Designing organs for medical transplantation

Denise Dador | ABC 7, Los Angeles

LOS ANGELES (KABC) -- Seventeen people die each day in the U.S. waiting for an organ transplant, but that may not always be the case. Thanks to breakthrough science, organ donation could actually one day become obsolete.

Currently 105,000 people are waiting for an organ to save their life, from kidneys to lungs to livers, the list is long.

Life is now being designed in the lab. Organs, limbs, wombs and even skin are being grown from a single cell.

Stephen Bruno waited 16 years for a liver transplant.

"You're not living. You're surviving, and you're not sure of when it's going to come, or even if it's going to come," said Bruno.

It finally came. What's happening inside one laboratory could put an end to the wait Bruno and thousands of others face each year. Researchers at the Institute for Regenerative Medicine at Wake Forest Baptist Medical Center are the first in the world to use human liver cells to create miniature livers.

"For the first time, we might have a solution to bypass liver transplantation, which is a major health problem throughout the world," said Dr. Shay Soker, Wake Forest Baptist Medical Center.

Within a year, Harvard doctor Joseph Vacanti will be transplanting ears grown on a scaffold onto a person. Vacanti became known throughout the world in the 1990s when he grew a human ear on the back of a mouse. Now he's using a person's own stem cells to do the very same thing.

"Ideally, it would be indistinguishable from a normal ear," said Vacanti.

But it doesn't stop there. Scientists at Cornell University are developing artificial wombs in which embryos can grow outside of a woman's body.



In Cincinnati, scientists are testing skin cells that can sweat, tan and fight off infection.

Zebrafish are being studied at Duke University. The way they can regenerate their fins could help scientists discover how to regenerate limbs for amputees.

The first artificial cell was born in Craig Venter's laboratory, which raises the question: Is the life line being crossed?

"It does raise concerns that engineers are running amok in biology labs and that they are playing God," said Dr. James Collins, professor of biomedical engineering, Boston University.

But researchers stress they are not creating life, only modifying life by working with cells that are already living, giving a second chance to millions of people who desperately need it.

The researchers stressed that creating tissues and regeneration is not cloning. It's using already-living cells to build organs from.

Girl waits, hopes for a new heart

BY DAVID DEMILLE • DDEMILLE | The Spectrum

ST. GEORGE - A 12-year-old girl whose heart suddenly stopped in PE class earlier this month is feeling better, but doctors say she needs a heart transplant.

Abby Doman, a cheerful, athletic girl who likes to play soccer, was in good spirits Monday as she prepared to be discharged from Primary Children's Medical Center in Salt Lake City. She is set to leave the hospital later this week but will need to live nearby until the right heart is available for a transplant.

The anxious wait could take some time, and doctors say Doman will need a new heart within a year.

"It's like a movie," Michelle Doman, Abby's mother, said from the hospital. "It's like a bad movie, but every once in a while you step back and say, 'Wait it's happening to us.'"

Abby was a seemingly healthy sixth-grade girl. She earns good grades and likes to play soccer. But in an instant, her life changed when she suddenly collapsed during running drills May 18 at Sunrise Ridge Intermediate School.

For eight long minutes, her teacher Cameron Murdock and others performed CPR. Paramedics arrived and needed to use two charges from a defibrillator to get her heart pumping again. She may not have had a pulse for 10 minutes, Michelle said.

"They saved her life," Michelle, who is a math teacher at the school, said of Murdock and other school staff who performed CPR. "She really shouldn't be alive right now, so we're lucky she's even here. It's a miracle."

Michelle was away from the school when the incident happened, taking her other daughter to have knee surgery, but she said the actions of her colleagues were the reason Abby made it to the hospital.

Abby was transported to Salt Lake City, where doctors diagnosed her with Hypertrophic cardiomyopathy, a condition in which the heart muscle thickens, making it more difficult for blood to leave the heart and forcing the organ to work harder to pump blood.

For many young, seemingly healthy athletes, the first symptom of the condition is a sudden collapse and possibly death caused by abnormal heart rhythms or the blockage of blood leaving the heart during heavy exercise.

"She was probably born with it, but we never knew," said Merideth Bruin, Abby's aunt. "We thought she was a perfectly healthy young girl."

A flood of support has poured in from family, friends and neighbors, from hand-drawn cards from schoolmates to fellow Sunrise Ridge teachers offering up some of their vacation time so Michelle can stay by her daughter's side.

Fellow students sang Abby a "happy birthday" song May 24 via a video call, and many have made the trip to visit her in Salt Lake City.

To help with the inevitable medical bills, a fun run fundraiser is slated for Friday at Little Valley Elementary School, with another scheduled for June 11 at Arrowhead Elementary School.

Murdock, who plays for the local semi-pro Dixie Rebels football team, said the Rebels would donate all of the revenue from their matchup June 11 with the Wasatch Revolution to the Domans.

Other future events may include a fun run and a horse race.

"It's incredible," Michelle said of the help from back home. "I cannot believe all the things I've heard."

A single mother with three children, Michelle said she likely would need all the help she can get, especially while living with Abby in Salt Lake City and trying to maintain a residence in St. George.

As her daughter battles for her life, Michelle said the goal is to focus on the present.

"I'm not looking past the summer," she said. "We're just trying to take it a day at a time."

New Providence 5K race raises organ donor awareness

By Liz Keill/Independent Press 

NEW PROVIDENCE - Two years ago, Erin Snyder needed a kidney. Fortunately, her brother Michael was a good match and he became the donor.

“My sister was lucky that I could donate to her” Michael Snyder said. “She didn’t have to go on the wait list, and that meant someone else could be moved up.”

The operation took place on June 9, 2009 and the 5K race, a first for the Sharing Network in New Providence, will be on Sunday, June 12, just two years and three days later.

“This is the inaugural. It’s the first time they’ve done it,” Snyder said of his involvement. The event is expected to bring donor families, recipients, volunteers, hospital partners and transplant centers together. 
Snyder is captain of Team Maitri a name, he said, that is derived from the Buddhist saying for the principle of loving kindness or loving friendliness. Snyder has been studying Eastern Philosophy at Rutgers University and, he said, this perspective hit home. “How do people become happy? By helping others,” he said.

Snyder said there are 10 people on his team, “but it’s not about the numbers.” Although some in the 5K race are competitive, others walk the route to show their support. The race is a U.S. Track approved course and has garnered support from such businesses as Pfizer, the presenting sponsor, Shop Rite, Saint Barnabas and a host of others. “How can a company say no to a worthy cause that saves people’s lives?”

Snyder asked. “The statistics are staggering. Over 90% of the population supports organ donation, but only 30% of eligible drivers have organ donation on their licenses, he said. “The truth of the matter is if you die in a car accident, you can save 50 lives.”

His goal, he said, is to take the unknown out of the organ donor experience by talking to others. He attends St. Andrew’s Episcopal Church in New Providence and, when members of the congregation were invited to speak, he described his donation for his sister. “I was amazed at the number of people who came up to me afterwards,” he said. “There would be someone who had a friend or relative who had gone through a procedure. Or someone else was thinking about it, but had concerns. The more you talk about it, the less frightening it is to people,” he said.

“You can lead a completely normal, healthy life,” he said of his experience. “So much that has changed over the last 10 years.” Today, the operation is done macroscopically so there is not the “stem to stern” intrusive approach. “I was out of work for two weeks” he said, “and my management was very supportive. I walked out the next day and was sitting in my recliner at home by 1 p.m.”

For his sister, it was a matter of dialysis or donation, he said. “The best thing to do was the kidney donation. I had blood tests and EKGs, chest x-rays and an MRI.” The procedure was done at St. Barnabas Hospital.

Snyder explained, “She was 31 at the time and I was 34. Now she’s 33 and is doing fine. She got married in October, 2010.”

Michael resides in Murray Hill and is employed with Honda in Madison while taking courses at Rutgers in Newark. They grew up in Chatham, where their parents still live.

“When the doctors told my mother that I was a match, she said, ‘It’s like I had Erin all over again.’”

