Teenager gets first permanent artificial heart

A 15-year-old Italian boy has become the first child patient in the world to be permanently implanted with an artificial heart.  The boy underwent a 10-hour operation in September 2010 and was doing well after the surgery. He could not be placed on the heart transplant waiting list as he was suffering from a muscle wasting illness called Duchenne syndrome.

Paediatric cardiac surgeon Dr. Antonio Amodeo and his team carried out the operation at the Bambino Gesu Children’s Hospital in Rome. Unlike previous artificial heart operations, this was not a temporary solution but a permanent one and was expected to give the boy another 20-25 years of ‘normal life.’

The artificial heart was around 4 cm long and had been placed in the left ventricle and its connection with the ascending aorta. It is an electrically activated hydraulic pump and is entirely located inside the thorax, in order to reduce the risk of infection. It is powered through a plug positioned behind the left ear. It is connected to a battery that the patient holds on a belt and is charged during the night like a mobile phone. The device weighed a little more than 90 gm – compared to adult ones which can weigh around 1 kg.

Dr. Amodeo said that the surgery was unique as “up until now it had only been performed on adult patients.”

Study on using kidneys from Hepatitis C positive donors

Can kidneys from hepatitis C positive donors be used for transplantation or not? Researchers at Johns Hopkins University studied data from more than 93,000 deceased kidney donors between 1995 and 2009. They found that while outcomes are slightly worse with hepatitis C positive patients who receive hepatitis C positive organs, the advantages of more timely transplants may outweigh the risk of waiting for a hepatitis C negative kidney. The study appeared in the April 2010 Journal of the American Journal of Transplantation.

Dorry Segev, MD, lead author of the study, said, “Many transplant centers don’t use hepatitis C positive kidneys at all, effectively consigning hepatitis C positive patients to an average unnecessary wait of a year longer than for an uninfected organ.” The extra year on dialysis increases the risk of death 10% to 15%.

The use of hepatitis C positive kidneys has been controversial in the past partly due to the difference in one-year and-three-year survival rates between those who receive an infected kidney and those who don’t.  Segev observed that the difference “is easily made up by getting off dialysis sooner.” However, Segev and his colleagues found that hepatitis C positive kidneys were two and one-half times more likely to be discarded than hepatitis C negative kidneys. One-third of the nation’s transplant centers did not use any hepatitis C positive kidneys for their hepatitis C patients, the study found, while 13% transplanted more than half of their hepatitis C patients with hepatitis C positive kidneys.

MORE KIDNEY TRANSPLANTS DONE IN ELDERLY PATIENTS NOW

A study appearing in the Clinical Journal of the American Society of Nephrology (CJASN) examined whether elderly patients with kidney failure have better or worse access to transplants now than they did in the past. The study included patients with kidney failure in the United State aged 60 to 75 years listed in the United States Renal Data System between 1995 and 2006.

The study revealed that elderly patients rarely receive a transplant, but they were twice as likely to get one in 2006 as in 1995. Elderly patients now benefit from greater access to organs from living donors and older deceased donors compared to a decade ago. They also die less frequently while waiting for a kidney than they did in the past.

The authors, Elke Schaeffner, MD (Charite University Medicine, Berlin, Germany), along with Caren Rose and John Gill, MD (St. Paul’s Hospital, University of British Columbia, Vancouver, Canada) urge clinicians to encourage elderly patients with kidney disease to consider transplantation over other forms of treatment. “Early engagement and education of patients and their families about the benefits and opportunities for transplantation may lead to further increases in the use of transplantation in this age group. Policy changes and research are also needed to further expand access to transplantation in the elderly,” they wrote.

World’s First Hi-Tech pancreas Transplant

For the first time in the world Italian doctors have carried out a robotically-assisted pancreatic transplant. This operation "creates new prospects for the treatment of diabetics," because its "mini-invasive" nature strongly reduces post-operation complications, the team at the university hospital in Pisa, Italy, said.

The transplant was carried out on September 27, 2010 on a 43-year-old mother of two who had suffered from Type I diabetes since she was 24 years old and had already had a kidney transplant. The patient suffered no complications from the three-hour operation and left the hospital on October 30, 2010. Pancreatic transplants have been very invasive until now because of the organ’s vascular structure and the fragility of diabetic patients, who in 50 percent of cases develop post-operative problems.