National Transplant Statistics Go Online - Available at www.unos.org:

By Robert Davis, USA TODAY 9/9/99

Key information about the nation's transplant centers, including patient survival rates, appears online Thursday, giving patients and doctors quick access to vital statistics. The national database is searchable by type of organ, geographic region and individual hospital and provides key details on the effectiveness of the nation's transplant program. The database is to be unveiled in Washington.

"There is no other medical field that produces this much information, this type of information to the public," says Donna Henry Wright, patient affairs specialist for the United Network for Organ Sharing (UNOS), the organization that runs the organ allocation system for the U.S. Government.

But critics say the database does not go far enough to meet recent recommendations from an Institute of Medicine report to Congress. That report called for a broad range of data to be made widely available for doctors, patients and researchers.

Wright says the information is being provided on line in part so that the 65,300 patients waiting for organs can monitor transplant activity. It won't tell them where they are on the list, but it may help them decide which transplant center has the best track record.

"It shows the system is not a mystical thing," says Wright, who received a liver in 1994.

For each transplant center it shows: the number on the waiting list, how many organs have been transplanted and how many people die waiting. Demographics of the waiting list, including blood type. How fast patients get their organs and how sick they are when they get them. Survival rates. How a center compares with others in the immediate area in numbers of transplants.

But critics say the database does not give such key facts as how sick patients are who die waiting. "It doesn't tell you what your chances are of dying on the waiting list," says Lisa Rossi of the University of Pittsburgh. "What they've done is repackaged some of the old data," says Craig Irwin of the National Transplant Action Committee, a patient advocacy group. 'I give it a marginal thumbs-up."

Jon Nelson of the Department of Health and Human Services, which has pushed UNOS to release more data, says: "The next step is having more current information that is in some sense more useful."


PVCS

Although UpBeat usually just accepts the loss of Tx recipients as "coming with the territory", I feel obligated to mention the passing of Tx Cal Miller of Indiana this past summer. Cal had received the Trans-myocardial Revascularization by laser in January of 1995, and as recently as April of 1999 reported he felt he was doing fine. While we are all pioneers, Cal took it to the limit with what was then an experimental procedure and it worked. The FDA has since approved it.

Errata: We learned something in the last issue in the synopsis report of the Registry of heart transplantation. Under the heading Heart Transplantation the third item down should have read, "The patient one half life (time to 50% survival) at transplant is 8.8 years, but after surviving the first year the one half life increases to 11.5 years." Mr. Gates' Word 7 arranges to print fractions in a special small type, but somehow his minions neglected to arrange for same to be electronically transmitted. Gee, that must be Microsoft's first screw-up!

UpBeat has shown up on the Internet! You can now actually read UpBeat at the following website on the Net: www.bmarsh.com/upbeat. Now if the appellation seems a touch similar to my own, it's because it's the home page of my brother, a retired computer guru, who lives in the woods of upper Michigan. I had no idea he had performed this service, which must have entailed considerable work - he has the archives back to 1996! So, don't stop the donations, but if you lose your copy or want to look up something you think you read here, there's your chance. One caution - I understand he also donates web space for a cat rescue group in Ohio, so if somehow you get misdirected and asked to provide a home for "Puffy", at least you'll know why.

At present it's looking as though the October issue of UpBeat will be one of those Transplant Sunday Funnies issues consisting of all the various cartoons I'm able to dig up in the dangerously tipsy piles of"maybe use" stuff on my desk. It's simple logistics - hoping to stay healthy enough to take a trip on some of the trains of western Canada. Let's just say the trains wobble too much to write.


Circulation Article Reports Ways Purple Grape Juice May Fight Narrowing Of The Arteries

- Clinician Cites Effect of the Juice in Study on Contributors to Coronary Artery Disease --

CONCORD, Mass., PR Newswire 9/?/99 Researchers from the University of Wisconsin Medical School have identified ways in which drinking purple grape juice may fight atherosclerosis, or narrowing of the arteries, according to a study in the September 7th issue of Circulation, a journal published by the American Heart Association. The study showed that when fifteen subjects, all people with coronary artery disease, drank purple grape juice for two weeks, the elasticity of their blood vessels significantly increased and the rate at which their LDL cholesterol oxidized significantly decreased.

"This is of great interest," notes John Folts, Ph.D., "because it suggests that consuming purple grape juice could positively effect the atherosclerotic process in several important ways. Previously, much of the potential benefit of consuming purple grape juice was attributed to its apparent ability to make the blood less likely to clot. Now we see that there appear to be two other beneficial factors at work as well."

Dr. Folts, the senior author of the study and director of the Coronary Thrombosis Research and Prevention Laboratory at the University of Wisconsin Medical School, has conducted extensive research in this area, with much of his previous work focusing on the ability of grape products to reduce the stickiness of blood platelets.

"There are a number of primary contributors to atherosclerosis," explains Folts, "Three of them are the stickiness of our blood, the reduced flexibility of our arteries, and the speed at which we oxidize LDL cholesterol. In previous studies, we saw that drinking purple grape juice reduced blood stickiness. What this study suggests is that drinking the juice has a beneficial effect on two other primary contributors as well." The study looked at fifteen men and women (average age 62.5 plus or minus 12.7) with coronary artery disease. Each person drank approximately 7 cc/kg/day* of the juice for 14 days.

