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How does your liver work?

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“The liver has many functions that are necessary for life. The liver helps process carbohydrates, fats and proteins, and stores vitamins. It processes nutrients absorbed from food in the intestines and turns them into materials that the body needs for life.

For example, the liver makes the factors that the blood needs for clotting. It also secretes bile to help digest fats, and breaks down toxic substances in the blood such as drugs and alcohol. The liver is also responsible for the metabolism of most drugs.”

Learn more from UNOS here.

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Liver Transplants: ‘Collateral Damage’ of Pandemic Drinking

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“The number of alcoholic hepatitis patients getting liver transplant more than tripled during the COVID-19 pandemic, a retrospective study found.

A difference-in-difference analysis from June 2020 to February 2021 found that liver transplants for acute alcohol-associated hepatitis more than tripled (268.5% increase) compared with expected trends, while the rate of patients with acute alcohol-associated hepatitis added to the transplant waiting list more than quadrupled (325% increase), reported Therese Bittermann, MD, of the University of Pennsylvania in Philadelphia, and colleagues.”

Read full article, here.

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FDA advisory committee unanimously agrees donor liver portable system is safe, effective

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“The FDA’s Gastroenterology and Urology Devices Panel, Medical Devices Advisory Committee voted unanimously that a portable system for near-normothermic continuous perfusion of donor livers with perfusate was safe and effective.

The system will be prepared by hospital pharmacy and include compatible packed red blood cells.

The panel addressed three questions related to the premarket approval of the device Organ Care System Liver System (TransMedics). The entire 14-member panel voted that the device is safe, all voted that the device is effective and voted 12 to 1 with 1 abstaining that the benefits of the OCS Liver System outweigh the risks.”

Read more, here.

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Young Race Car Driver Raises Awareness About Life-Saving Transplants

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Jeannine Williams saw the writing on the wall. It had been nearly 30 years since a hepatitis infection resulted in the need for a liver transplant at age 22. Decades of taking the immunosuppressive drugs required post-transplant had enabled Jeannine to live a full life, giving birth to two children even though doctors had originally predicted she’d survive just five years.

But those same life-saving drugs had taken a toll. In the years since receiving a new liver, Jeannine, 54, had vanquished breast cancer and multiple skin cancers, brought on because her immune system was suppressed. Then in 2018 came the unwelcome news she’d been expecting: Jeannine, from Oakley, California, needed a kidney transplant.

Read Clayton’s and Jeannine’s full story, here.

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Graft, patient survival improves in HIV, HCC liver transplant recipients

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“Outcomes have improved significantly among HIV/Hepatitis C virus-coinfected liver transplant recipients in the direct-acting antiviral era, according to data presented at the Digestive Disease Week.

“The practice of liver transplant for HIV-positive patients has been increasing since 2013 when the HOPE Act was passed; however, the number is still low, less than 1% of total liver transplants,” Jennifer Wang, from the University of Chicago, said during her presentation. “There is a significant geographic variation of HIV/HCV coinfected liver transplant practice with limited number of participating centers. Liver transplant outcomes for coinfected patients have improved significantly in the [direct-acting antiviral (DAA)] era and are comparable to patients without either infection.”

Wang and colleagues analyzed data from the Organ Procurement and Transplantation Network (OPTN) on adult patients in the United States who underwent liver transplantation between 2008 and 2019. They identified 70,125 liver transplant patients, 416 of whom were HIV-infected.”

Learn more, here.

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Despite COVID Vaccinations, Caution Still Crucial for Transplant Recipients

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“Long before COVID-19 changed the world, organ transplant recipients were wearing masks to shield themselves from airborne threats.

Immunosuppressive medicines, which often are a lifelong requirement after a transplant, add an extra layer of protection against viruses as common as a cold or as dangerous as COVID. Transplant patients are told to use masks for any group gatherings or airplane flights, and hand sanitizing is a must. 

While COVID has brought a heightened awareness of these patients’ health risks and fragility, a recent study by Johns Hopkins University researchers in Baltimore, Maryland, and a report from the Mayo Clinic in Jacksonville, Florida, may raise their sense of unease even further.”

Read the full article, here.

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Antibody Response to 2-Dose SARS-CoV-2 mRNA Vaccine Series in Solid Organ Transplant Recipients

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“Transplant recipients without prior polymerase chain reaction–confirmed COVID-19 were recruited from across the US to participate in this prospective cohort through a digital campaign. Those who completed the 2-dose SARS-CoV-2 mRNA vaccine series between December 16, 2020, and March 13, 2021, were included and followed up through April 13, 2021. As described previously,3 semiquantitative antispike serologic testing was undertaken with the Roche Elecsys anti–SARS-CoV-2 S enzyme immunoassay, positive cutoff of at least 0.8 U/mL, which tests for the receptor-binding domain of the SARS-CoV-2 spike protein, or the EUROIMMUN enzyme immunoassay, positive cutoff of at least 1.1 arbitrary units, which tests for the S1 domain of SARS-CoV-2 spike protein, both key measures of humoral immune response.4,5 This study was approved by the Johns Hopkins institutional review board; participants provided informed consent electronically.

The proportion of patients who developed a positive antibody response was assessed with an exact binomial confidence interval. The Fisher exact test was used to compare categorical variables, such as antimetabolite immunosuppression, and the Kruskal-Wallis test for continuous variables. All tests were 2-sided with α = .05. Analyses were performed using Stata 16.1/Windows.”

See the full study results, here.

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How Common is Cancer in Organ Transplant Recipients?

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As an organ transplant recipient, you already “know” several things:

  • You know what the anxiety and stress of end-stage organ disease feels like
  • You know that your life has been improved after receiving your transplant
  • You know that by taking care of your transplant, you can reduce the risk of rejection of the organ

Did you also know that the important immunosuppressants (anti-rejection medications) you take to prevent your body from rejecting your transplanted kidney, heart, lung, or liver may increase your risk of developing certain types of
cancer?1

While the risk of dying from cancer is low, you need to be proactive and get screened for various types of cancer—most notably skin cancer.

Read the full article, here.

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Valen Keefer Praises Donors Who Give Life to Transplant Recipients Like Her

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COVID-19 being what it is, Valen Keefer’s speech at the grand opening of CareDx’s newly expanded CLIA lab in Brisbane, California was a unique virtual event.

Valen was there as a virtual robot, sharing her inspiring story and leading the countdown for the ribbon cutting.

“Being a transplant recipient is a lifelong journey and having the opportunity to celebrate this new lab is so amazing,” said “Robot” Valen.

Valen’s journey as a multi-organ transplant recipient has been a compelling one—to say the very least.

She has lived through polycystic kidney disease (PKD), dialysis, lengthy hospital stays, a kidney transplant, and a liver transplant. She is a survivor through and through, with a prodigious passion for helping the transplant community.

Read Valen’s full story, here.

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