NJ Sharing Network brings families together
That principle was reinforced by Executive Director Elisse Glennon during a tour of the New Jersey Sharing Network Headquarters.

The 48,000 square foot facility has a memorial hall devoted to donors. Glennon said visitors often come to see the name of someone whose organ was donated to help save another’s life. “There are reunions, too,” she said. “Some families want to meet the donor. Others do not, or may not want to for 10 or 11 years.” It’s entirely up to the parties involved, she said.

The Sharing Network makes its conference room available for outside organizations, such as the Red Cross. The network also conducts special awareness events, such as education to high school and college students on the importance of organ donation. Over 300 volunteers support the outreach efforts.

The transplant laboratory is a fully accredited clinical testing facility that carries out matches between recipients and donors for the 10 transplant programs in New Jersey.

The highly trained staff and state-of-the-art technology help facilitate complicated transplants that would not otherwise take place. The laboratory has been a critical player in saving the lives of more than 9,000 New Jersey residents. Transplant research is a developing initiative.

Transplant coordinators are essential keys to the process. They are on call 24-7, usually in 12 hours shifts. The coordinator reviews medical and social history to determine suitability. The coordinators will assess if or when the family can be offered organ and tissue donation. When consent has been given, the intricate balance of meeting the families’ needs and providing guidance for donor medical management begins.

Many other elements are involved, such as hospital service managers, family support coordinators, funeral home liaison, recovery staff and family after care.

NJ Sharing Network was established in 2006. Glennon said that 50 years ago, the only way to receive a transplant was to see what was available locally. But 25 years ago, four people started a transplant center, with 58 organizations gradually formed throughout the country that do not overlap each other. The national registry makes it possible to match donors and recipients within hours. A kidney, she said, can last for 72 hours, but other organs must be used between four and six hours. She noted that summer has the highest volunme of bicycle and car accidents.

On site is a large warehouse area, where suitcases are already kept with materials needed. Once the donation is made by the hospital, it becomes the network’s responsibility to step in. By having all the materials needed in their own vehicles, network technicians don’t have to worry about what is where at a given location.

“Someone dies. Someone lives,” Glennon said of the emotional process that, with thought and compassion, gives comfort to both donors and recipients.

To participate in the 5K race, register at ShareNJ5K.org. For more information on the NJ Sharing Network, visit sharenj.org or call 908-516-5400.

Surgeon killed in shooting at Orlando hospital
by The Associated Press

ORLANDO, Fla. (AP) - Authorities say a murder-suicide in a parking garage at Florida Hospital in Orlando left a doctor and the gunman dead.

Police spokeswoman Lt. Barbara Jones identified the doctor as 41-year-old Dmitriy Nikitin. Hospital officials say Nikitin was a multi-organ transplant surgeon.

Jones said the gunman's identity was being withheld, pending notification of next of kin.

Police have released few details about the shooting Thursday evening. It's not clear how the gunman knew Nikitin.

The shooting occurred near the elevators on the first floor of the garage used by employees and patients' families.

Nikitin also taught at the University of Central Florida's College of Medicine. Last year, he was part of a surgical team that set a Florida Hospital record for the most number of transplants ever done in a weekend.

The Rise of the Red Market
How the best intentions of the medical community accidentally created an international organ-trafficking underground.

BY SCOTT CARNEY

It was a revolutionary idea at the time, and it succeeded wildly, helping create one of the most robust and safe blood supplies in the world. Today, Americans donate so much blood in excess of the country's needs that the United States is the number one blood exporter on the planet. We send almost 1.5 million gallons of blood plasma abroad every year, enough to fill two and a half Olympic swimming pools.

Titmuss's model also applied to acquiring and selling body parts -- which has since become the gold standard throughout medicine. In 1984, the U.S. Congress passed the National Organ Transplant Act, forbidding the sale of body parts and effectively requiring an altruism-based system for acquiring them. Anonymity, too has become the rule. In the 1960s, it was still possible for organ recipients to learn who donated the organ that saved their life. Now we take it as a given that such knowledge should be protected by the strictest standards of medical privacy. The prevailing logic has been that making it possible to connect the dots between donor and recipient could compromise the entire system, maybe even stopping people from donating their tissue in the first place.

Unfortunately, the anonymous-altruistic system has produced unintended consequences. Even Congress couldn't get rid of the market for body parts entirely: Individuals can't directly buy and sell bodies, but doctors, nurses, ambulance drivers, lawyers, and hospital administrators can all bill for their services. (You may not pay for a heart, but you definitely pay for a heart transplant.) And the flipside of anonymity is opacity: Although confidentiality provisions are meant to protect the interests of the donor, they also obscure the supply chain.

The result is a system whose best intentions create ample opportunities for criminally minded entrepreneurs. There are huge profits to be made by middlemen dealing in everything from kidneys to human eggs to sight-unseensurrogate pregnancies. In the age of globalization the brokers are adept at exploiting the knowledge and legal gaps between national jurisdictions to arrange just about any sort of organ acquisition, and advances in anti-rejection drugs allow people with widely diverse genetic backgrounds to swap organs. In Romania, Moldovia, Turkey, and Egypt brokers can easily acquire kidneys for $3000 and sell them for $50,000 or more. In 2008, an Indian broker was arrested for kidnapping people from the New Delhi slums and literally stealing their kidneys to sell to foreign transplant patients. In China, selling the organs of executed prisoners continues to be an official state policy.

Law and economics recognize three types of markets with varying degrees of legality: white, gray, and black. The trade in human flesh has evolved into its own category of commercial activity, what you might call the "red market" -- a market whose economic characteristics are complicated by the fact that customers owe their lives and family relationships to the supply chain, yet know perilously little about it. I spent the past six years tracking the red market across South Asia, Europe, and the United States, exploring the business practices of kidney traders, skeleton thieves, blood pirates, and child kidnappers. In every case, I was astonished to find that most people who bought a piece of a human being had no idea what series of events had had to occur to make that body part available.

Obscuring the source of raw materials for any market is almost always a bad idea. We would never allow an oil company to hide the locations of their oilrigs, or not disclose their environmental policies. And when an oilrig fails and leaks millions of barrels of petroleum into the ocean we demand accountability. Transparency is capitalism's most basic safety feature.

Solutions to the problem are hard to come by, however, and will likely require a wholesale revamp of the tissue donations system. Economists have argued that a commercial system similar to the one that exists in Iran for kidneys -- in which the state pays donors a modest sum for the organ -- could allow the market to regulate the human tissue supply. Others argue that it is possible to increase actual altruistic donation rates -- and cadaver donations for internal organs -- to the point at which supply and demand will be balanced, reducing the need for a red market.

In my view, neither is likely to work until we answer a simple question: At what point is one person entitled to use the flesh of another? The central problem with the human supply chain is that it has been dehumanized -- its very opacity allows us to elide the fact that we aren't just buying tissue, but a piece of a person, and one that comes with a history. Perhaps then we can accept that people are not commodities and our own lives are often predicated on the sacrifices of others.

Argentina celebra Día Nacional de Donación de Órganos

Buenos Aires, 30 may (PL) Argentina celebrará hoy el Día Nacional de la Donación de Órganos con resultados que el Ministerio de Salud de la Nación calificó de alentadores, en un informe difundido en esta capital.

En el transcurso de 2011, el número de donantes de órganos en Argentina creció un 32,8 por ciento respecto a igual período del pasado año, destacó el reporte, difundido el fin de semana último a propósito de la efeméride.

Hasta la fecha, en el país se realizaron 528 trasplantes de órganos gracias a 239 donantes reales, precisó la entidad, que elogió el rol estratégico desempeñado en esta materia por los establecimientos sanitarios y la comunidad hospitalaria.

En ocasión del este día serán reconocidos los hospitales que reflejan en sus resultados la incorporación de la procuración de órganos y tejidos como una actividad médico-asistencial, anticipó el organismo.

La efeméride fue establecida en homenaje al nacimiento de Dante, hijo de una mujer que recibió un trasplante hepático en un hospital público, lo cual le representó la posibilidad de regresarla a la vida, explicó la propia cartera sanitaria.

