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‘Heart in a Box’ Expands Transplant Opportunities

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The Smidt Heart Institute, Home of the Nation’s No. 1 Adult Heart Transplant Program, Uses Transmedics Organ Care System (OCS) to Grow Geographic Area of Service, Enabling More Lifesaving Organ Transplants

Dominic Emerson, MD, and Pedro Catarino, MD, both transplant surgeons with the Smidt Heart Institute, know how to be spontaneous. At any given moment, they can get the call that a donor heart or lungs are available, requiring them to quickly board a private aircraft to procure the vital organs.

Until recently, those flights were quick jaunts lasting no more than four hours—the time a donor heart can survive on ice. Now that is all changing, thanks to a medical device called the OCS Heart, or “Heart in a Box,” which enables transplant surgeons to travel to much farther destinations to procure lifesaving organs by acting as a miniature intensive care unit that keeps the heart alive.

“Cedars-Sinai has the biggest adult heart transplant program in the world and takes on some of the most complex surgical cases,” said Emerson, associate surgical director of heart transplant and mechanical circulatory support and surgical co-director of the Cardiac Surgery Intensive Care Unit at Cedars-Sinai. “The Heart in a Box technology is helping break down a major barrier of transplantation, ultimately offering many patients a second chance at life.”

Read more, here.

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Coronavirus antibody tests have had plenty of problems. Hopkins is developing a better, at-home version

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Plenty of people want to know whether they ever had COVID-19, and public officials need to know. But existing antibody tests that look for markers of the disease caused by the coronavirus have not met the challenge, with accuracy, cost and convenience problems.

Scientists at the Johns Hopkins University and elsewhere, however, are working on the next generation of these tests that can be done at home.

“We wanted to develop something you could use on your kids,” said Netz Arroyo, a Hopkins assistant professor of pharmacology and molecular sciences who joined with a biomedical engineer and a biophysicist to repurpose a common medical device to look for the virus.

“It would be easy and you may not even have to poke their finger every time,” he said. “Now you have to go to a lab and have a blood draw.”

Read the full article, here.

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New kidney and pancreas transplant allocation policies in effect

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“UNOS has implemented a new system for matching kidney and pancreas transplant candidates with organs from deceased donors.

The new approach is projected to increase equity in transplant access for candidates nationwide. It replaces distribution based on donation service area (DSA) and OPTN region with a more consistent measure of distance between the donor hospital and the transplant hospital for each candidate. This will further ensure the right organ gets to the right patient at the right time based on medical need rather than geography.

The policy was developed over nearly three years by organ donation and transplant experts, organ recipients and donor families from around the country, and input from thousands of people during three public comment cycles.

Kidney and pancreas offers will be offered first to candidates listed at transplant hospitals within 250 nautical miles of the donor hospital. Offers not accepted for any of these candidates will then be made for candidates beyond the 250 nautical mile distance.

Candidates also will receive proximity points based on the distance between their transplant program and the donor hospital. Proximity points are intended to improve the efficiency of organ placement by adding priority for candidates closer to the donor hospital. Candidates within the initial 250 nautical mile radius will receive a maximum of two proximity points, while those outside the initial circle will receive a maximum of four proximity points. The point assignment will be highest for those closest to the donor hospital and will decrease as the distance increases.”

Read all about the new policy, here.

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Immunocompromised And Concerned About The Vaccine? Here’s What You Need To Know

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“Lots of people have questions about getting vaccinated against COVID-19. That includes the millions of Americans with weakened immune systems that put them at higher risk of severe disease if they do get infected with the coronavirus.

“Patients want to know whether it’s safe to get it and, if they do get it, which one should they get? And of course, they also have concerns about how it can affect their own condition as well,” says Dr. Sharon Dowell, a rheumatologist at Howard University Hospital in Washington, D.C., who says she has been getting a barrage of questions from patients lately.

People can be immunocompromised for a wide range of reasons. Some are being treated with immunosuppressive medications for conditions such as rheumatoid arthritis, lupus, Crohn’s disease or psoriasis. Others are organ transplant recipients on powerful anti-rejection medications or cancer patients receiving chemotherapy.

Dowell and other doctors say vaccinating immunocompromised patients is especially important. But it also raises special considerations that these patients should discuss with their doctor beforehand. Here’s what you need to know.”

Read the full article, here.

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Outcomes among Transplant Recipients Hospitalized Due to COVID-19

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“Due to chronic immunosuppression as well as the presence of numerous comorbidities, the risk of developing severe COVID-19 may be high in kidney transplant recipients. Researchers in the United States, Italy, and Spain conducted a retrospective cohort study to examine the clinical outcomes among kidney transplant recipients to identify predictors of poor clinical outcomes. Results of the study were reported in the American Journal of Transplantation [2020;20(11):3140-3148].

