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  • 21 Jan 2020 2:58 PM | Cathy Teal (Administrator)

    This Machine Keeps Livers Alive for a Week Outside the Body

    And it could possibly bring bad livers back to life.


    By Caroline Delbert

    Jan 14, 2020

    New Atlas reports that scientists have a new way to keep livers alive for a week—and maybe to bring unfit livers back to life. The solution is a machine that mimics human body functions, which lets the liver continue to work like usual.

    Scientists hope this machine can extend viability for all livers and model a solution for other organs. More importantly, the machine can let livers restore themselves to health after damaging car crashes and other injuries that would take the organs of the running for transplant.

    The team of researchers responsible for the liver machine, all based in institutions in Zurich, has been building it since 2015. Existing, approved technology for livers keeps them alive for up to 24 hours, and supercooling has extended that to 27 hours, the team explains in its paper. Indeed, an increase of 12.5 percent is huge in the world of organ transplants, where organs must be harvested, transported, and implanted during potentially long surgeries.

    The existing technology works through perfusion, which is keeping the liver’s blood vessels open and active with a circulation of body-temperature blood or oxygenated blood replacement-type fluid. The Zurich team saw an opportunity to take simple perfusion and turn it into something more robust “by engineering a perfusion machine that [mimics] additional core body functions that are critical to liver health.”


    By choosing a goal of one week, the team aimed to give livers enough time to self repair and regenerate from damage, whether in the form of a traumatic injury in a deceased donor or a patient whose liver is being partly reduced or resectioned because of illness or other damage.

    The scientists' system of artificial organs comprising a complete liver-rejuvenating system includes what you’d guess: heart, pancreas, lung, kidneys, and bowels are modeled with things like oxygen pumps and added nutrients. There are also surprises, like basically a whoopie cushion that inflates and deflates to mimic how the diaphragm keeps the liver muscle itself exercised and stimulated inside our bodies. The team found this regular motion is part of what prevents necrosis in the liver.

    When a liver is injured, there are chemical and physiological markers. In this research, the scientists wanted to quantify how injured livers improved during the weeklong perfusion period, so they measured markers called DAMPs. The NIH explains what DAMPs are: “Damage-associated molecular patterns are endogenous danger molecules that are released from damaged or dying cells and activate the innate immune system.”

    Indeed, even if the liver could repair itself over time, the immune reaction triggered by DAMPs could be much more dangerous in a transplant recipient. The Zurich team received 10 livers that were too damaged to be transplanted and placed them in the perfusion setup.

    “We found that six of the livers, which we numbered 1 to 6, demonstrated a decrease in injury and inflammation markers and DAMPS. [...] Livers 1 to 6 were maintained viable for the targeted time period of 1 week, while livers 7 to 10 failed to reach this objective, showing ongoing cell death and signs of liver failure.”

    The livers that survived and bounced back had different kinds of injuries and damage, the team concluded. In application, this could mean injured livers all spend a few days in a perfusion system—like life support during a time when they can potentially recover. The livers that don’t recover will have things in common that help scientists better screen livers and improve perfusion going forward. Even a larger group of rejected livers with more consistent age grouping and other factors would help the Zurich team take the next step with its research.

    This kind of technology is so exciting, but it’s also extremely far removed from use in real patients. Having a working prototype and preliminary study results, however, is a big step. The improvement from 24 to 27 hours made a 12.5 percent difference and a big impact; a 600 percent improvement is certainly worth looking into.

  • 28 Dec 2019 10:10 AM | Cathy Teal (Administrator)

    America needs more live kidney donors. A good start would be to stop penalizing them. By 

    Editorial Board July 29, 2019, 9:30 AM CDT

    It’s illegal to pay for a human kidney, but it’s perfectly fine to beg for one. So if you’ve driven through Alabama, Indiana, South Carolina, Manhattan or Los Angeles recently, you may have seen billboards taken out by patients urging passers-by to part with their kidneys. Hundreds more patients seek living donors online; others search abroad (often with grim results). 

    There just aren’t enough organs to go around. For every 1,000 Americans who pledge to donate their kidneys after death, only three die in a way that permits a transplant. That frees up about 14,000 kidneys a year — about one for every seven people on the 90,000-strong transplant waiting list. The longer they wait — five years, on average — the sicker they get. Every day, some 13 people die waiting.