El pasado 2010, Argentina superó los mil trasplantes de órganos por quinto año consecutivo, colocándose en el segundo lugar en América Latina en cantidad de donantes de órganos por millón de habitantes (12.5).

Además, según el Newsletter Transplant 2010 publicado por el Consejo de Europa junto a la Organización Nacional de Trasplante de España, se situó en primer lugar en cantidad de trasplantes hepáticos, cardíacos, pulmonares y renopancreáticos.

Datos del Instituto Nacional Central Unico Coordinador de Ablación e Implante (INCUCAI) de esta nación suramericana indicaron, en tanto, que hasta el 9 de octubre pasado se habían realizado mil 002 trasplantes de órganos y 711 trasplantes de tejidos.

Debido al sostenido crecimiento de esta actividad, Argentina fue elegida por la International Society for Organ Donation and Procurement (ISODP) como sede del Congreso Mundial de Donación de �"rganos, previsto del 27 al 30 de noviembre próximo.

Por otra parte, a fines del pasado año el INCUCAI y el Instituto Nacional de Donación y Trasplante de Células, Tejidos y �"rganos de Uruguay (INDT), acordaron que pacientes de le vecina nación requeridos de transplantes de pulmón, de intestino o hepático pediátrico, podrán ser intervenidos aquí.

Men who shared prep coaching work now share kidney

BLOOMFIELD HILLS, Mich. (AP) — Bill Hertle and John Tryon share much more than years together as assistant high school football coaches for Bloomfield Hills Lahser, now that Hertle has given Tryon one of his kidneys.

Both men played football at the suburban Detroit school. They were hired as assistants when Dan Loria began putting together his first staff at Lahser in 2001. Tryon no longer coaches there but remains a regular at football events.

"It's very cool and they come off the background of teamwork being football coaches," said Dr. Jason Denny, a transplant doctor for the procedure and a former all-state quarterback at Holy Trinity High School in New York. "Me playing football myself, you understand that the contribution to the group is often greater than what you can get for yourself."

The transplant surgery was done May 10 at Henry Ford Hospital in Detroit, according to the Detroit Free Press.

Hertle, 50, lost his kidney function because of disease. His own father died at 51 of kidney disease. Hertle was on dialysis for about two years and said he hated it.

"Let me put it this way," Hertle said. "The first time they hooked me up I told them to unhook me, I was getting up and leaving. It's a lifestyle change — four hours squat in a chair with a fistula in my arm so I had to keep the one arm straight and I had a blood pressure cup on the other. It's uncomfortable and it's a four-hour run.

"I could live another 25 years on dialysis, but I wouldn't want to."

Hertle said he has respect for anyone willing to consider giving an organ. They include his wife, who turned out to be a match for him.

"At the 11th hour they canceled her out because she had kidney stones and other issues that excluded her from being a donor," he said.

That was when Tryon stepped forward.

"I was originally planning on getting tested, but I heard Sue matched so I stopped and didn't follow through," said Tryon, 53. "When I found out that fell through, I thought it through quickly and started going through the process. It takes a long time."

Tryon said he doesn't worry that his own health might be at risk should something happen to his remaining kidney.

"I believe God takes care of me," he said. "Because of that I can focus on other people. This is just the epitome of that belief system."

Teens have heart to heart
by Lauran Neergaard | Marietta Daily Journal

WASHINGTON - Courtney Montgomery's heart was failing fast, but the 16-year-old furiously refused when her doctors, and her mother, urged a transplant.

Previous surgeries hadn't helped and the North Carolina girl didn't believe this scarier operation would either. It would take another teen who's thriving with a new heart to change her mind.

"I was like, 'No, I don't want this. If I'm going to die, I'm going to die,'" Courtney recalls. "Now I look back, I realize I wasn't thinking the way I should have been."

Teenagers can add complex psychology to organ transplantation: Even though they're minors, they need to be on board with a transplant because it's up to them to take care of their new organ. Depression, anger and normal adolescent pangs - that tug-of-war with parents, trying to fit in - can interfere. It's not just a question of having the transplant, but how motivated they are to stick with anti-rejection treatment for years to come.

"The decision-making process that we go through, in terms of our ability to weigh factors in a rational sense, probably doesn't mature until you're in your late 20s," says Dr. Robert Jaquiss, pediatric heart surgery chief at Duke University Medical Center, where Courtney eventually was transplanted. "It introduces an enormous level of complexity to caring for these kids."

Then there's the sense of isolation. Far fewer adolescents than older adults undergo an organ transplant, making it unlikely that a teen has ever seen how fast their peers can bounce back.

Between 700 and 800 adolescents, ages 11 to 17, have some type of organ transplant each year. That's nearly 40 percent of the roughly 2,000 annual pediatric transplants. Teens fare better than any other age - child or adult - the first year after surgery. But long-term, adolescents do a bit worse than younger children, and the reason isn't biological, Jaquiss says. It's that teens, and young adults as well, tend to start slipping on all the required follow-up care.

One study found up to 40 percent of adolescent liver recipients eventually miss medication doses or checkups. It can be normal development, as teens start sleeping late and simply forgetting morning doses, or sometimes it's rebelliousness. Then there are medication side effects that Jaquiss says can be especially troubling to this image-conscious age group: weight gain, acne and unwanted hair growth.

And at the Children's Hospital of Pittsburgh, separate research with heart recipients has found chronological age is unrelated to "medical maturity." Young patients who had a hard time accepting a transplant as normal and who avoided family discussion of problems, for example, were less likely to stick with care.

Courtney's mother, Michelle Mescall, said that when the medical center advised that her daughter needed to agree to go on the transplant waiting list, "I said, 'Well she's a minor, what do you mean? I'm going to make this decision.' I was just floored that it was now her decision."

Legally, the hospital could have proceeded with mom's OK. But clinical social worker Shani Foy-Watson says if that happened, Courtney's resentment could have torpedoed her recovery, setting up just those kinds of problems with follow-up care.

Foy-Watson says it's not unusual for kids who've lived with serious illness for years to have a hard time imagining normalcy - at the same age when it's normal to seek more independence from their terrified parents.

Courtney, of Asheville, N.C., was diagnosed at age 8 with hypertrophic cardiomyopathy, a thickened and hard-to-pump heart that's the leading cause of sudden death in young athletes. Her mother tried to shield her from doctors' death warnings, but says Courtney became anxious and depressed early on.

She had a defibrillator implanted and later heart surgery that offered only temporary relief, fueling resentment of her mother's medical choices. Courtney eventually had to give up her beloved cheerleading, and last year required home-schooling.

As a few weeks passed with Courtney still resisting a transplant, the social worker tried a new tack: A 17-year-old football player had received a new heart at Duke a few months earlier because of the same condition, and already was back at school in Raleigh. Would he meet with Courtney?

It was a gamble. No one told Josh Winstead, now 18, the reason for the meeting, and they might not have hit it off. But they did, and Courtney immediately changed her mind.

"I guess me doing what I do, being a kid, helped out the most," says Winstead, who took Courtney to his prom a week before her surgery. "It was more just showing her how normal my life is."

You hear all the advice from friends and doctors, Courtney says, "but it doesn't hit home like when Josh would tell me, `I have the same scars you do and this is how it felt and this is how I feel now."'

She got her new heart last month. She's recovering well and exercising in hopes of getting back to the cheerleading squad.

Her mother's helping Courtney learn to handle a whopping 33 pills a day, and is proud of how her daughter has rallied: "I'm just dealing with how to let go and let her fly, but also be the parent of a 16-year-old."-

Doctor helps Ohio boy overcome bullying that prompted him to refuse kidney transplant he needs
CLIFF RADEL The Cincinnati Enquirer

CINCINNATI — The grade-school bullies called him so many names he wanted to die.

"Stupid," ''Freaky," ''Retarded" and "Trashcan" were the kindest things they said to their fifth-grade classmate, Josh Frey. The cruel words upset the 11-year-old Mason boy so much he refused a kidney transplant.

Josh needs that operation. His end-stage renal disease requires daily dialysis.

The bullying accelerated in January. Josh was so down in the dumps he didn't want to go to school.

