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Organ
Transplants Reclaim Lives
By Goody L.
Solomon
Amy
Luxnor, age 33, has been living with a transplanted
heart for seven and a half years, and “I plan to live to old age,” she said in
an interview. She needed the
replacement because hers became infected with inherited tumors.
Pearl Lambert, 56 years, in 2002 received a chunk of her
daughter’s liver, and says she is doing very well. Daughter Vicki, now 39,
said, she has had no ill effects. “I am very healthy.”
Organ transplantation is a medical marvel that warrants
more attention. Last year a record
of 27,033 transplant operations topped the number in 1994 by 10.8 percent. A new record is expected in 2006,
judging from the organ donations through May, said Cindy Speas, director of
community affairs, Washington Regional Transplant Consortium. Survival rates
have risen as well as operations.
A major problem exists, however, in that significant organ shortages
prevail. More about that in a moment.
Since 1954, when kidney transplants gave life to dying
patients, doctors have learned to transplant other organs, and “surgical
techniques have pushed the envelope to provide living donor transplants,” to
quote Amy Lu, MD, director of kidney and pancreas transplantation, Georgetown
University Hospital. Preservation solutions enable organs to be stored and moved
across state lines, she added, while improved medicines “keep the patient and
graft alive for much longer. Rates of rejection are less than
10 percent compared to 50 percent” years ago. Credit improved antibiotics, too, with
raising survival by controlling infections.
Physicians today have an expanding arsenal of meds from
which to choose the best for a particular organ and particular patient,
according to Randall Morris, MD, director, Laboratory Transplantation
Immunology, Novartis Pharma AG,
To
illustrate, cyclosporine, which debuted in 1983 as Sandimune, is now available in several versions having
different bioavailability. One called Neoral, may
increase the risk of infection but has been connected to fewer incidents of
diabetes in kidney transplant patients compared to Prograf (also called tacrolimus).
Diabetes is a leading heart disease risk in transplant patients. CellCept (micophenolate mofetil or MMF) fights rejection in a different way than
cyclosporine, and the two may be used together when organ rejection is a high
risk. In kidney patients, however,
CellCept can cause gastrointestinal side effects, and myfortic (mycophenolic acid or MPA), approved in 2004, might be chosen
instead, since a study reported July 2006 linked it to a reduction in GI
symptoms and severity, notably in African Americans. Ongoing research promises to yield drugs
that will be more effective in lower doses, will be needed for shorter periods,
and will have fewer side effects.
Now we come to that obstacle of too few organ donations. Patients often
wait months, even years, for a chance at recovery – and sometimes they can’t
hold on. Luxmor was on the top of the waiting list,
yet spent eight months in the hospital on a so-called Left Ventricular Assist
Device until a heart became available from a 13-year-old boy who died in a car
accident. An estimated 92,000 people are waiting for an organ transplant and 18
will die while waiting reports the U.S. Department of Health and Human
Services.
Only two-thirds (62 percent) of U.S. adults wish to donate at least one
of their organs or tissue, according to a survey by Donate Life America
(formerly the Coalition on Donation), an alliance of organizations around the
country seeking to inspire more individuals to promise to give body parts after
death. The coalition sponsors educational campaigns that strive to allay fears
and answer questions – explaining, for instance, that an open casket is possible
for a person who has given an organ.
Apparently everyone – regardless of age -- has at least
one body part that can be salvaged. Consider Jessica Ward, who died at age 19 of
a seizure disorder she had from birth.
She could not give major organs “as her heart had stopped,” explained her
mother Jeanne Ward. “She donated
arteries leading to the heart for patients with congestive heart failure; the
pericardia (the sac the heart sits in), which is used for patients with brain
surgery to cover the opening for that; bones in both arms from the wrist to the
elbow, and her leg bones. She also donated her Achilles tendon and skin for burn
victims.”
The
agency through which the donations were made and distributed reported, “Jessica
helped 23 lives in various states,” said Ward. “That helps us because Jessica was a
loving and giving person. My
husband and my daughters were so glad to know someone else’s life was saved or
enhanced by her donations,” said Ward.
Several websites have good information about how and why to donate
organs: ustransplant.org, unos.org, donatelife.net,
hrsa.gov.
Goody L. Solomon is Executive Editor, FNH
News Service,
Can That Fresh
Red Color on Meat Be Deceiving Us?
By Goody L.
Solomon
When choosing meat in the grocery store, do you look for a bright red
color as a sign of freshness? Of
course, you do. In random
interviews, friends, shoppers and family said they do, too.
Red
color is such a universal standard for fresh meat that processors Pactiv Corp.,
Precept Foods, Inc. (a joint venture of Hormel and Cargill) and Tyson’s, among
others, _ obtained FDA permission to use carbon monoxide to maintain the red
color in fresh packaged meat also known as modified atmosphere packaging. Technically, the agency classes the
substance Generally Recognized As Safe, or GRAS.
But
whoa, call out certain industry sources and consumer advocates; that red color
could be deceptive because it could hide harmful bacteria that
turns meat brown.
Kalsec
Corporation, which supplies ingredients such as spices and colors, petitioned
FDA November 15, 2005, to withdraw its GRAS approval. The company argues the law
requires carbon monoxide in fresh packed meat to be regulated as a color
additive, which must go through a long and detailed approval process. “This is a
new pigment being formed,” said Don Berdahl, Ph.D.,
Kalsec vice president and technical director, in an
interview.
Paprika extract, Berdahl
added, has GRAS status but cannot go into fresh meat because of the potential
for consumer deception. “We don’t
think it is right to put carbon monoxide into meat to do the same thing as
paprika.”
Consumer Federation of America and Safe Tables Our Priority (S.T.O.P.)
sent a letter to FDA January 17, 2006, similarly urging the agency to rescind
its GRAS approval for carbon monoxide in fresh meat. “Carbon monoxide masks the
natural coloration of meat by reacting with myoglobin
in the meat and producing a bright red color…(that) has
been found to last ‘beyond the time of spoilage’.”
The Agriculture Department concurs with FDA. Robert Post, director,
labeling and consumer protection staff of the Department’s Food Safety and
Information Service, said, “The color changes the same as in an untreated
product.” Spokesmen for both departments said meat could be wholesome though
brown in color, and odor is a more telling sign of
spoilage.
Retailers and beef producers side with the feds. A study
by the National Cattlemen’s Beef Association found carbon monoxide in modified
atmosphere packages contributes to longer shelf life of T-bone steaks, sirloin
steaks and ground beef patties, and thereby prevents losses at retail.
“
Here
in Washington, Barry Scher, spokesman for Giant Foods,
said, “We have stringent regulations of our own to make sure meat sold is
fresh.”
Bottom line for consumers? Pay attention to the
Use By dates required on meat packages by FDA and USDA. Kalsec’s Berdahl said , “I have a package in the refrigerator with a Use By of
November 26, 2005, and it is as bright red as when first packaged…FDA has not
asked companies to study extended life in consumer refrigerator beyond the
date.”
.