"This study suggests that drinking purple grape juice may promote these heart healthy mechanisms. Combined with what we have learned from previous studies on grape juice's ability to decrease platelet activity, it makes sense to include daily consumption of purple grape juice as part of a diet high in fruits and vegetables and low in saturated fat."

Welch's Purple 100% Grape Juice has been certified by the American Heart Association for its HeartCheck program. The study was underwritten, in part, by the Oscar Rennenbohm Foundation, Madison, WI; the Nutricia Research Foundation, The Netherlands; and Welch Foods Inc., A Cooperative, Concord, MA.

*

1 K = 2.2046 pounds
7 CC = .2366 ounces

So a person weighing 200 pounds would weigh 90.7kg, therefore 90.7 X .2366 = 21.45 ounces or say two large ice tea glasses not filled to about an inch and a half from the top (not real scientific, huh?). Seems doable, but those on a "sugarbusters" diet would be in heavy violation.

One wonders about a good red table wine----?


Meanwhile Down on the Farm: Pig Transplants Deemed "Fairly" Safe

By Lauran Neergaard - AP Medical Writer

WASHINGTON (AP 8/19/99) --The most rigorous study ever on the safety of transplanting animal parts into humans found no evidence that people caught a worrisome pig virus. The reassuring finding could spur experiments using pigs and other animals as organ donors.

At issue is "xenotransplantation," transplanting organs or cells from one species into another. Doctors hope this still highly experimental field could one day save thousands of lives by easing a worldwide shortage of donated organs.

But some scientists fear animal-to-human transplants also could cause new epidemics. The AIDS virus is thought to have jumped from monkeys to people long ago, and just last year pigs in Malaysia were sickened by a deadly new virus that they spread to people.

So scientists are breeding pigs -- the most likely species for xenotransplants -specially tested against infections. But concern rose when researchers recently discovered the genes of all pigs harbor a previously unknown virus that test-tube experiments showed could infect human cells.

The virus did not harm the pigs, but nobody knew if it would hurt humans.

The new study, published in Friday's edition of the journal Science, suggests this so-called "porcine endogenous retrovirus," also known as PERV, is not a big threat.

Scientists at the British biotechnology company Imutran Ltd. tracked down 160 patients from eight countries who were treated experimentally with living pig tissue. Using the most rigorous viral testing available -- and supported by testing at the U.S. Centers for Disease Control and Prevention -- Imutran scientists found no evidence PERV had infected the 160 patients.

Among the virus-free patients were 36 people deemed at high risk because they had very weak immune systems.

"It's really good news for all those people waiting for this potentially lifesaving technology," said lead researcher Dr. Khazal Paradis of Imutran, which is developing ways to transplant entire animal organs.

The study is not proof that xenotransplantation is safe, cautioned CDC's Dr. Louisa Chapman.

"It's a substantial advance that ... gives us more confidence" about allowing certain experiments to proceed, she said. But all xenotransplants must continue to be closely watched for viruses, she added.

The patients studied included diabetics who had received transplants of pig pancreas cells, bum victims who had temporary pigskin grafts, or liver- or kidney-failure patients who had their blood filtered through pig livers or kidneys outside the body while awaiting a human organ transplant.

The study's biggest surprise: Pig cells remained alive, with no detectable ill effects, inside a small group of Russian patients eight years after they had an unusual treatment.

"We did not expect the pig cells to survive for that long," Paradis said.

The Russians had undergone therapy apparently used nowhere else. The blood of 100 child burn victims was filtered through a fresh pig spleen for one hour to help them fight severe infection. Blood normally runs through the spleen, part of the immune system, and Russian scientists have contended this therapy works. Regardless, Paradis found living pig cells in 23 of the 100 Russians.

In most other experiments, the human immune system quickly has killed animal cells -- another roadblock to attempting transplants of entire animal organs.

The downside when animal cells survive is that "any virus may not be seen by the immune system either," said Dr. Jonathan Allan, a virus expert at the Southwest Foundation for Biomedical Research in San Antonio, who has been outspoken about the potential risk of xenotransplantation.

"This study is not a green light" to rush ahead, warned Allan, who wants xenotransplant experiments limited to small numbers of closely monitored patients.

For now, that is the U.S. Food and Drug Administration's approach. It is allowing a few small pig-to-people experiments, including implants of fetal pig cells into Parkinson's disease patients' brains, while scientists hunt potential infections.


Pig Xenotransplant Study Shows No Infection Evidence:Novartis
- "safe for long periods..."

ZURICH (DJ 9/19/99)--A study in Thursday's journal Science, reports there is no evidence of Porcine Endogenous Retrovirus (PERV) infection in 160 patients previously treated with living pig tissue, Novartis AG (NVTSY) said Thursday.

The study is the largest to assess the safety of xenotransplantation of cells, tissues or organs from one species to another. The study was run by Imutran Ltd., the Novartis Pharma Ag company.