He discussed his depression with his doctor, Rene G. Van De Voorde III. The medical director of Cincinnati Children's Hospital Medical Center's dialysis unit volunteered to go to Josh's school, Stewart Elementary in Sharonville.

He talked to Josh's fellow students, bullies included. No one mentioned the b-word.

Instead of talking about bullying, he told them what it is like to be Josh, to be poked with lots of needles and never cry, to take seven different kinds of medicine and never complain. And to be connected to a dialysis machine every night when he goes to bed.

"No big deal," Josh says. "It's just another IV needle."

After the doctor's visit, Josh's classmates called him by another name: "Brave."

Josh's mom, Barbara Frey, talked about her son's ordeal recently while sitting in the cafe of the Barnes & Noble Bookstore in Warren County's Deerfield Township.

Between return visits to the cafe, Josh and his sister, Katie, 9, quietly roamed the aisles while their mom spoke.

Barbara Frey wanted Van De Voorde "to get some recognition for what he did. He went to Josh's school on his off day. He made things better for Josh. What he did was extraordinary."

Shauna McDowell, Stewart Elementary's principal, agreed.

"How many doctors do you know who would take their day off to talk to a bunch of fifth-graders?" she said. "He made a difference. Now, we have monthly assemblies reminding the kids to watch what they say and be nice to each other. Because it has had lasting results, his visit was huge."

Not so, demurred Van De Voorde. He saw his visit as part of "a collaborative effort" and praised Josh's mom for "being on top of his problem."

Barbara Frey has always been on top of her son's problems. Before he was born, doctors told her he had life-threatening abnormalities on both of his kidneys. Predicting he would only live a matter of days, they recommended an abortion.

Frey and her husband, Robert, decided to "pray for a miracle. And we got one." Josh was celebrating his 12th birthday Saturday.

When the bullying started, she noticed that her son "went from happy to sad" about going to school. That happened about "a month after we moved back here from Maryland two weeks after the start of this school year."

Katie Frey witnessed the bullying. Twisting her little hands around the tail of her red T-shirt, she described in a whisper how she rode the school bus home "and heard those boys in the back of the bus say bad words to my brother. It made me cry."

Van De Voorde noted that Josh "was pretty extraordinary" during his school visit where he "talked about Josh's condition and why he can't do some of the activities at school."

The physician asked Josh to stand in front of the class.

"I was sitting in the second row, fifth in," Josh said. "Getting up there was easy."

What Josh did next could have been difficult for a fearful kid. But, he did it with ease. The doctor asked him to pull up his shirt. Josh showed his classmates a scar on his abdomen from his first dialysis.

Josh had his first kidney transplant at the age of 3. His body rejected the organ when he was 5.

Josh also showed the class the dialysis catheter protruding from his stomach. Van De Voorde demonstrated how the catheter connected to a dialysis machine.

Then, he showed the class a photo of a real kidney and passed around a plastic model of the organ.

The photo and the model kidney "created a queasy factor," the doctor said. Some kids left the room, including one bully.

Van De Voorde observed that his patients frequently encounter bullies. "Kidney patients miss a lot of school. They're sick. Bullies like to pick on them."

Bullying can be hazardous to your health. "It affects the patient's psychological and social well-being," Van DeVoorde said. So, he was not surprised when Josh declined a second kidney transplant.

"That's the one thing in his life where he feels in control," the doctor said. "He can't control what those bullies say. But he can control the transplant. He's just acting out."

Since Van De Voorde spoke to the class, his patient has stopped acting out and the bullies have cut down on their acting up. Now, Josh wants a kidney transplant.

"In June," he said with a smile. "Or sooner."

At the end of the doctor's show-and-tell session, a student raised his hand. He looked at Josh and said: "Some of the things you do scare me. Josh, you're brave."

Josh knows he's not alone in being bullied. Studies show that between 15 percent and 25 percent of U.S. students are picked on and verbally abused with some frequency.

The 11-year-old has two words of advice for other kids dealing with bullies: "Ignore them."

If that doesn't work, call Dr. Van De Voorde. The visit he paid to Josh's school turned into a prescription for transforming bullies into human beings.

Rockford hospital switches to Ill. organ transplant network

By: Paul Merrion | Crain's Chicago Business

In a decision that will help ease Chicago’s chronic shortage of human organs for transplants, the federal government will allow one of Rockford’s three major hospitals to leave a donation network in Wisconsin and align with one that serves Northern Illinois.

The hard-fought switch to Itasca-based Gift of Hope Organ and Tissue Donor Network comes after a year of deliberation by the federal Center for Medicare and Medicaid Services, which oversees 58 regional non-profits that collect and distribute kidneys, hearts, livers and other organs within their territories.

In Gift of Hope’s territory, which covers 179 hospitals in all but the bottom third of the state, about 300 people die each year waiting for a transplant. With about 800 transplant operations conducted annually, primarily by Chicago hospitals, the local supply will increase nearly 5% with an additional 30 to 40 organs coming from Rockford instead of going to Wisconsin.

The waiting time for a kidney in Wisconsin is about 11 months, while it averages about four years in Chicago. More than 4,700 people are on a waiting list for organ transplants in Gift of Hope’s region.

“This will be a good thing for patients in Illinois, and the hospitals,” said Jarold Anderson, Gift of Hope’s president and CEO. “There just aren’t enough organs to go around. Demand is way up there, and supply is down.”

Since 1997, Rockford’s OSF St. Anthony Medical Center had been allowed by a waiver to work exclusively with the University of Wisconsin Organ Procurement Organization in Madison, about 45 minutes away. But St. Anthony sought to realign with Gift of Hope after the university’s medical system, UW Health, affiliated with Swedish American Hospital, St. Anthony’s biggest competitor, in March 2010.

“UW decided to enter our marketplace as a competitor,” said David Schertz, president and CEO of St. Anthony, which announced plans last week to merge with the city’s other big hospital, Rockford Health System, which is already part of the Gift of Hope network, along with St. Anthony’s parent company, Peoria-based OSH Health Care System.

Mr. Schertz said the realignment also will reduce costs and allow for systemwide education about organ donation procedures.

The University of Wisconsin opposed the switch, arguing that St. Anthony accounts for about 10% of its organ supply.

“We were obviously quite disappointed” by the decision, said Jonathan Sender, director of federal relations for the university. “We certainly feel this will disadvantage not just Rockford patients and people from Illinois who come here for service, but it will hurt Wisconsin recipients as well.”

Gift of Hope supplies organs to Peoria-based OSF St. Francis Hospital, Memorial Medical Center in Springfield and seven transplant centers in the Chicago area, including Advocate Christ Medical Center, Northwestern Memorial Hospital, Children's Memorial Hospital, Rush University Medical Center, Loyola University Medical Center, University of Chicago Medical Center and the University of Illinois Medical Center at Chicago.

Flesh for sale
From kidney brokers to blood farmers, a journalist exposes the the "red market" in human body parts

Source: Salon.com - What to Read

During the mid-2000s, Scott Carney was living in southern India and teaching American anthropology students on their semester abroad when one of his charges died, apparently a suicide. For two days, he watched over her body while the provincial police investigated her death, reporters bribed their way into the morgue to photograph the newsworthy corpse, local doctors performed an autopsy, and ice had to be rounded up to retard decomposition. Finally, his boss asked Carney to take pictures of the girl's mangled remains for analysis by forensic experts back in the States.

This unsettling experience gave Carney his first inkling of how a human being becomes a thing. When he abandoned academia for investigative journalism (he writes for Wired, Mother Jones and other publications), his South Asian surroundings offered him many examples of the ways human bodies -- in part or in whole -- are transformed into commodities. He calls this the "red market," a term that encompasses the trade (legal and illegal) in human bones, blood, organs, embryos, surrogate pregnancy and living children.

"The Red Market: On the Trail of the World's Organ Brokers, Bone Thieves, Blood Farmers, and Child Traffickers" is the alarming product of Carney's research. It includes vivid, on-the-spot reports from Indian "bone farms," where remains looted from graveyards are processed into skeletons for Western anatomy students (hundreds of reeking bones left out to bleach in the sun) and tsunami refugee camps where most of the residents bear the scars of kidney "donations." Carney relays these tales with enough florid touches ("Toads the size of baseball mitts hop across the muddy track") to make them seem downright hallucinatory.

