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THE YEAR IN REVIEW IN TRANSPLANTATION.

When historians look back on 2002, they will find several here-to-fore secondary issues dominated the year in transplantation. Organ donation and allocation issues, new government regulations, even anticipated advances in stem cell research played second fiddle to the following:

*The emergence of living donation as the major growth area in providing organs for more than 100,000 patients world wide waiting for life saving organs -- voluntary living donors produced more than half of the organs available for transplantation in the US.

*The birth of an informal global network of transplant centers where needy recipients can pay for donated kidneys and split livers led several prominent transplant organizations-American Society of Transplant Surgeons, American Medical Association, Organ Procurement and Transplantation Network/United Network for Organ Sharing to support a trial offering financial incentives to families to increase their willingness to donate. However, the American College of Surgeons and the National Kidney Foundation voiced strong opposition to payment of any kind.

*Several research breakthroughs in xenotransplantation which heartened many professionals who feel that animal-to-human transplants are the best hope in the near future to combat the donor shortage and eliminate the angst caused by commerce in organs.

*The tragic deaths of several transplant recipients from tainted tissues and organs which led to a number of lawsuits and calls for increased regulation of testing organs and tissues prior to being transplanted.

Here is a look at some of the major news developments in transplantation in 2002 listed in chronological order:

JANUARY

*Researchers at the University of Missouri and Immerge BioTherapeutics successfully clone 4 miniature pigs lacking a copy of the 1,3-galactosyltransferase (GGTA1) gene, the gene that causes hyperacute rejection. PPL Therapeutics, the Scottish company that created Dolly, the world's first cloned mammal, also reports cloning 5 pigs that also had one copy of the GGTA1 gene knocked out.

*The American Society of Transplantation (AST) launches a nationwide effort to get private companies to change employee policies to remove any financial disincentives for employees seeking to become a live organ donor.

*University of Pittsburgh reports renowned playwright, novelist, and AIDS activist Larry Kramer received a liver transplant after 7 months on the waiting list. at the University of Pittsburgh Medical Center (UPMC).

*A 31-year-old California prison inmate serving 14 years for robbery is thought to be the first person to receive a heart transplant while in a state prison. The transplant is performed at the Stanford Medical Center.

*Mount Sinai Hospital in New York City temporarily halts live liver donor transplants following the death of a man who donated part of his liver to his brother.

*Continuing economic and political problems in Argentina forces the Transplantation Society to relocate its 2002 Congress to Miami, FL.

*National Academy of Science panel of experts releases report calling for ban on reproductive cloning while strongly supporting use of therapeutic cloning.

FEBRUARY

*Using cells derived from cloned cow fetuses, scientists at Advance Cell Technology grow functional kidney-like organs that were not rejected when implanted in adult cows, the first reported use of cloning technology to grow genetically matched organs for transplantation.

*A study reported in the Lancet based on national data from 1988 to 1996, shows that African Americans and Asians were less likely to be alive 2 and 5 years after liver transplantation compared with whites and Hispanics.

*Senators Bill Frist (R-TN) and Christopher Dodd (D-CT) introduce the Organ Donation and Recovery Improvement Act (S. 1949) which contains provisions designed to increase organ donation, provide financial support to living donors, study the effectiveness of donor registries, and improve the recovery, preservation, and transportation of organs and tissues.

*Chris Klug becomes the first organ transplant recipient ever to win an Olympic medal when he captures the bronze medal in the men's parallel giant slalom snowboard.

*The National Kidney Foundation issues a report showing that more than 20 million adult Americans have chronic kidney disease and most do not know it, and an additional 20 million others are at increased risk.

* Scientists at Texas A&M University, with funding by Generic Savings & Clone, successfully clone the first domestic cat.

MARCH

*The Department of Health and Human Services Office of Inspector General (OIG) issues a report saying donor registries are far from a panacea for the nation's transplant problems and that at least until existing registries are improved no additional ones-including a national donor registry-should be established.

*The New York State Department of Health concludes inadequate staffing was a contributing factor in the January 13 death of a live liver donor at Mount Sinai Hospital in Manhattan. The hospital says it will stop using first-year medical students to care for transplant recipients.