    The Wrong Way to Leave the Organ Transplant List

    Almost one-third of the people removed from the kidney transplant waitlist in 2017 died or grew too sick for surgery during their wait.

    Source: OPTN/SRTR Annual Data Report 2017

    "Other" includes patients who refused transplants, recovered without them, or traveled outside the U.S. to receive them.

    That’s why living donors are so important — and why donations should be encouraged rather than penalized.

    Roughly 6,000 Americans donate one of their kidneys each year, typically to a family member or friend. It’s hardly an easy decision. Complications are rare, and healthy donors generally don’t experience long-term problems — some evidence suggests they actually live longer than average. But all surgeries carry risks, and donors have to plan for a two- to six-week recovery period. This puts them at risk of being laid off. They might also find themselves denied health or life insurance. Donors should be protected from these costs not just to reward their generosity, but because their selflessness provides clear public benefits.

    The gain to the recipient, of course, is obvious. With a kidney transplant, a patient can live a relatively normal life. Without it, he or she must spend an average of five to 10 years on dialysis — a costly, grueling process that often interferes with work and family — followed by an early death. Dialysis patients report lower quality of life and more complications than transplant patients. They are less independent and die sooner. There’s a reason doctors consider kidney transplants the treatment of choice. And patient outcomes tend to be best of all with living-donor kidneys.

    But transplants aren’t just better for patients; they’re a better deal for taxpayers. A year of dialysis costs nearly three times as much as a transplant, and Medicare covers about 80% of dialysis costs for most patients. 

    1 That’s an outlay of $35 billion each year. Every transplant saves taxpayers about $146,000 over the course of the recipient’s lifetime. Researchers estimate that if every American who needed a kidney could get one, it would save taxpayers $12 billion a year.

    Supply, Meet Demand

    In 2017, one kidney was available for every five Americans waiting for a transplant.

    Source: OPTN/SRTR 2017 Annual Data Report

    If everyone benefits from living donations, then the state should take action to encourage them — and indeed, many states are. Colorado, Idaho, Maine, Maryland and New York have all passed bills to encourage living organ donations and prevent donors from being discriminated against. And at the federal level, a bipartisan group of representatives in February introduced the Living Donor Protection Act, which would ensure donors can take up to three months off work to recover and would prohibit insurers from limiting coverage or charging higher premiums to live organ donors. These are good first steps.

    Even bolder thinking may also be in order — for example, revisiting the 1984 law that bans payment for organs. If the government gave $45,000 to each living donor as “an expression of appreciation by society,” as some nephrologists have proposed, it would save up to 10,000 lives a year and taxpayers would still come out more than $10 billion ahead. Such a plan could end the kidney shortage at a stroke. The prospect of the impoverished in effect selling their organs is admittedly disturbing — but is it any more disturbing than the fact that, as things stand, the wealthier, whiter, and younger you are, the more likely you are to receive one of those rare living-donor kidneys?

    Still, one step at a time. Before debating new incentives for organ donation, at least take down the disincentives already in place. Nobody should lose a job or be denied health insurance for saving a life.

In 1972, Congress extended Medicaid eligibility to the vast majority of Americans with chronic kidney disease, regardless of their age or ability to pay. One analyst described the entitlement as “the first (and perhaps last) designed to cover a particular diagnosis.”

    To contact the senior editor responsible for Bloomberg Opinion’s editorials: David Shipley at

  • 10 Jul 2019 4:05 PM | Cathy Teal (Administrator)

    Today, President Donald Trump signed an Executive Order to launch  Advancing American Kidney Health , a bold new initiative to improve the lives of Americans suffering from kidney disease, expand options for American patients, and reduce healthcare costs. The initiative provides specific solutions to deliver on three goals: fewer patients developing kidney failure, fewer Americans receiving dialysis in dialysis centers, and more kidneys available for transplant.

    As directed by the Executive Order, the U.S. Department of Health and Human Services (HHS) announced today that the Centers for Medicare & Medicaid Services (CMS), through its Center for Medicare and Medicaid Innovation (CMMI), released a proposed required payment model and four optional payment models to adjust payment incentives to encourage preventative kidney care, home dialysis, and kidney transplants. The Department’s Assistant Secretary for Planning and Evaluation (ASPE) also released a paper entitled Advancing American Kidney Health , which lays out a number of areas for action, including measures called for in the executive order, for various components of HHS to improve kidney care.

