WCTF.org Transplant News

Regulators are exploring whether organ transplant drugs made by Roche and Novartis increase the risk of an often-fatal neurological disease. The Food and Drug Administration said Thursday it has identified 16 cases of patients developing the rare neurological ailment while taking Roche's drug CellCept, which is used to avoid rejection in organ transplant patients. U.S. regulators approved ... [full story]

Transplant Information Line. Make a referral. Make an appointment. Get more information. 800-605-6175 [continued]

Man Needing Transplant Offered Seven Livers (WSB-TV 2 Atlanta)
A professor in need of a organ transplant to replace his illness-damaged liver is offered help from seven different potential donors.

New Montefiore Program Targets Elder Abuse and Neglect

Victims Evaluated; Physicians Trained to Identify Abuse

NEW YORK, April 10 /PRNewswire-USNewswire/ -- Montefiore Medical Center has launched a clinical, educational and research initiative to tackle the growing problem of elder abuse and neglect with the support of a one-year, $150,000 grant from the Caring Commission of UJA-Federation of New York, with the potential for an additional $300,000 over the next two years.

"There are about 140,000 elderly in the Bronx and many of them are vulnerable to elder abuse and neglect due to social isolation, cognitive impairment and/or physical frailty," says Laurie Jacobs, MD, chief of Geriatric Medicine at Montefiore. "Our goals are to provide better care for the victims of abuse, to train our physicians and care givers to identify abuse and to track the frequency and types of elder abuse for policy purposes."

Geriatric Consultation Team

The grant-supported initiative was recently launched when Montefiore established a special consultative team to help physicians and other clinicians evaluate suspected older adult victims of abuse and to help link them to community-based services for social and legal assistance. The team, under the direction of Karin Ouchida, MD, a geriatrician, has been called in on a referral basis for over a dozen cases at Montefiore's inpatient and outpatient facilities, and for patients in the community.

"Victims of elder abuse and neglect are often isolated, and physicians are among the only people they may trust or confide in," says Dr. Ouchida. "Most physicians have not been trained to identify elder abuse and neglect, and need to acquire the skills to elicit relevant information not only about their patients' physical condition, but also about attendant quality of life issues."

Training Physicians to Recognize Abuse

To address this educational gap among physicians, the initiative trained Montefiore's geriatric and geriatric psychiatry attendings and fellows to identify and evaluate elder abuse and neglect. Through their participation on the consultation team, these physicians can provide critical recommendations for the care and management of both victims and caregivers. Programs will soon be underway to train residents and other health care personnel as well. This April, monthly workshops to train medical students from the Albert Einstein College of Medicine will begin. Ultimately, the program will train all 180 medical students who rotate through Montefiore each year.

Abuse vs. Neglect: Tracking Frequencies

"Serious elder mistreatment may be missed if too narrowly defined as physical abuse," says Ouchida. "While we treat frail elders who are victims of threats or physical violence from caregivers with mental health or substance abuse problems, these cases are typically outnumbered by those involving neglect. At the heart of many neglect cases lies a critical mismatch between a patient's basic needs for nourishment, medications and hygiene and the caregiver's ability to meet those needs. An elderly woman who cared for her demented husband for twenty years may no longer be able to provide adequate support and supervision when her own cognitive and physical impairments worsen. In this example, the solution is not to assign blame but to provide assistance to both parties."

To get a handle on the frequency and types of elder abuse and neglect, Montefiore researchers will be tracking the cases they identify, with the aim of expanding services in the Bronx and advocating for improvements in policy.

Montefiore's Division of Geriatrics

Montefiore's Division of Geriatrics is uniquely qualified to undertake this project since it provides service across a broad spectrum of geriatric care: medical home visits, ambulatory care, long term care and acute care. Along with its partner, the Albert Einstein College of Medicine, it also has very robust education and training programs in geriatric medicine for physicians at all levels of training. In addition, the physicians are engaged in clinical research activities centered on many of the problems the elderly face such as medication management, clinical decision-making, osteoporosis, and home safety.

National and New York City Statistics

The National Elder Abuse Incidence Study found that over 550,000 adults aged 60 and over experienced abuse or neglect in domestic settings in 1996, yet only 21 percent were reported to and substantiated by Adult Protective Service agencies. The Department for the Aging estimates there are 50,000 cases of elder abuse each year in New York City.

Montefiore Medical Center encompasses 124 years of innovative medical "firsts," pioneering clinical research, outstanding patient care, dedicated community service and ground-breaking social activism.

A full-service, integrated delivery system caring for patients in the New York metropolitan region and beyond, Montefiore is a 1,122-bed medical center that includes: three hospitals -- the Henry and Lucy Moses Division, the Jack D. Weiler Division and The Children's Hospital at Montefiore; a large home healthcare agency; the largest school health program in the US; a 21-site medical group practice integrated throughout the Bronx and Westchester; and a care management organization providing services to 179,000 health plan members.

