A new liver transplant method adds a new facet to the term "going green". The method of re-seeding liver cells, essentially a form of bio-re-hauling, may become a promising option for patients in need of liver transplants.

Researchers from Massachusetts General Hospital’s Center for Engineering cleared live cells from liver tissue to leave a framework. They “re-seeded” healthy liver tissue into the framework, where tissues eventually regenerated.

The goal is for the tissue to attach to host tissues, where it would take root and redevelop unhealthy tissue. Although experimentation is in its early stages, the method was successful in laboratory rats.

“As far as we know, a transplantable liver graft has never been constructed in a laboratory setting before,” lead researcher Dr. Korkut Uygun told BBC News.

If it proved effective in humans, it could be a realistic answer to the donor organ shortage. Roughly 15,000 people are in need of a new liver each year, while the actual number available is a mere 4,500. This method could help make previously rejected organs acceptable for transplant.

“We haven’t been able to go beyond several hours in the rats,” Uygun says, “but it’s a great start.”

Want to know more? See Uygun’s article in Nature Medicine.

 

’Tis the season for giving, and some people are taking it to the extreme. Thirteen people donated their kidneys for what they’re calling a “kidney swap.” Donors had nothing to gain, but because of their generosity 13 lucky recipients have a little extra to be merry about this Christmas.

 

End-stage renal disease, also known as kidney failure, can’t be treated with medication. When the kidneys cannot function, the body can’t filter out its wastes, and the person will eventually die. The only way for a person to survive this condition is to undergo dialysis or receive a kidney transplant.

 

This is one of the largest kidney swaps that’s ever occurred, the Associated Press reported. Donations such as this do more than just help the kidney recipients. They cut the wait list and give hope to the entire pool of patients who need kidneys.

 

Transplants are very complicated procedures, and much of the difficulty lies in finding a compatible donor. In the United States, nearly 105,000 people are waiting for an organ transplant. It is estimated that another 4,000 are added each month.

 

Patients waiting for an organ must register with the National Organ Procurement and Transplantation Network (OPTN). This registry helps match patients with the most compatible donors. The shortage of kidneys makes this process extremely difficult, and only a small number of patients are ever lucky enough to receive one.

 

Finding a compatible donor can take years. Because of the donation, however, the wait was cut significantly. Doctors from Georgetown University Hospital and Washington Hospital Center completed the 26 operations in just six days.

 

Five of the recipients needed to undergo a procedure known as plasmapheresis, a process of filtering the blood to retain antibodies that will keep the body from rejecting the kidney. All of the donations were life-saving operations.

 

"People keep wanting to know why, why, why," donor Sylvia Glaser, 69, says. "It sounds very trite but you pass through this world, and what do you ever do that makes a difference? You are giving someone a life, and there is no substitute for that."

 

Although they were complete strangers prior to the donation, donors and recipients were finally able to meet for the first time this Tuesday.

Early obesity in women may be linked with difficulty in becoming pregnant. Women who became obese by age 18 and participated in a weight-loss surgery study showed higher rates of infertility and polycystic ovarian syndrome (PCOS).

Forty-two percent of the women in the study trying to conceive experienced infertility, but pregnancy was more likely for women who became obese after age 18. The good news is, surgical weight loss may increase fertility.

The study, the Longitudinal Assessment of Bariatric Surgery (LABS), provided information on the fertility of obese women considering surgical weight loss procedures.

Obesity can interfere with a woman’s hormone levels, making it difficult to become pregnant. This also makes vitro procedures less likely to work. Even in the event of conception, there are major health risks to both mother and child. Not only are miscarriage rates higher, but there are also a higher rates of premature and still-births.

Weight loss surgery, also known as bariatric or metabolic surgery, which includes gastric bypass surgery and lap banding, may help obese women trying to conceive. Many women don't know that having such a procedure is an option.

Research shows that bariatric surgery can reduce pregnancy complications for obese women, and LABS participants were no exception. Roughly 62 percent of LABS participants who underwent surgery who hoped to conceive experienced at least one live birth after infertility.