    “President Trump is tackling the toughest issues in American healthcare, and few areas need reform more than the way we treat kidney disease,” said HHS Secretary Alex Azar. “Decades of paying for sickness and procedures in kidney care, rather than paying for health and outcomes, has produced less-than-satisfactory outcomes at tremendous cost. Through new payment models and many other actions under this initiative, the Trump Administration will transform this situation and deliver Americans better kidney health, more kidney treatment options, and more transplants.”

    Across America, 37 million patients suffer from chronic kidney disease and more than 726,000 have end-stage renal disease (ESRD). There are nearly 100,000 Americans waiting on the list to receive a kidney transplant, and kidney disease ranks as the ninth leading cause of death in America.

    Approximately twenty percent of dollars in traditional Medicare—$114 billion a year—are spent on Americans with kidney disease. Yet of the more than 100,000 American who begin dialysis to treat end-stage renal disease each year, one in five will die within a year. HHS has laid out three goals for improving kidney health:

    1. Reducing the number of Americans developing end-stage renal disease by 25 percent by 2030
    2. Having 80 percent of new ESRD patients in 2025 either receiving dialysis at home or receiving a transplant
    3. Doubling the number of kidneys available for transplant by 2030

    This week, HHS is taking a number of immediate actions toward these goals. To reduce the development of end-stage renal disease, CMMI released a set of four optional payment models, expected to enroll more than 200,000 Medicare patients in arrangements that give providers new incentives for preventing kidney disease and managing kidney patients’ health in a more comprehensive and person-centered way.

    To provide more options for people with kidney failure, CMMI also announced a required payment model, known as ESRD Treatment Choices, which will enroll all dialysis providers in approximately half of the country and provide new incentives to encourage dialysis in the home.

    To enhance patient access to transplantable organs, all five new payment models will give providers new incentives to help eligible patients receive transplants.

    The President’s Executive Order also calls for HHS to:

    • Launch a public awareness campaign to increase knowledge of chronic kidney disease, which 40 percent of American patients do not know they have
    • Reform the organ procurement and management system in the United States to significantly increase the supply of transplantable kidneys
    • Expand support for living donors through compensation for costs such as lost wages and child care expenses
    • Encourage development of wearable or implantable artificial kidneys, through cooperation between developers and the Food and Drug Administration (FDA) and support for KidneyX, a public-private partnership between HHS and the American Society of Nephrology

    As laid out in the ASPE paper, Advancing American Kidney Health, HHS will also, among other measures:

    • Improve Centers for Disease Control and Prevention (CDC) work on tracking and detecting chronic kidney disease throughout the population and supporting state and local efforts to develop a public health response for people with key risk factors
    • Expand work to study and implement evidence-based approaches to preventing kidney disease through CDC and the National Institutes of Health
    • Support work on portable dialysis options through the Assistant Secretary for Preparedness and Response to ensure individuals who need dialysis have ready access to treatment in the aftermath of disaster situations
    • Inform development of new kidney disease treatments that align with patient preferences, including alternatives to dialysis, through patient surveys being developed by the FDA
    • Examine ways to improve CMS’s ESRD payment policies
    • Continue research work through NIH to advance precision medicine for kidney disease
    • Launch additional prize competitions through KidneyX to support the development of new tools for preventing, managing, and treating kidney disease
    • Work further toward reducing disparities in performance among Organ Procurement Organizations (OPOs) and transplant centers with the goal of increasing recovery of kidneys by OPOs and utilization of kidneys by transplant centers.

    Read more about the CMS/CMMI models here:

    Read the ASPE paperAdvancing American Kidney Health here: *

    Read the proposed rule on the CMMI models here: - PDF *

    * People using assistive technology may not be able to fully access information in this file. For assistance, contact

  • 10 Jul 2019 3:29 PM | Cathy Teal (Administrator)

    JUL 10, 2019, Pittsburgh Post-Gazette

    An executive order signed Wednesday by President Donald Trump aims to increase the number of organs available to transplant and to improve treatment of kidney disease in hopes of preventing the thousands of deaths every year among people waiting for an organ transplant.