Freakish as these stories can be -- none more so than the dairy farmer who kept several men prisoner in sheds, some for more than three years, extracting their blood to sell to a nearby hospital -- they are the secret face of the age of modern medical miracles. Poor people supply human flesh in various forms for rich people, while a well-meaning ethical system of anonymity and mandated "altruism" allows middlemen to siphon off most of the profits.

When the supply isn't sufficient to the demand, some enterprising individuals take it upon themselves to even things up. One of the most heartrending stories Carney tells is of an Indian family who bankrupted themselves trying to find their son, who was kidnapped by an orphanage and essentially sold to an American adoption agency. The Midwestern couple that may have adopted the boy are resisting attempts to establish the child's identity, even though the Indian father tells Carney he understands "it's not realistic for us to ask for him back, but at least let us know him."

Denial makes such injustices possible. Carney argues that the inequities of the red market were only exacerbated by regulations like the National Organ Transplant Act of 1984, which prohibited the sale of human organs and tissue and was championed by then-Sen. Al Gore as a way to make sure that the human body could not be treated as "a mere assemblage of spare parts." Although Carney is no fan of the market philosophy that would reduce our bodies to salable "widgets," he thinks we need to face up to the fact that altruistic donation will never provide as much of these precious materials as we desire. "As a society we neither want to accept open trade in human tissue, nor do we want to reduce our access to life-extending treatments. In other words, we want to have our cake and eat it, too."

He also thinks "absolute transparency of the supply chain" would go a long way toward eliminating the brokers, recruiters and suppliers who exploit those driven to trade their kidneys and blood for cash or to rent out their wombs. "Every bag of blood should include the name of the original donor, every adopted child should have full access to his personal history, and every transplant recipient should know who gave him an organ," he writes. (Contrary to what you see in the movies, much of this information is sequestered by what Carney regards as "misguided" privacy laws.) Yes, the hustlers will immediately commence forging documents, but even so, "a clear paper trail makes it easier to flag dangerous operators."

And while he doesn't come right out and say it, Carney obviously thinks the world's privileged patients ought to revise their expectations and reconcile themselves to their mortality. He more or less implies that the handful of years most kidney transplant recipients gain from the operation may not be worth the cost in exploitation. (Most Indian "donors" get as little as $800 for their organs -- though some are promised more -- not enough to make a significant difference in their circumstances or lift them out of destitution for more than a year or so. This is out of the $14,000 or so paid by the recipient for the transplant.)

No doubt Carney doesn't linger on this point because he knows it's a nonstarter. Most people would countenance a good deal of dodgy behavior if it meant a few more years of life for themselves or a loved one. Nevertheless, it makes sense that they be made aware of how much their survival may have cost others, and Carney rightly decries the "depersonalization of human tissue" that obscures that cost. This challenging and revelatory book makes it a little bit harder to overlook the human being in every human body.

IT IS ILLEGAL TO BUY AND SELL ORGANS FOR TRANSPLANT IN THE UNITED STATES AND MANY COUNTRIES AROUND THE WORLD, HOWEVER THE PRACTICE OF PREYING ON THE DISADVANTAGE AND THE POOR CONTINUE TO OCCUR.  WHILE THE WORLD HEALTH ORGANIZATION IS MOUNTING PRESSURE ON MEMBER COUNTRIES TO ADOPT AN ORGAN DONATION AND TRANSPLANT POLICY THAT ELIMINATE THE SALE OF ORGANS THERE IS STILL MUCH WORK AHEAD.  BECAUSE OF THE GROWING TRANSPLANT WAIT-LIST AND THUS SCARCITY OF ORGANS IN THE UNITED STATES, AMERICANS ARE TRAVELING ABROAD TO OBTAIN A LIFE-SAVING TRANSPLANT.  IF EVERYONE AROUND THE WORLD WERE TO DESIGNATE THEIR WISH TO BE A DONOR UPON THEIR DEATH, THESE PRACTICES WOULD BE ELIMINATED.

United States officials propose further retreat from first-come, first-served organ donation

Source: CJMA

The United States Network for Organ Sharing (UNOS) has long prided itself as being entirely egalitarian, distributing organs on a first-come, first-serve basis without regard to wealth, class, race or other consideration.

But another chink may be about to appear in that philosophical armour as the agency, which operates the Organ Procurement and Transplantation Network, says it is considering a revision in its policies for allocating kidneys, including the allocation of younger kidneys, to younger recipients. The policy changes would basically extend a rule implemented in 2004 that prioritized allocation of organs to pediatric recipients.

The changes would also result in the creation of a kidney profile index that would rank the quality of all donated kidneys according to the period of time they might be expected to last after they are transplanted. That would largely be based on the health of the donor.

In turn, potential kidney recipients would be assigned a number indicating their projected life expectancy after the transplant, with the presumption being that younger recipients will live longer.

The index would then be used to match the top 20% of kidneys to the 20% of candidates with the longest post-transplant life expectancy. All remaining kidneys would be allocated to recipients on the basis of age criteria. Kidneys would be matched to recipients whose age fell within 15 years of the donor’s age.

When the network was established in 1986, allocations were made strictly on a first-come, first-serve basis, and tissue typing.

Although tissue typing remains an issue, medications that reduce the likelihood of rejection have resulted in a system that now primarily uses a patient’s length of time on the waiting list as the main criteria for determining whether he will receive a kidney.

While the waiting list approach doesn’t discriminate between potential recipients, it does not effectively maximize the success rate of transplants or minimize the number of patients who die waiting, says Kenneth Andreoni, chair of the UNOS Kidney Transplantation Committee and associate professor of surgery at the Ohio State University College of Medicine in Columbus, Ohio.

Critics fear the proposed changes will unfairly favour younger recipients, or may reduce the rates of living donations, as suggested by a recent opinion piece coauthored by a member of the UNOS ethics committee (NEJM 2011;364: Epub1285–87). It argued that the 2005 policy change to prioritize allocations to pediatric recipients led to fewer living organ donations and surmised that the proposed policy changes will have a similar effect, by pushing younger, healthier candidates to the top of the wait list, putting older candidates at a disadvantage.

But Andreoni counters that the assumption that the system would disadvantage adults isn’t valid. Candidates who enter the waiting list for better quality kidneys would be ranked on a points-based system, which takes into account age and time spent on the wait list among other factors, he says. For those individuals, receiving a kidney from a living donor would still be faster and have a higher success rate.

Andreoni adds that the average age of donors has risen in recent years, as kidneys from older donors are now considered acceptable. “Twenty five years ago when I started, a donor was considered old if they were over 45. That’s not the case these days.”

Those older kidneys can be matched to recipients of the same age group, he says. “It’s an obvious, easy way to increase transplantation: Getting kidneys that are usable to people who can better use them.”

Donor kidneys are now classified as either “expanded criteria donor” or “standard criteria donor.” The former account for about 15% of the donor pool and are typically donated by those who are either older or have a medical condition that may lower the organ’s life expectancy.

The proposed new index would indicate the quality of the kidney, based on the donor’s health, height, weight, age, race, ethnicity, disease state (such as hypertension or diabetes), and cause of death if deceased.

Andreoni says the donor profile index would give a “more granular” assessment of each kidney, and would better match organs with recipients, according to probability of transplant success.

“The average person will get the same quality kidney,” as 14 years is currently the typical age difference between donors and recipients, he says.

The proposed changes would undermine the existing system’s principle of providing all candidates with an equal chance of receiving a kidney by introducing a new life-expectancy standard, says Arthur Caplan, a professor of bioethics at the University of Pennsylvania. “We can ask which standard is better, or ask potential donors: what do you intend? To give everyone an equal chance or save the most lives and life years with your gifts? The answer to that debate is an empirical question, asking what do people want when they say, ‘I want to be an organ donor’.”

There are several ethical dimensions to the debate, Caplan says.