The medical center is ranked by the prestigious Leapfrog Group among the top one percent of all U.S. hospitals based on its strategic investments in sophisticated and integrated healthcare technology.

Montefiore's distinguished centers of excellence include cardiology and cardiac surgery, cancer care, tissue and organ transplantation, children's health, women's health, surgery and the surgical subspecialties. Montefiore, the University Hospital for the Albert Einstein College of Medicine, is a national leader in the treatment of diabetes, headaches, obesity, cough and sleep disorders, geriatrics and geriatric psychiatry, neurology and neurosurgery, adolescent and family medicine, HIV/AIDS and social and environmental medicine, among many other specialties. For more information, please visit our websites www.montefiore.org or www.montekids.org.

First Call Analyst:
FCMN Contact:

Source: Montefiore Medical Center

CONTACT: Steven Osborne, sosborne@montefiore.org, or Mike Quane,
mquane@montefiore.org, both of Montefiore Medical Center, +1-718-920-4011

Web Site:

http://www.montefiore.org/
http://www.montekids.org/

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Profile: Transplant News

Prospective Microbial Analysis of Bronchoalveolar Lavage Fluids with Immune Function Testing Can Distinguish Between Fungal Colonization and Fungal Disease In Lung Transplant Recipients

/CAUTION -- ADVANCE FOR RELEASE AT 4 P.M. EDT TODAY/

Data from 150 lung transplant patients demonstrates potential to improve management of risk for infection

/ADVANCE/ BOSTON, April 10 /PRNewswire/ -- A prospective analysis of data collected from 170 patients receiving lung transplantation at the University of Pittsburgh Medical Center (UPMC) has suggested that the ImmuKnow(R) assay of cell-mediated immunity (CMI), when combined with microbial analysis of bronchoalveolar (BAL) fluids in immunosuppressed patients, can help to differentiate between patients with fungal colonization and those patients with active fungal infections. These data were presented in an oral session today by Shahid Husain, MD at the annual meeting of the International Society for Heart and Lung Transplantation (ISHLT) in Boston, MA.

"Our hypothesis was that global immunoreactivity, as measured prospectively using the ImmuKnow assay of CMI, would be different for patients with fungal colonization as compared to patients with true fungal infections," said Dr. Husain. "This hypothesis appears to have been borne out by our preliminary results."

"Our study has shown that ImmuKnow values are significantly different for patients with fungal colonization as compared to patients with true fungal infections six months after transplantation," Husain continued.

Data were collected prospectively from 170 lung transplant recipients at UPMC between 2003 and 2006. These patients provided a total of 712 blood samples for analysis, while also being prospectively monitored and classified for episodes of infection according to standardized criteria.

All patients received alemtuzumab induction and tacrolimus suppression to prevent organ rejection. Results of ImmuKnow assays of CMI were included in the analysis if and when they were obtained within 30 days of a documented episode of clinical syndrome (fungal colonization/fungal disease).

In the initial 6-month period following T-cell depletion (while patients were still receiving prophylaxis), the investigators observed no statistical differences between measures of CMI and clinical condition of the patients. However, beginning six months after transplantation, when prophylaxis was stopped, there were significant differences in CMI between clinically stable patients (188 ng/mL ATP) and those with evident infections documented by microbial analysis of BAL (91 ng/mL ATP; p < 0.001). The median ImmuKnow measure of CMI based on samples from 45 patients diagnosed with fungal colonization (but no clinical infection) was 188 ng/mL ATP, which was not significantly different from the median value of samples from all clinically stable patients. However, this CMI value was significantly higher than the value in the six transplant patients with fungal disease (78 ng/mL ATP; p < 0.01).

"This study expands our understanding of the applicability of the ImmuKnow immune function assay in effective management of lung transplant recipients in the post-transplant setting," stated Dr. Husain. "While we had demonstrated an association between infection and low ImmuKnow values in an earlier study, we now have specific preliminary prospective evidence that will guide us in predicting risk for fungal infection in these immune-suppressed patients over time."

Dr. Husain's presentation was entitled, "Use of an immune monitoring assay to distinguish between fungal colonization and fungal disease in lung transplant recipients." Dr. Husain is currently Assistant Professor of Medicine and Director of Transplant Infectious Diseases in the Division of Infectious Diseases and Multi-Organ Transplantation, Toronto General Hospital-University Health Network, Toronto, Canada.

About ImmuKnow(R)

ImmuKnow is an immune cell function assay that can detect cell-mediated immunity (CMI) in adult immunosuppressed patients by measuring the concentration of adenosine triphosphate (ATP) released from CD4 cells following cell stimulation.

The ImmuKnow test is a qualitative assay and does not directly quantify the level of immunosuppression.

Results of ImmuKnow assays should be used in conjunction with clinical presentation, medical history, and other clinical indicators when assessing the immune status of any individual patient. The use of the ImmuKnow assay as described in this study has not been cleared by the FDA. The company may use data from this study or similar studies to support a future FDA marketing application for a similar indication.