After weight loss surgery, doctors advise women to wait at least 18 months after surgery (6 months after banding) before trying to become pregnant. They also suggest using contraceptives while waiting for the body to become more stable.

“As the incidence of obesity increases in the United States, women’s health care practitioners are likely to care for a substantial number of patients who will undergo bariatric surgery,” says Dr. William Gibbons of the American Society for Reproductive Medicine. “Studies like this one are extremely useful to help us determine how to advise these patients and best meet their needs.”

Find more information about pregnancy after bariatric surgery, or test your knowledge with Healia’s Pregnancy Quiz.

It may be in your best interest to postpone surgery until regular OR hours. According to a study appearing in The Journal of Bone and Joint Surgery, patients with after-hours operations have 24 percent more unplanned follow-up operations than those who went under the knife during regular office hours.

“Although everyone wants to be treated immediately… it is not always best to rush a patient to the OR in the middle of the night,” explains Dr. William M. Ricci MD, Associate Professor of Orthopaedic Surgery at the Washington University School of Medicine.

The study followed 203 patients who underwent orthopaedic surgery—surgery on bones and joints. While there was no significant difference between radiation exposure, healing time or actual treatment, there was a noticeable disparity between operations that occurred between the daytime and nighttime shifts.

All operations used intramedullary nail fixation to mend tibial or femoral fractures. This is a procedure in which a rod, or “nail”, is used to set the bone. The day was divided into two shifts—the morning shift between 6:00 a.m. and 4:00 p.m., and the night shift thereafter.

Second shift patients had shorter operations, but they also had more follow-up operations and more nail removal surgeries—27percent versus 3 percent for patients whose surgeries occurred during regular office hours. Dr. Ricci believes that much of this can be attributed to the long hours many surgeons put in.

“The reality is that the on-call night surgical team may not be well rested as it is likely they had just finished a normal day shift,” Ricci says. Ricci, who is also chief of the Orthopaedic Trauma Service in the Department of Orthopaedic Surgery at W.U., also explains why non-emergency operations should wait.

“We in the healthcare industry don’t have unlimited resources,” Ricci says. “Many hospitals in the U.S. do have a dedicated night team of orthopaedic surgeons who otherwise are without daytime responsibilities. There are surgical teams on-call for those instances when treatment must be immediate.”

Ricci believes giving orthopaedic surgeons more time to operate on trauma patients can help reduce the risk of minor complications from nail fixation surgeries. He encourages patients to wait for surgery if possible, but insists that actions be taken immediately in urgent situations: “Naturally, when the medical condition is emergent and time is a critical factor, immediate surgery should proceed regardless of time of day.”

Older men who use drugs to treat urinary retention may be at higher risk for complications following cataract surgery, according to a new study published in The Journal of the American Medical Association. The researchers reported that men who use tamsulosin hydrochloride are more than twice as likely to develop serious complications following cataract surgery than those who do not take the medication.

Tamsulosin hydrochloride treats urinary problems caused by an enlarged prostate by relaxing prostate and bladder smooth muscle tissue, allowing urine to be more easily expelled. But the study found that the medication also relaxes the smooth muscle in the eye’s iris. This can lead to iris detachment and swelling of the eye, causing complications during surgery.

Patients who had taken tamsulosin hydrochloride within two weeks of the date of cataract surgery were at the highest risk for complications. Patients who had taken the drug in the past, but not within 14 days of the operation, were significantly less likely to experience adverse events following surgery.

Nearly three quarters of men have enlarged prostates that effect urination by the time they are 70 years old. Tamsulosin hydrochloride is a commonly prescribed treatment for the condition. However, many older males also develop cataracts for which surgical intervention is recommended. To avoid complications during surgery, the researchers recommend patients tell their doctors about any urinary medications they are currently using.

To talk to other patients with enlarged prostates, contribute to the Healia Prostate Diseases Online Health Community and Support Group. Visit the Healia Cataracts Online Health Community and Support Group to share your cataract story.


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