The Ballad of Billy The Kidney

Italian cooking and artificial hearts: the case of Angelo Tigano

Congratulations are due to Angelo Tigano - the southern hemisphere's first recipient of a mechanical heart.

This surgery was conducted at St Vincent's Hospital, Sydney.

This device is not a substitute for a transplanted heart, but it givers the patient extra time before a transplanted heart becomes available.

Artificial hearts were, until now, extremely cumbersome hospital-bound devices. Whilst I am not a medical expert, it seems t this untrained eye that this option gives everyone involved - patient, doctors, family - some clearance time.

Well done ! And I do hope that he long continues to enjoy his mum's cooking.

• Artificial heart transplant first, SBS World News Australia, 16th August 2010

• Pictures from Mr Tigano's media conference via AAPimage

• YouTube vide of implantation of artificial heat, uploaded by CumberlandCourier (ADVISORY: shows surgical scenes.)

Face/off: the case of Oscar

• Reader's advisory:  The links at the foot of this page go to images which may distress some readers.

This week's news included the story of "Oscar", a 31-year-old Spaniard who is the recipient of a major face transplant. This involved composite tissue transplantation - including, bones, cartilage, teeth and skin.

A very good article in The Australian newspaper summarises the ethical issues involved in such a procedure.

One that has certainly exercised my mind is the issue of a perceived "identifiable" transplant of an external organ(s), rather than the completely anonymous transplant of an internal organ.

Even though this is, in dealing with the face,  a fallacy - the recipient's underlying facio-maxilliary structure will alter the new face's identity over time - nonetheless there is an entirely understandable issue of whether some families of prospective donors will find this too confronting:

"Transplants are laden with meanings that have profound consequences for individuals and their social relationships," he [Professor Paul Komesaroff] says. Surely, the transplant of something so drenched in meaning as a face will heighten the trauma.

Certainly the ethical issues need to be discussed and analysed.  And i sincerely hope that transplant co-ordinators and educators will recognise this issue and tackle it.

But a person who is living with terrible disfigurement from accident or birth defect would want these issues to be resolved firmly.

• Leigh Dayton, new face, new future, new issuers: full-face transplant, The Australian, 31st July 2010.

Reader's advisory:  The links which follow go to images which may distress some readers.

Jonathan Gillis on organ transplantation

An interesting interview on ABC Classic FM radio this morning, as Associate Professor Jonathan Gillis was interviewed by Margaret Throsby.

Dr Gillis is State Medical Director of the New South Wales Organ and Tissue Donation Service.

In the interview, he takes to some of the myths surrounding the issue of organ transplantation.  But he comes across as a very humane chap, also taking on board the incredible difficulty surrounding the decision of the next of kin to allow donation.

Well worth a listen.

• Introduction and Link page to download of interview
  

Up next - the wearable artificial kidney

Recently I received an announcement concerning a wearable artificial kidney.

The device, weighing about 5kg and worn like a belt, is intended to provide continuous portable artificial dialysis.

Interesting!

• Picture credit: media release from Kidney Health Australia

• Media release from Kidney Health Australia

• Presentation from Xcorporeal Inc, manufacturers [PDF file] [HTML document]

Xenotransplantation in Australia

The National Health and Medical Research Council has announced that the ban in Australia on xenotransplantation is about to be lifted.

According to the Sydney Morning Herald, this will be

opening the way for research into the use of pig cells in fighting diabetes, Parkinson's disease, Huntingdon's disease and strokes.

• The image of Porky Pig is from Wikimedia Commons

The vexed issue of transporting donor organs

Local media has this week reported that Australian scientists have developed an improvement in the solution in which donor hearts are transported – making a donor heart viable for up to 14 hours, as against the current situation of 5 or so hours.

The solution also apparently makes the organ generally more viable for transplantation, even when rapid transfer is accomplished.

The time factor is of great importance in a geographically-large nation such as Australia, where it can be impossible to move a donor organ coast to coast due to limited time frames. 

This would also have effects in other geographically-large nations such as the USA (which geographically is about the same size as Australia) or Russia.

