Hurricane Katrina's devastation includes transplant candidates, dialysis, medical community.

The myriad acts of mayhem wrought by Hurricane Katrina on Gulf Coast residents were magnified cruelly in the storm's impact upon organ transplant candidates, dialysis patients and other hospital patients and the medical community in general. Crippled transportation and communications systems, toxic waste and overall physical devastation in the region all rendered medical caregivers essentially helpless for days in parts of Louisiana, Mississippi and Alabama.

Kelly Ranum, executive director of the Louisiana Organ Procurement Agency, said the hurricane "truly crippled" the agency and emphasized that for the 1,600 Louisianans on the nation's waiting list for an organ time is running out.

"We had two donors last week in an outlying parish but it's been very challenging to say the least," Ranum told Transplant News. "There is lots of military patrolling the airspace and there is a limited time to get in and out. We had to sacrifice a lung recovery because we just didn't have enough time and there were snipers shooting and a lot of other activity on the ground. But on the same day we had a DCD donor in the Shreveport area."

Ranum said that while the "situation today and everyday looks a little brighter," it is impossible to know what is going to happen. "It's struggling to maintain the donor program, giving donor families hope, getting doctors to work and how to balance the needs of our staff," she explained. "It's a challenge we face everyday, we adjust and are trying to be flexible with everyone."

One of the biggest donor issues involved establishing a referral policy for people with "tremendous health issues," Ranum noted. "People have been exposed to waste water and we have to take special precautions about who can be a donor. Knowing the type of water they've been exposed to - oil, human waste, human carcasses - we decided to be very conservative. We've kept the final decision to just one individual, our medical director, so that we are very consistent. So far we haven't had any problems."

With a majority of the LOPA staff displaced, the phone and Internet communications system in shambles, LOPA has established the LOPA Hurricane Katrina Relief Fund to help get the operation running again and to provide direct financial support to LOPA staff members.

"The devastation from Hurricane Katrina crippled us as an agency. We have staff members who have lost everything. Yet they still have focused on fulfilling our mission," Ranum said. "I applaud their commitment to this agency, the donor families, and the recipients. This fund will support that commitment until we can restore normal operations."

Members of the transplant community who wish to donate are asked to send contributions to the LOPA Hurricane Katrina Relief Fund, 301 Kaliste Saloom, Suite 101, Lafayette, LA 70508. For more information contact LOPA at (337) 269-07044 or [e-mail]

Transplant-related organization hurricane relief efforts

All of the major transplant organizations responded quickly to offer help for victims of the hurricane including transplant patients, dialysis patients, blood donation, and offering contributions of financial support. Here is an overview of various agency responses.

North American Transplant Coordinators Organization

In a memo to members, NATCO President Charles Alexander wrote: "NATCO plans to do all we can to help those who have been displaced by the devastation of Hurricane Katrina and hopes to team with other transplant-related organizations. NATCO is working with pharmaceutical companies and other major transplant organizations to expedite access to indigent drug programs, and facilitate temporary access to transplantation medications for displaced patients in the affected region. The details of these efforts will be posted an updated on our Web site at www.natco1.org/HurricaneKatrina.htm

If you receive patients from any of the transplant centers in New Orleans, Mississippi or Alabama and need information, please contact the NATCO office, and we will assist in efforts to locate appropriate staff from those transplant centers to assist in guiding treatment for these patients." NATCO office phone number: [phone]

Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing (UNOS)

The OPTN/UNOS issued a release saying it is contacting and offering any available assistance to transplant centers and organ procurement organizations in the areas most affected by the hurricane. The OPTN will take any possible measure to assure that transplant candidates and recipients receive medical services with the least possible disruption, and to facilitate lifesaving organ donation.

The OPTN also said it will help members transfer candidates to active transplant programs or to make alternative arrangements to place donated organs.

In order to assist transplant candidates and recipients who may have relocated during the hurricane, the OPTN/UNOS provides a list of transplant centers near the storm damaged area that provide short-term medical care. They can be found online at: www.optn.org/news/newsDetail.asp?id=482

Transplant candidates and recipients are also encouraged to call the UNOS toll-free Patient Services Line [phone] between 8:30 a.m. and 5 p.m. Eastern Time Monday through Friday.

National Kidney Foundation (NKF)

The NKF noted that kidney patients without access to dialysis treatment face life-threatening danger and announced it had created a relief resource network posted on its Web site: www.kidney.org, which offers dialysis locations and treatment information, other patient assistance and information for health care professionals interested in volunteering for the effort.

The NKF appointed Preston A. (Tony) Englert, Jr., the chief operating officer of the National Capital area affiliate to direct efforts to assist patients with the problems they face and will face in the future.

NKF Chief Executive Office John Davis noted, "Tony will lead our New York based Gulf Coast Assistance Task Force which was established in the past week. Our staff has been actively engaged with NKF Affiliates in the region and in touch with government and private organizations working on behalf of our patients."

Davis also noted that the NKF's Louisiana Affiliate relocated to Baton Rouge and "is working tirelessly to help patients even though the staff has suffered great personal losses themselves."

The foundation also set up a hurricane relief fund to help meet the needs of both dialysis and transplant patients. Contributions should be sent to The National Kidney Foundation Patient' Hurricane Relief Fund, 30 E. 33rd St., New York, NY 10016. NKF stressed 100% of the funds will go directly to patient assistance.

American Liver Foundation (ALF)

The ALF issued a release warning that patients with liver disease and liver transplants affected by the hurricane must have access to their medications. In addition, ALF noted that residents and relief workers should be aware that conditions in the Gulf Coast, and particularly in New Orleans, may pose an increased risk for Hepatitis A infection.

Overcrowding, contaminated water and compromised sanitation systems can increase the risk of Hepatitis A transmission. Hepatitis A is a treatable, preventable virus that is spread from person to person by putting anything in the mouth that has been contaminated with stool containing the hepatitis A virus, ALF said. Though the Centers for Disease Control and Prevention (CDC) has not reported evidence of widespread Hepatitis A contamination in the hurricane affected region they do recommend that all individuals over two years old receive the Hepatitis A vaccine, ALF noted.

For information on seeking treatment, contact ALF's national HelpLine [phone] or go online: www.liverfoundation.org

National Marrow Donor Program (NMDP)

"In the aftermath of Hurricane Katrina, the NMDP is working to locate displaced transplant patients and families," the organization said in a press statement. "With a network of more than 150 medical centers, the NMDP can help displaced transplant patients and their families-and the physicians who may have assumed their care-connect to transplant centers which can support continuation of their treatment."

NMDP also said its Office of Patient Advocacy case managers are available to assist displaced patients to address issues including cultural and language barriers or financial and insurance challenges in order to restore critical care needs. NMDP can also assist the physicians who may have assumed care of the patients and connect them to the specialized medical care required for bone marrow or cord blood transplant. Case managers can be contacted at [phone].

The Marrow Foundation, a fund raising partner to the NMDP, has established Operation LifeGift, an emergency fund for Hurricane Katrina victims seeking marrow or cord blood transplants. To contribute or learn more, visit the foundation's Web site: www.themarrowfoundation.org.