*Elias Zerhouni, MD, executive vice dean of the John's Hopkins University School of Medicine in Baltimore, named by President Bush to direct the National Institutes of Health (NIH).

*Infections caused by transplanting tainted solid organs and tissues are cited as the cause of death in 3 transplant patients. The cases involve a Minnesota man who died from routine knee surgery which was attributed to a bacterial infection caused by tainted tissue allograft, and 2 women who died of Chagas disease after receiving solid organ transplants from the same Latin American donor.

*The longest-living recipient of a self-contained artificial heart, Tom Christerson is released from Jewish Hospital in Louisville, KY.

APRIL

*Italy's AIDS Commission and National Transplant Center overturns a ban prohibiting Italians with HIV infection from receiving liver transplants from cadaveric donors.

*British doctors successfully use gene therapy to restore the immune system of a Welsh toddler born with x-linked severe combined immunodeficiency (X-SCID), commonly known as "bubble baby syndrome," a rare genetic illness that renders sufferers extremely vulnerable to infection.

*Cadaveric donation shows virtually no increase over 2000, according to data released by the Department of Health and Human Services (HHS). More than half of the solid organ donors in 2001 came from live donors - 6,445 of the 12,522 total donors, an increase of 12.5% over 2000.

Living donors increased by 13.4%, while cadaveric donors increased by just 1.7%.

*Senator Jesse Helms (R-NC) undergoes open heart surgery to replace a failing artificial heart valve installed 10 years ago.

MAY

*President Bush and Senator Bill Frist (R-TN) issue statements supporting a total ban on all human cloning-reproductive and therapeutic. Forty US Nobel Laureates sign joint statement supporting therapeutic cloning in transplantation for research.

*Chinese surgeons perform the world's first whole ovary transplant.

*The American Society of Transplant Surgeons' ethics committee endorses a pilot program to see if offering a small financial incentive to donor families in the form of a funeral benefit might increase their willingness to donate.

*Bill Anderson, CEO of LifeNet, dies of injuries sustained in a car crash in North Carolina. He becomes an organ donor.

*The Coalition on Donation launches its first ever organ donation campaign aimed at the Hispanic community.

JUNE

* Senator Susan Collins (R-ME) introduces legislation aimed at significantly increasing the federal government's regulatory oversight of the US tissue banking industry.

*The American Medical Association (AMA), and the Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing (UNOS) Board of Directors join the American Society of Transplant Surgeons (ASTS) in supporting the study of offering financial incentives to increase organ donation.

*The American College of Surgeons expresses "grave concern about the public discussion of payment for organ donations," says "valid studies" needed as part of a "real attempt to find valid solutions to the problem of organ donation without making the issue one of compensation."

*CryoLife, Inc., Atlanta, GA, receives a warning letter from the Food and Drug Administration (FDA) after an inspection of the company's human tissue processing laboratories. Company says it will comply with FDA recommendation on improving quality control.

JULY

*University of Michigan researchers report developing a procedure known as extracorporeal membrane oxygenation (ECMO) that allows donors' blood to run through a machine that oxygenates it and pumps it back into the body to support non-heart-beating donation.

*The Association of Organ Procurement Organizations reports that while number of potential organ donors in the US has stabilized-11,000 to 14,000 annually--less than half become donors and minority donation continues to lag with about 1 in 4 donating.

*Mount Sinai Hospital reopens liver transplant program, says first year residents will no longer work on the transplant service, 2 health care practitioners will be assigned to the transplant unit at all times, and all pages from the unit will have to be answered within 5 minutes.

*CryoLife is hit with 7 separate lawsuits over the death of Minnesota man following knee surgery attributed to tainted tissue. Also subject of class action lawsuit alleging the company knowingly made false and misleading statements regarding its quality control problems.

AUGUST

*The Centers for Disease Control and Prevention (CDC) reports three transplant athletes and dozens of other people who attended the US Transplant Games held in June at Disney's Wide World of Sports Complex in Lake Buena Vista, FL are suffering from salmonella.

*A federal jury finds that Abbott Laboratories, Abbott Park, IL infringed on a patent of Novartis Pharmaceuticals, East Hanover, NJ when it marketed a generic version of Neoral.