  • 28 Jun 2019 2:34 PM | Cathy Teal (Administrator) 

    June 18, 2019, 6:47 AM PDT

    By Saphora Smith

    LONDON — The organs of members of marginalized groups detained in Chinese prison camps are being forcefully harvested — sometimes when patients are still alive, an international tribunal sitting in London has concluded.

  • 09 Jan 2019 4:09 PM | Cathy Teal (Administrator)


    Good dental hygiene is important for everyone but it’s especially important for transplant recipients because small infections in the mouth can spread to the rest of the body and anti-rejection medications can make the body more susceptible to the risk of infection. 

    For this reason, the six-month time period following your transplant is critical.

    According to guidelines from the American Heart Association and the American Medical Association, it is recommended that no elective dental work, including cleanings, be done during the first six months following a heart, lung, liver, kidney or pancreas transplant. 

    After six months, it is recommended that heart, lung, liver and kidney recipients seek routine exams and cleanings. 

    For heart and lung transplant recipients, it is recommended that, prior to the dental appointment, patients take 500 mg of the antibiotic amoxicillin (four capsules).  

    For liver and kidney transplant recipients, it is not necessary to take antibiotics prior to routine dental appointments from a transplant perspective; however, patients are advised to consult with their primary care doctor and dentist to determine whether antibiotics may be needed for other medical conditions, unrelated to the transplant.  

    Should your primary care physician or dentist recommend taking an antibiotic before your dental appointment, here’s a partial list of medications that are acceptable to be given with immunosuppressive medications:

    • Antibiotics
    • Amoxicillin (if allergic, an alternative antibiotic will be recommended by the transplant team)
    • Clindamycin
    • Ciprofloxacin
    • Doxycycline
    • Levaquin
    • Pain Medications
    • Percocet
    • Tylenol #3

    Whenever you have a dental appointment, please remember to let the dentist know you are a transplant recipient and share the medications that you are currently taking. 

  • 15 Mar 2018 4:14 PM | Cathy Teal (Administrator)

    By Dennis Thompson
    HealthDay Reporter

    THURSDAY, March 8, 2018 (HealthDay News) -- Your wallet takes a hit when you donate a kidney to save someone's life.

    That could be the reason for a steady decline in U.S. kidney donations by men and by people in low-income households, a new study suggests.

    The living kidney donation rate among men dropped by 25 percent between 2005 and 2015, but remained stable among women, the researchers found.

    Kidney donation rates also declined for poor and lower-income families over that period, according to the report.

    Money appears to be at the root of these trends, said Dr. Jagbir Gill, an assistant professor of nephrology at the University of British Columbia in Vancouver, Canada.

    "We found that in both men and women, donation rates dropped the most in the lower-income groups, and the effect was much more pronounced in men," Gill said.

    Medical costs are covered for people who choose to donate a kidney, but many incidental costs are not repaid, he said. These include travel expenses and lost wages from missed work time.

    "We believe because there are these financial barriers to donation, people in higher-income groups are able to sustain that more," Gill said. "People who are in lower-income groups are taking a big financial hit and they might not be able to support that hit when they donate."

    Living kidney donations declined from 6,647 in 2004 to 5,538 in 2014, said Dr. Krista Lentine, a professor of medicine at St. Louis University and chairwoman of the Living Donor Committee for the United Network for Organ Sharing.

    The supply of donated kidneys is not keeping up with demand. About 101,000 people await kidney transplants in the United States, but in 2014 only 17,100 kidneys came from living or dead donors, according to the National Kidney Foundation.

    To figure out why fewer people are donating kidneys while they are alive, Gill's team analyzed transplant data and U.S. Census data.

    The investigators compared donation rates among income categories, and found that living donation declined among both men and women who were in the lower half of U.S. earners.

    But while donation remained stable or even increased among women in the top half of the nation's earners, it either declined or remained stable among men.

    "Men typically or more commonly are the primary earner in the household. They have more dependents on their health insurance plans. They also are generally paid more than women," Gill said.

    "What may be happening is that the financial consequences of taking time off work or concerns over job security may be more marked in men than women, and that may be why we're seeing this drop in men," he added.