"This study is an important milestone in the development of this potentially lifesaving technology," said Dr. Corinne Savill, chief operating officer at Imutran. "We hope in the long-term that this will help to save the lives of patients worldwide waiting for an organ transplant."

The study showed there is no evidence of PERV infection in 160 patients, including 36 patients who were pharmacologically immunosuppressed and therefore presumed to be at increased risk of infection, Novartis said.

Of the patients, 23 showed clear evidence of circulating pig cells, but no infection even though some of these patients had been treated with living pig tissue more than eight years previously. Four patients had a positive response in the antibody test.

"This finding demonstrates that pig tissue can survive in the human body for long periods with no ill effects," Novartis said.

The purpose of the study was to determine whether there had been transmission of PERV to patients treated with the living pig tissue and, if so, whether there was any evidence of harm.

Patients included in the study had been treated up to 12 years previously with pig skin grafts for severe burns, pig pancreatic islet cells for diabetes or had their blood perfused outside the body through pig spleens, kidneys or livers.


CryoLife Announces First SynerGraft -R- Biologic Heart Valve Implants in Human Patients; Transspecies Transplant Performed Without Use of Immunosuppression

ATLANTA--(BW HealthWire 8/31/99)-CryoLife, Inc. (NYSE:CRY), the leader in the development and commercialization of living human tissue implantable devices and a manufacturer and distributor of stentless heart valves and surgical adhesives, today announced that two human females had each received a tissue-engineered SynerGraft(R) porcine heart valve in the aortic position. Dr. Mark O'Brien, a paid consultant to CryoLife, Inc. and a member of the CryoLife Cardiovascular Medical Advisory Board, performed the first implants of tissue-engineered heart valves in Brisbane, Australia.

The research and development which led to this unprecedented surgery were made possible, in large part, by grants totaling over $1.1 million from the National Institutes of Health (NIH). Additional SynerGraft research is also being funded by a $2 million grant from the U.S. Department of Commerce, National Institute of Standards and Technology (NIST).

CryoLife's SynerGraft technology incorporates the use of a porcine heart valve which is depopulated of its cells and is expected by the Company to repopulate following implantation with the cells of the heart valve recipient, producing a bio-engineered human heart valve similar to the patient's own heart valve.

Steven G. Anderson, President and Chief Executive Officer of CryoLife, said, "1 believe the successful implant of a tissue-engineered heart valve is an enormous milestone for our company and our SynerGraft technology.

The SynerGraft technology has multiple applications, but holds particular promise for cardiac surgery in children since we believe that the bio-engineered heart valve should have the capability to remodel itself with the recipient's own cells, potentially growing with the child. I believe the implantation of a tissue-engineered heart valve represents a revolutionary breakthrough in implantable device technology. SynerGraft technology enables a trans-species transplant of an unfixed biologic heart valve without requiring the use of immunosuppression."

Mark O'Brien, M.D., of the Department of Cardiac Surgery at The Prince Charles Hospital, Brisbane, Australia, said, "The implantation of these two heart valves, which took place one week ago, is a landmark event in heart surgery. To our knowledge, these are the first implantations of tissue-engineered heart valves in the world. This SynerGraft technology may revolutionize the replacement of heart valves, making life-saving surgery available to expanded numbers of patients."


Organ Transplant Pigs Won't Be A Boon For Farmers

(Not to mention the pigs - Ed.)

CHICAGO (Reuters8/20/99) - Raising pigs for human transplant organs will likely benefit only a fraction of U.S. hog farmers, industry sources said on Friday.

"These pigs we're going to use for sources of organs are not at all the same pigs that we're raising for meat," said Ron Plain, agricultural economist at the University of Missouri.

Plain said hogs bred for meat were much larger and the number of pigs needed for transplant use would be significantly less than those raised for food.

About 100 million hogs are produced a year in the U.S. for food. About 100,000 hogs would be raised separately as "designer pigs" for transplant purposes, Plain estimated.

"The potential numbers would be about one-thousandth of the number we need for food," Plain said.

Researchers Thursday said a study of 160 patients who had been exposed to pig tissue in various ways showed not one was infected with a pig virus as long as 12 years after.

There are nearly 40 drugs and pharmaceuticals currently produced from hogs including heart valves, skin for burn dressings and insulin, said Paul Sundberg, assistant vice president of veterinary issues for the National Pork Producers Council in Des Moines, Iowa.

"Right now we don't really have a reliable product, but this is an exciting step forward in this research and if it bears out it certainty will be something to. watch;" Sundberg 'said.


Anxious for a cartoon? We are too/Forgive our file conversion problems and stay tuned - Ed.
Disclaimer: The material in this document has been collected by Don Marshall and friends. New ideas and materials are welcome all the time. Nothing herein is ever to be construed as medical advice. As a policy, UpBeat is sent upon request to heart and heart/lung transplant recipients and other interested parties. Donations of $15 per year, or more, from Tx recipients, if not a burden, are vital. From all others the donation is specifically requested. The date shown after the name on the address label indicates the last time a donation was received. Please make checks payable to Don Marshall, as we cannot afford to become nonprofit. Send materials, letters, or checks to:

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