*Scientists at PPL Therapeutics produce the world's first double gene "knock-out" piglets. Four healthy piglets are born without the gene--alpha 1, 3 galactose- responsible for making an enzyme that adds sugar to the surface of pig cells that leads to hyperacute rejection of the pig organ.

SEPTEMBER

*All US organ procurement organizations (OPO) and transplant centers are put on alert to the risks of West Nile Virus following confirmation that 4 transplant recipients have contracted the illness. The US Department of Health and Human Services issues the alert after it determines the West Nile virus infection could have been contracted from an infected organ donor.

*California adopts a law permitting embryonic stem cell research involving both the destruction and donation of human embryos. The action sets up a potential clash with the federal government policy that allows federal funding of a restricted number of stem cell lines.

*A new study finds that more than 40% of lungs rejected for transplantation may actually be transplantable.

OCTOBER

*US researchers report their study of 305 paid donors in India reveals there is little long-term financial gain and donors often experience health problems. A small study in Great Britain that finds almost half of 29 UK patients who traveled abroad and paid for a kidney in recent years subsequently died.

*The National Kidney Foundation (NKF) Board of Director's votes unanimously to oppose any effort in the US to allow for even the testing of offering a financial incentive to donate, vows to take fight against incentives to Congress.

*Five of 6 organ transplant recipients who received organs donated by an Oregon man who died 2 years ago with undiagnosed case of hepatitis C die, one from liver disease which may have originated from the donor.

Government officials say the donor was properly tested for HCV but probably slipped through the 6 to 8 week window in which an infected donor can appear to be healthy. Two lawsuits filed against the agencies that provided the organs and tissue.

*Health officials in the US and France suspend several studies on gene therapy experiments because the treatment which cured a 3-year-old French boy of severe combined immunodeficiency (SCID) i.e. "bubble boy disease," may be responsible for giving him a leukemia-like disease.

*Government Accounting Office issues a report showing that members of racial and ethnic minorities continue to have a harder time than Caucasians in getting an unrelated bone marrow transplant in the US despite a 10-fold increase in minority donors in the past 10 years.

NOVEMBER

*HHS Secretary Thompson's Advisory Committee on Transplantation (ACOT) recommends a detailed set of standards for the transplant community to follow for live organ donors. The committee emphasizes that all live donors must undergo a thorough consent process, be provided with a donor advocate, and be enrolled in a national registry.

*The NIH selects 10 US transplant centers to participate in a 7-year Adult to Adult Living Donor Liver Transplant Cohort Study. One area of study includes comparing outcomes of patients receiving a liver from a live donor compared to those who receive livers from cadavers.

*World's first trachea transplant performed at the San Vicente de Paul University Hospital in Medellin, Columbia.

*Thoratec gets FDA approval to market LVAS HeartMate for permanent support for end-stage heart failure patients who are not eligible for heart transplants.

*Widow of an artificial heart implant recipient who died 10 months after receiving the implant files a lawsuit against Abiomed, Inc., the maker of the device.

*UNOS/OPTN board votes to reduce importance of HLA matching in deciding who gets organs in effort to remove an important bias against minority candidates on the kidney transplant waiting list.

*Great Britain's National Health Services says it is seriously looking into lifting a ban on providing financial compensation for live organ donors.

DECEMBER

*US Supreme Court refusal to block a lawsuit alleging the Los Angeles County Coroner's office improperly removed the corneas of dead children without first obtaining parental consent raises fears in transplant community that a harmful precedent could be set affecting future medical examiner laws nationwide.

*Italian fertility expert Severino Antinori, MD, claims a woman pregnant with a cloned embryo will give birth in January 2003.

*British transplant surgeon says development of new immunosuppressive regimens make full face transplants a viable option if donors can be found.
COPYRIGHT 2002 Transplant Communications, Inc.
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Article Details
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Author:Warren, Jim
Publication:Transplant News
Geographic Code:1USA
Date:Dec 27, 2002
Words:2243
Previous Article:Stanford University to create $120 million stem cell research institute.
Next Article:FDA approves tissue forming drug to treat osterporosis.
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