Affordability isn’t an issue, as the government pays for transplants, he explains. “That takes ability to pay off the table.”

But what remains is the question of deciding how to allocate a “scarce and expensive resource,” adds Caplan, who supports the proposed changes, with reservations. People with inadequate life insurance, for example, would still delay doctor visits, reducing their chances of early diagnosis.

While the US has one of the world’s highest rates of organ donation, more than 100 000 names are on the waiting list for organs (88 000 for kidneys) and an estimated 18 patients die daily while on the list.

The National Kidney Foundation said in a statement that it supports the proposed changes but has some concerns (www.kidney.org/news/newsroom/AllocationConceptPaper.cfm). A hospital can now send a kidney to any of nearly 250 US transplant centres for evaluation and each has its own criteria for accepting kidneys. Those that are rejected by one hospital can be sent to another, explains Dolph Chianchiano, the foundation’s senior vice president of public policy.

“There’s a time lag that is engendered. … [in this] serial offer-acceptance procedure,” Chianchiano says, adding that the approval process needs to be streamlined. Some transplant centers “routinely turn down organs they would theoretically accept.”

Some centres only accept the highest quality kidneys because they are seeking the “best possible outcome profile,” Chianchiano says. Better quality kidneys lead to a higher rate of successful transplants, making the transplant centres look good to private insurance companies.

The kidney foundation statement asserts that the time lag is one factor responsible for the number of viable kidneys — 250 on average — that are discarded annually. Other factors include inconclusive biopsies regarding the health of the kidney.

But varying acceptance rates at transplant centres are to be expected, says Dorrie Dils, chief clinical executive at Lifeline of Ohio, a nonprofit organization that manages organ donation in Ohio. “I personally can understand why there are varying acceptance policies or things that might concern one surgeon for one patient that may not concern them for the next patient,” she says. “No two recipients are the same.”

Dils adds that most transplant centres do, in fact, want to maintain a certain performance level, making allocation more difficult. “[Surgeons] certainly don’t want to take a gift from a donor and put it into someone that’s not going to be successful.”

The proposed changes are now up for public consultation and are expected to be reviewed by UNOS’s board of directors in 2012. But “even if everything was adored by all, it would still be a while” before the proposal is finalized, Andreoni says.

— Samia Madwar, Ottawa, Ont.DOI:10.1503/cmaj.109-3887

British woman dies in Fethiye, saves lives of three Turks by donating organs, Turkey

TODAYSZAMAN.COM

Three organs from a British tourist in Turkey's Aegean province of Muğla have been donated to Turkish patients waiting for transplantation, doctors said on Sunday.

The British tourist, Janet Bradley (70), who was staying in her hotel room in the tourist haven of Ölüdeniz, suddenly suffered a cerebral hemorrhage and was taken by ambulance to the private Lokman Hekim Esnaf Hospital in Fethiye on Thursday.

The massive stroke incapacitated the British woman. Severe hemorrhaging caused significant brain damage, leaving her in a vegetative state.

Fethiye State Hospital Deputy head doctor and Fethiye Organ Transplantation Coordinator Uğur Çomak then contacted Bradley's relatives and asked if they would be willing to approve transplantation of her organs to waiting patients.

The family approved the donation, and Çomak submitted Bradley's tissue characteristics to the organ donation center. Doctors soon identified three Turkish patients with matching tissue characteristics.

Her kidneys have been sent to two patients in İzmir Ege University Hospital, while her liver has been sent to a patient in İstanbul's Florence Nightingale Hospital.

Çomak told reporters that he hopes the donation of the English tourist's organs will set an example for Turks with regard to organ donation.

Explaining that the patient could not survive after a severe cerebral hemorrhage and brain death, Çomak said this donation is “very important for us.”

The deputy head doctor of the hospital, Murat Aynacı, told reporters that the donation of the patients' organs to Turkish families is very important in terms of increasing public awareness about organ donation.

Three families united by tragedy, generosity
By KIMBERLY HOUGHTON | Union Leader

MERRIMACK — Two complete strangers came together on Saturday to meet the family of Jonathon Simeone, the young man whose unexpected death one year ago helped save their own lives.

Simeone provided life-saving kidneys for Jeanette Dsouza of Boston and Charles Zayat of Rhode Island, who gathered this past weekend to remember their generous organ donor and his passion for riding.

The two kidney recipients met Simeone’s parents and fiancee while dedicating the Lawrence Road dirt bike park and naming it the Jon Simeone Memorial ATV Park.

“I feel like I have got a new lease on life, and I don’t know if I would be here without Jon,” said Dsouza, 67, who was on the national organ transplant waiting list for about three years.

She had been on dialysis since 2004, and was gratified when Simeone’s kidney turned out to be a perfect match. On May 29, 2010, Dsouza received Simeone’s kidney, and she has been dreaming of the day she would have the opportunity to meet his loved ones.

“I feel like I am a part of their family now,” she said, adding it was an emotional day filled with tremendous gratitude and love.

Simeone, 20, died last May doing what he loved most, riding bikes. Four days after his motorcycle struck a deer on the Everett Turnpike in Merrimack, Simeone succumbed to his injuries.

But his journey was not yet over, according to Tanya Shenk, a close family friend.

“Jon’s wish was to save others,” said Shenk. “And not only did he save two lives, but he saved two families and helped preserve their legacies.”

The Lawrence Road bike park was dedicated in his honor on Saturday during a brief ceremony attended by dozens of friends, relatives and Gov. John Lynch.

Zayat said he was proud to be a part of Saturday’s event, saying he was anxious to meet the family of his donor.

“I know that some families prefer not knowing all of the details, but I really wanted to find out about my donor and learn his story,” said Zayat, 68, who is a diabetic and was on dialysis since 2002. Now, Zayat says he is healthier and happier, and owes that to a young man he never even had the privilege of meeting.

Roger Blais, president of the New Hampshire Right Riders club, helped organize the dedication of the bike park. His father, Richard Blais, built a kiosk describing the history of the park and Simeone’s biography.

Simeone’s mother, Candy, called Saturday the “angelversary” of her son’s death, describing him as a child full of life, her best friend and a hero at the time of his passing.

“Thank you both for agreeing to meet us and becoming a part of our family,” she told the two organ recipients in a crowd of tearful spectators.

Candy Simeone plans to host helmet awareness days at the park, reminding dirt bike and motorcycle riders about the importance of wearing safety gear such as helmets. She is also using her family’s tragic story to promote the importance of organ donation. Last August, she organized a memorial concert to help raise money for the New England Organ Bank, and about 60 people registered that night to become organ donors.

Organ donor's family raises awareness

Ryan Clark | Coshoctom Tribune

FALMOUTH - Stephen Elrod was driving to work down the AA Highway on a foggy morning in July 2009 when a tractor trailer pulled out in front of him, causing an accident that ended his life at just 24 years old.

Stephen's parents didn't even know that sometime prior to the accident, he had filled out an application to be an organ donor.

"People told us afterward that this was really important to Stephen," said his father, Rick. "We never knew that, to him, donating was really special."

Nearly two years after the accident that took their son's life, Rick and wife Judy Elrod are helping to present the first "Stephen's Dinner for Life," a celebration dinner featuring entertainment to benefit the Kentucky Circuit Court Clerk's Trust for Life, a nonprofit organization dedicated to raising awareness about the need for organdonation in Kentucky.

The dinner - which also features speaker Dick Veale (an organ recipient) and a concert from local country-rock band Borderline - will be held from 6:30 to 11:30 p.m. June 18 at Stonewood Gardens banquet hall on Memory Drive in Falmouth. Cost is $35 per person or $250 per table of eight, and reservations must be taken by June 12. Call 859-322-6332 or emailkybred60@aol.com if interested.

After commissioning a sculpture in Stephen's honor at Georgetown College(where the entire Elrod family attended, including Stephen's 23-year-old brother Jon) the family decided they wanted to do something more to honor their son and organ donation. Stephen, a valedictorian at Pendleton County High School, played basketball and graduated from Georgetown College. At the time of his death he was studying for his MBA.

"We really didn't know what else to do," Judy Elrod said. "Then we ran into a woman with Trust for Life, and this just progressed over a six- to eight-month period."

