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Who gets an organ transplant? Waitlist rules are complicated.

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Last week, a hospital in Boston removed a patient from its heart transplant waiting list over his refusal to receive a COVID vaccine. Although many hospitals had been enforcing such policies throughout the pandemic, the news took off internationally.

But the spotlight on vaccination status ignores the complexities of organ transplantation outside the pandemic. “There are a ton of requirements for transplant eligibility,” says Dorry Segev, a transplant surgeon at New York University. The ethics of transplant decision-making are different from those of other kinds of medical care, in large part because there are fewer organs than there are people in need. According to the American Transplant Foundation, more than 100,000 Americans are currently on transplant waitlists.
Read more here.

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What are the Common Lab Tests That Patients Receive After Heart Transplant?

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As a heart transplant recipient, you’ll quickly find yourself being asked to take a laundry list of blood tests. While this can be inconvenient and frustrating, it’s also really important. Your doctor can’t tell what’s going on with your new heart by looking at you. Blood tests provide information on how well your heart is functioning and how your medications may be affecting your body. By reviewing the results, your physician may adjust medications, recommend changes to your diet or fluid intake, or recognize the need for additional examination.

But what are the specific tests and what is the purpose of each? With the help of Dr. Shelley Hall, Chief of Transplant Cardiology and Mechanical Support/Heart Failure at a large university medical center in the southern US, in this article we discuss:

– Complete blood count
– Comprehensive metabolic panel
– Infection testing
– Natriuretic peptide test
– Immunosuppressive drug levels
– Donor specific antibodies
– AlloMap® Heart
– AlloSure® Heart

Read more here.

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Most liver transplant recipients mount adequate COVID-19 antibody response

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The majority of liver transplant recipients are able to produce a functional antibody response to COVID-19 infection, according to data published in Gut.

“Our findings suggest that the humoral response of [liver transplant (LT)] recipients is only slightly lower than expected compared with that of COVID-19 immunocompetent controls,” Chiara Becchetti, MD, of the department of visceral surgery and medicine at the University of Bern in Switzerland, and colleagues wrote. “Additionally, we showed that the majority of LT recipients is capable of mounting an adequate neutralizing activity against SARS-CoV-2 and that neutralizing ability was associated with the presence of antinucleocapsid antibodies.” Learn more here.

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Lung transplants encouraging treatment for COVID-19 patients, but long-term outcomes still uncertain

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Recent data bolster the value of lung transplants for some COVID-19 patients, indicating they do as well after surgery as those who needed new lungs for other reasons.

The complicated, risky procedure remains rare, though, doctors said, and there is still much they’re learning about how well transplants work for COVID-19 patients. Learn more here.

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Some Kidney Transplant Patients Respond to Fourth COVID Vax Dose

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“A fourth dose of mRNA COVID-19 vaccine boosted antibodies among half of kidney transplant recipients with suboptimal immune responses after three doses, a French case series found.

Among 92 patients with low anti-spike IgG titers (below 143 binding antibody units/mL) 1 month after the third dose, 50% reached the 143 BAU/mL threshold considered adequate against the initial COVID variants at 1 month following their fourth dose, reported Sophie Caillard, MD, PhD, of Hôpitaux Universitaires de Strasbourg in France, and colleagues.”

Read more here.

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20 Common Kidney Transplant Q&A

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“When your kidneys fail, treatment is needed to replace the work your own kidneys can no longer do.  There are two types of treatment for kidney failure: dialysis or transplant. Many people feel that a kidney transplant offers more freedom and a better quality of life than dialysis.  In making a decision about whether this is the best treatment for you, you may find it helpful to talk to people who already have a kidney transplant. You also need to speak to your doctor, nurse and family members.”

Learn more here.

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Temporary MCS a Safe, Effective Strategy for the Transplant Waitlist

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“Use of temporary mechanical circulatory support (MCS) as a bridge to transplantation was a good strategy for many people following implementation of the 2018 national donor heart allocation policy, yet hemodynamic criteria may need to be modified to better identify the most urgent transplant candidates.

Within 14 days of status 2 listing, people with either a percutaneous endovascular MCS device or an intra-aortic balloon pump (IABP) received a heart transplant in 64.2% of cases, and only 1.9% died or were delisted for worsening clinical condition (a figure that rose to 3.1% at 30 days on the waitlist).”

Learn more here.

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Lung Transplant After COVID-19: What Patients Need to Know

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“COVID-19 is a complex disease. In some people, it can be a mild respiratory illness that is easy to recover from. In others, it can be severe and lead to a lengthy hospital stay. Patients with severe COVID-19 might need intensive care and a ventilator to help them breathe.

For people with severe illness, sometimes the only life-saving option is a lung transplant. As a pulmonologist who specializes in caring for both patients with severe COVID-19 and those who receive a transplant, I’ve seen firsthand the difference a lung transplant can make.

Here’s what our expert lung transplant team at the Temple Lung Center knows about performing these critical procedures”

Learn more here.

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COVID-19 and Heart Failure

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COVID-19 restrictions are easing. What does that mean for heart failure patients?

Although the coronavirus is still a major health threat, restrictions are easing across the nation. That leaves many people— including heart failure patients — wondering if it’s safe to go out in public and get back to a normal routine. 

The most important thing to remember is that people with heart disease, including heart failure, are at risk of getting much sicker or even dying if they get COVID-19.  So if you have a history of heart disease or have a risk factor for heart disease or stroke, stay informed and stay cautious. 

Learn more here.

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Naperville Couple: Life After Husband & Wife Match for Kidney Transplant

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“It’s the story of two people who are a match in a perfect and unexpected way. In July 2019, Naperville resident Aaron Rhoden suffered a stroke due to his high blood pressure. Afterwards, his kidney functionality was so low that he needed a transplant. That’s when an “unusual alignment” happened according to his doctor.

His wife, Tonya Rhoden, didn’t hesitate to take the tests necessary and the two found out they were a perfect match. The couple, married since 2016, said one in every between 50,000 and 100,000 spouses will be a match. The two are “six out of 10 markers identical,” said Aaron in a story we did with the two back in April before the kidney transplant.”

Read full story here.

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