ImmuKnow is a product of Cylex(TM), a privately held global life sciences company and the leader in the development and manufacture of research and in vitro diagnostic products intended to assist in the assessment of immune function.

About Cylex(TM) Inc.

Cylex(TM) is a privately held global life sciences company that is the leader in the development and manufacture of in vitro diagnostic products that are intended to illuminate immunity. ImmuKnow(R) is the in vitro diagnostic utilized to detect cell-mediated immunity (CMI) in an immunosuppressed population, and is increasingly being adopted at organ transplant centers throughout the US and abroad. The Company's patented technology provides an innovative platform allowing clinical researchers to simply and reproducibly measure CMI for the development of new diagnostics, biomarkers and companion assays. The Company is based in Columbia, MD.

First Call Analyst:
FCMN Contact:

Source: Cylex

CONTACT: Lynn Shepherd, +1-267-250-7376, lshepherd@voxmedica.com or
Ketura Lispi, +1-215-925-9901, klispi@voxmedica.com, both of Vox Medica for
Cylex

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Profile: Transplant News

MASONS GIVE U OF MINNESOTA $65 MILLION FOR CANCER RESEARCH

Largest gift ever to U of M brings total giving from Masons to $100 million

MINNEAPOLIS/ST. PAUL, Minn., April 10 /PRNewswire/ -- The University of Minnesota has received its largest gift ever -- $65 million from Minnesota Masonic Charities -- to the University of Minnesota Cancer Center. With this pledge, Masonic support of cancer research and care at the University of Minnesota over the past 53 years totals $100 million. In recognition of this record-breaking gift, the University of Minnesota Cancer Center will now be called the Masonic Cancer Center, University of Minnesota.

"The Masonic Fraternity is proud to expand its partnership with the Masonic Cancer Center for a cure. The gift is new, but the giving is not," said Raymond G. Christensen, M.D., Grand Master of the state's nearly 17,000 Masons.

"The Masons' legacy of giving to cancer research at the University of Minnesota has transformed our ability to find cures and better ways of preventing, diagnosing, and treating cancer," said University President Robert Bruininks.

The $65 million over 15 years will allow the Masonic Cancer Center to expand its work, including bringing research to clinical practice for improved cancer prevention, diagnosis, and treatment. Researchers will also be able to expand studies of cancer survivorship to better understand and address care for people living with cancer.

"Our continued partnership with Minnesota Masonic Charities and this extremely generous gift will allow us to take the Masonic Cancer Center to the next level," said Douglas Yee, M.D., director. "We will be able to significantly expand our capabilities in cancer research and treatment. We thank the Masons for their confidence in us."

Highlights of the Masons' legacy of support include $1 million to build the Masonic Memorial Hospital, which admitted its first patient in 1958. The building still stands today as a cancer clinic and general research building. Since then, Minnesota Masons and members of the Order of the Eastern Star have generously provided $35 million to support cancer research and patient care, including a $10 million pledge to build a new state-of-the-art cancer clinic. Additional support was given to build the Masonic Cancer Research Building. That four-story building, completed in 1996, is home to the newly renamed Masonic Cancer Center, one of just 39 comprehensive cancer centers recognized by the National Cancer Institute (NCI) -- and the only one in the Twin Cities area. This highest level designation is awarded to institutions that make ongoing, significant advances in cancer research, treatment, and education.

The Masonic Cancer Center was founded in 1991 to provide a collaborative environment for researchers to work on the causes, prevention, detection, and treatment of cancer. Its several hundred members are some of the world's leaders in research on bone marrow transplantation, childhood cancers, cancers of the breast and bone, cancer genetics, tobacco research, immunology, new treatment development, and epidemiology.

Masons belong to the world's oldest and largest fraternal society. Minnesota Masonic Charities makes charitable contributions averaging nearly $5.6 million a year, as part of annual services totaling nearly $70 million. They made the current $65 million gift to the university through the Minnesota Medical Foundation, which raises funds for the University's Cancer Center, Medical School, School of Public Health, and related areas in the Academic Health Center.

Contact: Molly Portz, Academic Health Center, (612) 625-2640

Patty Mattern, University of Minnesota, (612) 624-2801

First Call Analyst:
FCMN Contact:

Source: The University of Minnesota

CONTACT: Molly Portz of Academic Health Center, +1-612-625-2640; or
Patty Mattern of The University of Minnesota, +1-612-624-2801

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Profile: Transplant News

Every 11 minutes, another name is added to the list of Americans who need an organ transplant. [full story]

A good preoperative evaluation allows the anesthetist to assess different medical conditions, to evaluate risk factors and to educate the patient before anesthesia and surgery. [read more]

Until the autopsy results for 15-year-old donor Alex Koehne came back, Gerardo Trueba was enjoying a new lease on life. [full story]