Stephen's liver went to a 60-year-old married father of two from Ohio. His left kidney went to a 17-year-old girl from Ohio, while his right kidney went to a 17-year-old high school wrestler from Kentucky. His aortic and pulmonary valves went to hospitals in Georgia and Virginia.

"At first, when you think about it it's sad," Judy Elrod said. "But then you realize a part of him is still living. That really is a good feeling."

Rick Elrod says this is not a memorial - it is a celebration of life.

"It doesn't bring him back, but it brings awareness," he said. "With all of the other horrible things going on that day, I didn't have to make the decision for him to donate. He did that for us, and this is a way to continue his work and spread his name."

Monday Matters: Transplant Survivor Touts Organ Donation

By Rusty Garrett | Times Record

Roy Tipton is a man who has been on the medical equivalent of death row several times.

In 1985, he was diagnosed with auto-immune hepatitis and told he may have 10 years to live - a grim pronouncement for a man of 37. He endured years of medical evaluations and visits to doctors. His name gradually climbed to the top of a crowded donors list - and then dropped off as he contracted two separate pernicious lung infections.

Having battled the infections, he sweated out several "dry-runs" for transplant.

On one occasion, he was an alternate recipient and the primary recipient was given the organ. On another, doctors rejected the organ he was to receive as unsuitable for transplant.

Altogether, 19 years, 11 months and 29 days elapsed between the time Tipton was told he would need a new liver and the transplant.

Today, six and one-half years after receiving a liver transplant, he counts himself much more than lucky.

"I am blessed," Tipton said. "There was no luck involved. It was by the grace of God that these things happened."

Tipton said what he endured changed him not only physically, but spiritually. He is grateful for the gift of life he has received, and is certain all that occurred has been for a reason.

"If I can get one person to donate an organ, to save a life, I will do it," he said.

Another element of Tipton's lesson is to never give up. To someone facing issues as daunting as his, he said the important message is, "fight to the last battle."

He admits nearly succumbing to defeatism at his darkest time, when doctors told him there was nothing they could do, and sent him home.

It was a time when the disease attacking his liver was becoming more aggressive. He was suffering from frequent, brief comas, and even during periods of consciousness, he had no energy.

In a 2005 article about his experience, Tipton told the Times Record: "I remember one time in particular I asked the doctor to give me something to put me to sleep where I wouldn't wake up ... I was tired of living. I was tried of going through everything. It's very depressing to go through and think that this is the way the rest of life is going to be."

He said it was at such times prayers from friends and supporters pulled him through.

He also credits the untiring love of his wire, Cathy, who continued to hope as his own hope was failing.

"She stood by me when I needed her," he said. "There were times I absolutely fought with her as she got me to take my medications."

Tipton first shared his story with the Times Record in April 2005, a few months after the transplant. The occasion was National Donate Life Month, a time designated for raising awareness of the critical need for organ, tissue and blood donation.

The story caught the attention of an Alma woman who knew Tipton in his youth.

The woman put the newspaper clipping aside. She pulled it out earlier this year when her brother, Paul Bottoms, was visiting.

Bottoms, who grew up in Mountainburg, knew Tipton when the two attended Alma High School. The two formed a friendship but parted ways after school. Bottoms moved away, and said he last seen Tipton in 1966 and had lost contact with him.

"I hate medical stories," said Bottoms, a broadcast media veteran who now lives in Richmond, Va. "But that story was the most amazing thing I had ever read."

He said Tipton's experiences had "all the elements" of a great story about a man who, hit with multiple adversities "just kept getting up."

Bottoms said he was so taken with the story he phoned Tipton from a Mountainburg truck stop, then delayed his departure for another day so the two could meet over lunch.

Bottoms said he left his meeting with Tipton even more convinced that his story was one worth sharing. "I felt I ought to use all the talent I can to tell people about it. I thought somebody would want to hear him speak."

Upon returning home, Bottoms said he began contacting area civic clubs to see if they would be interested in having Tipton speak to their group. After receiving no response from Fort Smith clubs, he expanded his offer to clubs in Van Buren. The Van Buren Lions Club responded, and a date was set for Tipton's appearance.

Tipton spoke at the club's meeting last week. He said he was appreciative for the chance to get out his message.

At 63, Tipton said he remains active today, with relatively few restrictions. He enjoys gardening, and already has harvested some peppers and has tomatoes ripening in the backyard of his Barling home.

He said he is most appreciative of the time he has been given to spend with his family. He and Cathy's three children and five grandchildren live nearby, as do his parents.

"I watch what I do," he said. He restricts himself to canned or bottled liquids and eats a sensible diet. He wears a respirator when he works outside as a protection against wind-borne irritants. He said he is also particularly cautious during cold and flu season.

"I have been given the gift of life. I don't want to do anything to damage that," he said.

Student giving stranger a kidney

By NEIL STEINBERG | Chicago Sun Times

Before the sun comes up Tuesday, Rachel Garneau’s boyfriend will drive her from her home in Elmhurst to the University of Chicago Medical Center, where a surgeon will operate on this perfectly healthy 20-year old college junior and remove her left kidney.

Typically, this kind of donation is made to save the life of a loved one — you give your kidney to a brother or sister, for instance, suffering from kidney failure. Or, if you are not a suitable donor for your relative, you give a kidney into the national donation system, and somebody angling for a kidney for their loved one gives one to yours, forming a “cluster” of donation that can involve half a dozen people.

But Garneau’s four siblings are fine. She doesn’t know anyone who needs a kidney. She just wants to donate hers.

“We have a young lady, an incredibly generous person who said, ‘I want to give up my kidney to just anybody,’” said Dr. Yolanda T. Becker, the transplant surgeon who will perform the operation and director of the hospital’s kidney program.

“I’m excited,” said Garneau, a few days before the surgery. “I’m really looking forward to it.”

Altruistic donation of a kidney is not as rare as one might imagine. Nearly 1,000 people have done it nationwide. There is a website, Matchingdonor.com, that says it facilitated 100 organ donations and has 2,000 people signed up hoping to donate.

Still, the number of people willing to give kidneys is nowhere near the need. The waiting list for kidneys nationwide has 82,000 names on it, and with dialysis such a taxing procedure, 12 people a day die in the U.S. waiting for a kidney to become available.

Garneau is majoring in anthropology at Notre Dame, and is planning to study in Rome in the fall. She plays intramural volleyball. Eventually, she’d like to spend a few years in the Peace Corps, then start a family.

What inspired her to consider this now?

“I honestly don’t remember what got me into this at all,” she said. “I first starting thinking about this three years ago, when I was 17. I’ve never known anybody who had kidney problems, I never knew anybody who had serious medical issues. One day, I started thinking about it, doing the research ... a few hours later, I went downstairs I told my parents I wanted to donate my kidney.”

Her mother and father reacted the way most parents would.

“They sort of ignored me at first because they thought I was joking,” she said. “When they realized I was considering it, they said ‘No. End of discussion.’ They said the surgery is risky, what if you get hurt? What if you die? It seemed one of those things you say on a whim.”

But she persisted. Why?

“Honestly, I don’t know,” she said. “I don’t think it’s a religious thing, I was raised Catholic, I never really felt like God was a part of this, necessarily, I guess it could be, but I never really felt that way. I decided to do it, I got this idea in my head and it won’t go away. I can’t not try to do something. My family has always been very giving, very charitable toward others.

That could be a part of it.”

This kind of altruism is certainly nothing new for Garneau. When she was 15 she told her parents she wanted to help people overseas.

“I decided I wanted to volunteer in Africa,” she said. “They let me go with a friend for a month when I was 16. I went to Ghana to work in an orphanage.”

Her father, who works as a meat cutter, declined to be interviewed; her mother, a special education teacher, died suddenly in 2008 from an infection picked up in a hospital a month after she was diagnosed with leukemia — though Garneau points out that she decided to donate her kidney before she knew her mother was sick.

Garneau approached the hospital last fall and assumed she’d donate her kidney by Christmas.

Instead, she had half a year of interviews and medical tests.