The Australian newspaper reported this as follows:

The crucial extra hours would for the first time allow a heart that suddenly became available on the east or west coasts of Australia to be flown across the country if a suitable match were identified -- or even across the Tasman [Sea, to New Zealand].

This is especially important in the case of my country, which amongst the advanced nations of the world has a poor record of organ donation.

It also appears that this would also open donor organ movement between Australia and New Zealand.

An increase in the range of potential donor organs would, to my untrained eye, appear to be a path to long-term increase in likely success of organ transplants overall.

At the moment this breakthrough is geared to donor hearts. A stated aim of this research is to extend this to other donor organs.

The research for this breakthrough was undertaken at the Victor Chang Cardiac Research Institute of Sydney. 

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Articles in

• ABC [Australia] News Online

• Sydney Morning Herald
  

Image credit:  from the blog Hannah's World

The Gift

Brace yourself, folks.  In its ongoing quest to regain its lost ratings crown, and in its ongoing ratings war of attrition with the 7 Network, the 9 television network in about to re-launch the reality series The Gift.

Neale Prior, writing in The West Australian, sums the situation up neatly by writing:

The Nine Network has had more than its share of reality TV flops of late, so it is probably a good thing that it is transplanting a proven performer back into its schedule.

To its credit, the one previous series of this program is credited with a 40% increase in organ donor registrations in Australia - off an admittedly low base figure, given that Australia has one of the worst figures in the Western world for organ donations.

Anything that raises this figure cannot be a bad thing.  So I will watch next Wednesday's episode and report back.

• The Gift is currently scheduled at 9pm on Wednesday nights on 9 and affiliate stations.

• Thinking of making your donor intentions known? In Australia, you can register for organ donation at the Australian Organ Donor Registry.  Elsewhere, discuss this with your family medical practitioner or (in many countries) your driver-licencing authority.

• Wherever you are, discuss your wishes closely with your next of kin and clearly make your wishes known.
  

A possible vaccine for skin cancer and its relevance to transplant patients

Recently Australian Associated Press carried a story concerning the possibility of a vaccine to fight skin cancer.

The story was carried in the Sydney Morning Herald from the basis of a generalist readership - especially here in Australia where skin cancer rates are through the roof.

But there is extra relevance for transplant patients.

In my pre-transplant workshops I was informed of an extra propensity to sunburn and a possible extra risk of skin cancer die to the effect of my immune-suppressant medications.

It would be very interesting if this risk could be reduced by a simple vaccination (unless, of course, the vaccination posed a risk to the transplanted organ).

Great figures in Transplant / Non-transplant History: Jean Harlow

The first subject in my fortnightly series Great figures in Transplant / Non-transplant History is Jean Harlow (1911-1937).

Jean Harlow was an American film actor who made 41 films between 1928 and 1937.

She is probably best remembered for her roles in The Public Enemy (1931) and Bombshell (1933).

She also appeared as an extrain a restaurant scene in City Lights (1931), a film by Charlie (Sir Charles) Chaplin.
 

The writer Graham Greene wrote a rather memorable description of Harlow's characterisations.  Quoted by The Internet Movie DataBase, he wrote that

Her technique was the gangster's technique - she toted a breast like a man totes a gun.

Jean Harlow died of end-stage renal failure (ESRD) in 1937, well before dialysis and transplant technology had been developed.  At that time, death was the usual outcome for ESRD patients due to this lack of medical and surgical technology.

Suggested websites on Jean Harlow include:

• This YouTube clip from The Public Enemy introduces Jean Harlow's character to James Cagney. It was posted by astique333 (high-speed internet connection required to view this).

• Jean Harlow: the official site
• Wikipedia article on Jean Harlow
• IMdB article on Jean Harlow
• Harlowville
• Who is Jean Harlow? : A SquidWho page prepared by Jaguar Julie

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• The picture at the top of this post is from the Jean Harlow Photo Gallery on Silent Ladies and Gents.
• Would you like to suggest a famous person for this series?