    Lentine said these results suggest that financial concerns may play a stronger role in the decision to donate a kidney than the potential risks of donation.

    "There's a growing recognition of the risks of donation," she said, pointing to research that found a small but significant increase in kidney failure risk among donors. "I personally don't think that's a major contributor to the decline, but it's important to recognize and to counter that."

    It's against the law to pay organ donors in the United States, and rightly so, Lentine noted.

    "The countries that have done that have raised a lot of concerns for capitalizing on the vulnerable," she explained.

    But steps can be taken to make sure that kidney donation doesn't also pick a person's pocket, Lentine said.

    The American Transplant Foundation pointed to the proposed Colorado Living Organ Donor Support Act as a potential way to protect donors from taking a financial hit.

    It would grant organ donors at least 10 days of paid leave, and provide employers a 35 percent tax credit on the employee's regular salary for the leave period.

    "This is a specific example of what can be done to make giving the Gift of Life easier for all living donors, regardless of their gender," the foundation said in a written statement.

    Another piece of legislation is the Living Donor Protection Act, a proposed federal law that would bar insurance discrimination against donors and protect their right to coverage under the Family and Medical Leave Act, Lentine said.

    The new study was published online March 8 in the Journal of the American Society of Nephrology.

    More information

    The National Kidney Foundation has more about kidney donations.

    Copyright © 2018 HealthDay. All rights reserved.

  • 01 Sep 2016 8:51 AM | Cathy Teal (Administrator)

    Finding Organ Donors Concealed in Plain Sight

    David Bornstein

    Second of two articles.

    Last June, after it became clear that their 3-month-old son, Nathan, needed a liver transplant, Rob and Christina Whitehead of Mokena, Ill., created a Facebook page to tell his story. Word spread quickly. “More than a hundred people called our donor hotline,” recalled Talia B. Baker, director of the Living Donor Liver Transplant program at Northwestern University Feinberg School of Medicine.

    Read entire story here:

  • 26 Aug 2016 1:13 PM | Cathy Teal (Administrator)

    A Cost-Benefit Analysis of Government Compensation of Kidney Donors


    From 5000 to 10 000 kidney patients die prematurely in the United States each year, and about 100 000 more suffer the debilitating effects of dialysis, because of a shortage of transplant kidneys. To reduce this shortage, many advocate having the government compensate kidney donors. This paper presents a comprehensive cost-benefit analysis of such a change. It considers not only the substantial savings to society because kidney recipients would no longer need expensive dialysis treatments—$1.45 million per kidney recipient—but also estimates the monetary value of the longer and healthier lives that kidney recipients enjoy—about $1.3 million per recipient. These numbers dwarf the proposed $45 000-per-kidney compensation that might be needed to end the kidney shortage and eliminate the kidney transplant waiting list. From the viewpoint of society, the net benefit from saving thousands of lives each year and reducing the suffering of 100 000 more receiving dialysis would be about $46 billion per year, with the benefits exceeding the costs by a factor of 3. In addition, it would save taxpayers about $12 billion each year.

    Read full article here:

  • 19 Jul 2016 11:11 AM | Cathy Teal (Administrator)

    AHC Media: Continuing Medical Education Publishing

    Study: $50,000 Would Make Most Americans More Likely to Donate a Kidney

    Yet compensating donors remains illegal

    June 24, 2016

    The majority of U.S voters surveyed by telephone stated they’d be more likely to donate a kidney if they received $50,000 in compensation, according a recent study.1 However, paying donors remains illegal under the National Organ Transplant Act of 1984. The study’s key findings include the following:

    • 68% of participants would donate a kidney to anyone, 23% would donate only to certain people, and 9% would not donate.
    • 59% said being paid $50,000 would make them more likely to donate a kidney, 32% said compensation did not sway them, and 9% were negatively influenced by payment.

    The researchers conclude that, “because thousands of lives might be saved should compensation increase the number of transplantable kidneys, laws and regulations prohibiting donor compensation should be modified to allow pilot studies of financial incentives for living kidney donors.”

    Thomas G. Peters, MD, FACS, FASN, the study’s lead author and professor emeritus in the department of surgery at University of Florida’s College of Medicine in Jacksonville, views the findings as a call to action.