“We really put her through the wringer to make sure it was something she really, really wanted to do,” said Dr. Becker. “The potential donor is seen by a social worker, a psychologist, a living donor advocate, to make sure we are not doing anything bad.”

The hospital held an ethics conference with two dozen doctors, nurses, social workers and psychologists to discuss the case.

“Some were arguing very vehemently that there is no medical benefit to her,” said Dr. Becker. “Some people felt she was very young.”

Many would-be donors are sent away.

“About 30 or 40 percent we reject, for all kinds of reasons,” said Dr. Becker. “They don’t realize just what they’re up against. We want to give them multiple opportunities to ask questions or back out. We made her come back almost half a dozen times. She’s so unusual, so young. We want to make sure we’re protecting our donors. I’m not going to whack somebody over the head and take their kidney out.”

What about the Hippocratic oath, what about “first do no harm?”

“She’s an adult,” said Dr. Becker. “She gave me permission. I did speak with her father, just to give him the facts. The operation is risky — any time you operate, there is a minute but very real chance of death. Still, I feel very comfortable that this young lady has given informed consent. She knows what she’s getting into. If I didn’t feel comfortable, I wouldn’t proceed.”

Dr. Becker has done this before. I wondered how she felt, taking a kidney from a perfectly healthy young woman.

“To be honest, in some ways it’s more stressful to take one out of healthy person than to put one into a sick person, because you are taking something away form that healthy person,” she said. “It’s not an operation they need to have done. They’re not sick. There is a slightly added level of stress.”

I mentioned to Dr. Becker that, in my view, if Garneau were signing up for the Marines we wouldn’t think twice of applauding her selflessness, even if she were going to fight in Afghanistan where she could possibly be injured in a far more grievous way than losing a kidney (your remaining kidney enlarges to pick up the slack, and since kidney disease typically strikes both kidneys, having an extra is only useful in the case of physical trauma, like a car accident).

“That was the argument brought up at the ethics conference,” she said. “It’s less dangerous than going to Iraq and getting shot.”

Garneau couldn’t quite put her finger on her exact motive. What does Dr. Becker think of what Garneau is doing?

“I just think she’s on a higher moral plane,” she said. “She’s great. She’s awesome. She is just an incredibly generous person who saw this is the right thing to do.”

'Medical miracle': Kidney transplant has lasted 40 years and going strong

By RICHARD CRAVER | Winston-Salem Journal

When Jack Young's kidneys began failing at age 17 in 1967, he became convinced he was living on borrowed time.

Even after being told in 1971 he was eligible for a kidney transplant from his sister, Sharon — only the third ever planned at N.C.Baptist Hospital — Young didn't take the opportunity "all that seriously," even though it represented ending the ordeal of eight hours of dialysis twice a week.

All that Young, a West Jefferson resident, knew of organ transplants was that they were painful and likely wouldn't extend the recipient's life by more than a few months.

So even though his sister was a near-perfect match, he risked his preparation by sneaking out of the hospital for a banana split — a dietary no-no for someone on dialysis. It delayed the surgery for two weeks.

"I had been going to the church chapel to think about the decision, to think about living and dying," Young said. "When they took me back for surgery, I wasn't sure I would make it. I was just so sick that I wanted it over with one way or another.

"But I determined that since there were so many people pulling for me," including fund-raising events by a local radio station and his college fraternity, "that I had to see it through."

On Friday, Young and his family will celebrate what Wake Forest Baptist physicians call a medical miracle — living 40 years with a transplanted kidney still functioning normally. A community event of more than 150 people will take place June 5.

Although the National Kidney Foundation does not track longevity among kidney transplant recipients, officials said Young is likely among the longest living survivors in the country. The first kidney transplants were done in the 1950s.

"Jack's kidney function is better now than it was when I first began to see him 2½ years ago," said Dr. Scott Satko, who oversees Young's care at Wake Forest Baptist as an internist specializing in nephrology.

200 transplants a year

Satko said the average transplanted kidney functions for about 10 years, although he cautioned "every patient is different."

A group of four Wake Forest Baptist transplant surgeons performs more than 200 kidney transplants combined on an annual basis. The average wait for a kidney is three years.

"People are getting kidneys now that doctors wouldn't have tried years ago, including some in the 70s," Satko said. "Transplant recipients are more likely to die now of old age or other disease than kidney disease.

"Essentially, if someone gets past 10 years with normal kidney function following a transplant, the odds are good the kidney will last another 10 to 30 years."

Dr. Jesse Meredith, who performed Young's transplant, reminisced with Young, a semi-retired art instructor, about their experience following Young's recent routine checkup with Satko. They laughed and shared stories more like dear friends than patient and doctor.

Meredith performed all of Baptist's kidney transplants from 1970 to 1989. He became a professor emeritus in 1993, but at age 88 still provides lectures to students.

As commonplace as a kidney transplant is today, it was considered a high-risk procedure at the time of Young's operation, Meredith said. Even now, 75 percent of transplanted kidneys come from cadavers.

Even though Meredith performed the two previous kidney transplants at Baptist, and he was confident Young's body would not reject the kidney, he still spent the night in the intensive-care unit after the surgery.

"There are three kinds of rejections," Meredith said. "One that happens the day the organ is put in, one that happens within a week and one that is chronic, years down the road.

"Although I was pretty sure the surgery would be a success, I just didn't want to be too far away in case something happened.

"We also didn't know all that much about the impact of a kidney transplant to the donor, such as the risk of renal failure and complications, which made what Jack's sister did all the more remarkable," Meredith said.

'The Lord was in it'

Sharon Young Parsons, 25 at the time, wasn't too keen on the idea when she, their mother and an uncle came to Baptist Hospital to be screened for a match. Their 10-year-old brother also was a suitable match, but too young for the surgery.

"My mom and my uncle both said, 'Let it be me,' and I hoped it would be one of them, too," Parsons said. "But I just knew before we came to Winston that it would be me."

Parsons said she prayed over the decision, in part because Jack didn't ask her to donate her kidney. She said she initially wasn't willing to accept the answer she got from God.

"Oh, I would argue with Him and wrestle with Him because this was a part of my body, and I had a 6-year-old and an 18-month-old at home, and my husband wasn't thrilled about it, either," Parsons said. "But I knew the Lord was in it, and that was that."

Meredith said that in some ways, the surgery was tougher on Parsons than on her brother. She said she was cut open from her navel to the middle of her back.

Even though she went back to work after six weeks, she said it took years before her back felt normal where the kidney had been.

"They had the second person who had been a donor at Baptist talk to me," Parsons said.

"He said that Jack would be getting better sooner than I would, and he was right. I didn't want to eat and struggled to drink anything while Jack was regaining his strength."

The pain proved worthwhile, Parsons said, after she saw that "Jack had taken this second chance at life to heart."

"He has witnessed to and touched a lot of people about his experience and his faith. That change in him just confirmed to me the Lord was in it."

Show and tell

Meredith said he ought to take Young along with him as a show-and-tell to his medical students — living proof of what life-changing surgery looks like 40 years later.

"We take dialysis for granted these days, but it was considered as experimental treatment in the 1970s that some high-up medical officials didn't support," Meredith said.

"I'm not sure Jack would be alive today if he had to stay on dialysis all these years."

Besides having a near perfect donor match, Meredith said that Young's "rebelliousness" made him the kind of patient who tended to do well after major surgery.

"He didn't sit back. He took ownership of his recovery," Meredith said.

Young went back to Appalachian State University the next fall. He met his wife, Cynthia, a year later while pursuing his master's degree in art education.

"I couldn't play sports anymore, but I took up hiking and horseback riding and concentrated on my art, writing and on traveling,"Young said.

"I saw life in a whole new way after the transplant, like I was born again — not taking away from the Christian belief in being born again — but life here on Earth had new meaning."

Shaking Meredith's hand once again, tears formed in the corners of Young's eyes when he said, "It's not often you get to thank someone for a job well done 40 years after the job was done."

Tearing up herself, Cynthia Young said, "Jack was given the chance to live the life God meant for him to, doing God's will, and he's done it.

"We're so blessed."