The study was led by Paolo Cravedi, MD, PhD, division of nephrology, department of medicine, Icahn School of Medicine at Mount Sinai, New York, New York. The cohort included 144 kidney transplant recipients who were hospitalized due to COVID-19 at 12 transplant centers in North America and Europe. The 12 centers were participating in the TANGO International Transplant Consortium. All kidney transplant recipients ≥18 years of age with a functioning allograft who were admitted to a hospital between March 2 and May 15, 2020, were included.”

Read the full study, here.

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Cancer Patients and Transplant Recipients Need Both COVID-19 Vaccine Doses

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“Natural immunity and vaccine responses may be weaker in people with immune suppression, so they should get their second dose promptly

A majority of people with cancer and organ transplant recipients are capable of mounting an immune response to the SARS-CoV-2 coronavirus and can gain immunity from COVID-19 vaccines, according to recent research. But people with immune suppression may have slower and weaker responses to natural infection or vaccination, so it is especially important that they get their second dose on schedule.

People with serious immune suppression are at risk for more severe complications and death due to COVID-19. This group includes cancer patients who use immune-suppressing therapy, transplant recipients who take immunosuppressive drugs to prevent organ rejection and people with AIDS (advanced, uncontrolled HIV disease).

It is well known that immunosuppressed people can have weaker immune responses to natural infection and vaccination, but SARS-CoV-2 immunity in this population is not well understood. What’s more, cancer patients on treatment and other people with advanced immune suppression were generally excluded from COVID-19 vaccine trials (though people with well-controlled HIV could enroll).”

Read the full article, here.

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Signs & Symptoms That Your Body is Rejecting Your Transplanted Kidney or Heart

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A person living with a transplanted organ can live a healthy and normal life.

However, to increase your chances of long-term success, experts say that immunosuppressants (anti-rejection medications) must be taken every day as directed.1

“A transplanted organ is seen as a foreign object—or an ‘unwelcome visitor’—by your body,” says Nikhil Agrawal, MD, a nephrologist with Beth Israel Deaconess in Boston. “That is why your body’s immune system works hard to react against—or ‘reject’—the transplanted organ. Immunosuppressants suppress your body’s immune system and prevent rejection.”

The signs and symptoms of rejection could differ based on your transplanted organ. Below are a few things to look out for if you are a kidney- or heart-transplant recipient.

Read the full article, here.

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Managing Anxiety as a Transplant Patient in a COVID-19 World

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Transplant recipients never needed a COVID-19 pandemic to be anxious about infections.

Long before the pandemic, living with a transplanted organ had its own caution, stress, and anxiety about illness.

Throw social isolation into the mix and your anxiety is only made worse.

Social Distancing’s Impact on Transplant Recipients Mental Health

Isabel Stenzel Byrnes has lived 16 years with a double-lung transplant. Byrnes is a licensed social worker and grief counselor from California who says she started to feel the effects of social isolation about two months into the pandemic.

“I was starting to really find myself in a slump, and missing the energy shared with human beings,” said Byrnes, who copes by taking socially distanced walks with people.

One positive aspect of life during COVID-19 is that today we have computers, tablets, and Smartphones, which can be useful resources to visually and auditorily connect transplant recipients with their doctors, nurses, psychiatrists, social workers, colleagues, and friends.

Read the full article, here.

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The Most Important Topics to Talk to Your Kidney Doctor About After a Transplant

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You have been given the gift of a kidney donation.

You have energy and strength that you haven’t had in a while.

You have a new lease on life, and it’s a new day.

Now what?

Be Sure to Ask Your Transplant Doctor About These Important Topics

Now that you have had a kidney transplant, you are going to want to lead your healthiest life so you can protect your gift.

Read the full article, here.

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Getting Important Blood Draws from Home—All Your Questions Answered About RemoTraC™ 

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Before COVID-19, most kidney- and heart-transplant recipients got their weekly or monthly blood tests at the hospital or a local blood-draw center. When COVID-19 touched down, however, hospitals became places where exposure to the coronavirus was higher.

Patients who are on immunosuppression—such as transplant recipients—are likely to be at a higher risk of severe infection and associated complications of COVID-19.1 Therefore, it is critical that transplant recipients have routine access to their transplant-lab testing in environments that limit their exposure to the coronavirus.

How do you solve such a dilemma?

Since March 2020, over 5,000 transplant recipients have turned to RemoTraC.

Learn more about RemoTraC, here.

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