    “The striking number is the 59% that would be moved further toward donation if offered compensation,” he says. “That’s six out of ten people.”

    From 2004 to 2013, the authors note, 63,742 patients died or became too sick for a transplant while waiting for a kidney. “The ethical implication, in my view, is that we have a potential source of lifesaving organs that is not being accessed,” says Peters. “Because of that, people who are fully evaluated and deemed appropriate for treatment with a kidney transplant are dying while they are waiting.”

    While some programs reimburse donors for lost wages, travel expenses, and follow-up care, many donors do not qualify. “The ethical question, in my view, is that we have identifiable, salvageable individuals who are facing needless death because we don’t have the means to save them,” says Peters. “These people have a name, they are cared for by a particular medical center in America, and are on a waiting list.”

    Peters uses the analogy of an orthopedic surgeon caring for a patient needing a knee replacement, who could put in an artificial knee, enabling the patient to walk that same day. “It’s the same with kidneys — only we can’t replace the kidney we’d use today with a kidney we might get tomorrow from a living donor,” he says.

    The following are ethical arguments used against paying kidney donors:

    Such payment would commodify body parts.

    “The fact is, though, that in America it’s legal to pay surrogate mothers, and ova and sperm donors,” Peters says. “And certainly everyone in the transplant endeavor is paid.” That includes the hospital, the transplant surgeon, the transplant coordinator, nurses on the transplant floor, and immunology experts. “Everybody is paid but the donor,” says Peters.

    A black market for organs could develop.

    “But our concept is that this all would be highly regulated,” says Peters.

    Payment could coerce persons to perform an act that they ordinarily would not perform: donating a kidney.

    “Well, that’s the whole idea. That’s what we want,” says Peters. “Even though our paper indicates that the vast majority of people are willing to give a kidney to anyone or someone, over 90%, it really doesn’t happen.”

    What people say they’ll do is not necessarily what they do in reality, he says.

    “In our cohort of respondents, most people were positive about donating,” says Peters. “But if you offer the money, that moves the needle. And it might move it in real time.”

    Peters says it’s important to consider the history behind the National Organ Transplant Act of 1984, which made it illegal for individuals to sell organs. “Those persons who said we should not pay donors were mostly the transplant surgeons, who opined at the time that altruism was the motivation that ought to drive organ donation,” says Peters.

    The idea was reinforced when a businessman attempted to start a brokerage service paying individuals for kidneys, which was completely unregulated. “We were all appalled by that,” says Peters. Peters and others met with former Vice President Al Gore, at the time a Tennessee Congressman, who wrote into the bill the clause about barring compensation.

    “However, Gore said at the time, that if the circumstances of organ donation without compensation does not meet the need, then we should reconsider whether or not some form of compensation should be tried,” says Peters. “That is something that is very seldom spoken about.”

    The origins of the law, says Peters, “were largely the brainchild of those of us who were practicing at the time.” Though the numbers of individuals on a waiting list who died needing a kidney were small at the time, Peters still viewed the deaths as needless. “There were not a lot of people who agreed with me at the time. I was outspoken about this and did not have a lot of collegial support,” he says.

    Over the next decade or two, the numbers of people on the transplant recipient list grew. “We were able to save more and more lives, but the lives we were saving were of a miniscule number compared to the need,” says Peters.

    The need is now so great, and the resources so scant, says Peters, that other approaches are needed to increase the recovery of transplantable organs. “A lot of smart people have tried to do it,” says Peters. “All of the ideas for the last 30 years that have been tried have failed.”

    Pennsylvania Congressman Matt Cartwright recently introduced legislation that would allow for certain non-cash incentives, such as contributions to a retirement fund, to compensate donors.

    “There is no question that what we are doing currently is failing,” says Peters. “Even the opponents say we have to improve organ donation. It’s failing, and it is costing lives needlessly.”


    1. Peters TG, Fisher JS, Gish RG, et al. Views of US voters on compensating living kidney donors. JAMA Surg. Published online March 23, 2016. doi:10.1001/jamasurg.2016.0065.


    • Thomas G. Peters, MD, FACS, FASN, Professor Emeritus, Department of Surgery, University of Florida College of Medicine, Jacksonville. Phone: (904) 244-3925. Fax: (904) 244-3870. Email:


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