transplant

Celebrating the Gift of Life, One Transplant at a Time

by Columbia Surgery on February 7, 2012

The December 2011 edition of the Manhattan Times featured two CLDT patients, Jeff Isaacs and Tony Herrera, in Celebrating the Gift of Life, One Transplant at a Time. Both had been severely ill with end-stage liver disease, but went on to receive liver transplants at NYP/Columbia: Isaacs received a deceased donor organ, and Herrera received a living donor liver from his son. Read the inspiring story of how transplantation not only treated their diseases, but completely transformed their lives.

Tagged as: liver, transplant

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Liver Donors and Transplant Recipients Share Personal Stories on Facebook

by Columbia Surgery on February 1, 2012

Organ transplantation may be the most intense journey that a family ever experiences, complete with daunting challenges and the joys of triumph. On the Facebook site of the Center for Liver Disease and Transplantation, many organ donors and recipients have shared the stories of their struggles so that others will know what to expect and that they are not alone.

One such story is that of Kevin Martinsen, who received a living donor liver from his brother Daniel. Read how Kevin and Daniel share their moving stories in their own words.

So Many Roads, Ease My Soul: A Story of Living-Liver Transplantation

Kevin Martinsen

Kevin Martinsen

Tagged as: liver, transplant

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The Center for Liver Disease and Transplantation Announces New Appointments

by Columbia Surgery on January 20, 2012

NewYork-Presbyterian Hospital has a distinguished track record for liver transplantation and features a team of world renowned leaders in the field. The Center for Liver Disease and Transplantation offers a seamless integration of medical, surgical, radiological, and support services — using both deceased and living donor liver tissue, and minimally invasive laparoscopic techniques whenever possible.

Founded in 1998, the Center for Liver Disease and Transplantation at NewYork-Presbyterian Hospital/Columbia University Medical Center is one of the first liver programs built from its inception as a multidisciplinary unit. As of July 2011, the Center had performed more than 1,400 liver transplants, including over 200 living donor transplants. NewYork-Presbyterian Hospital/Weill Cornell Medical Center’s strong hepatobiliary program was bolstered by the addition of adult liver transplantation to its services in 2010.

Together these programs provide compassionate, individualized care to a wide variety of patients, combining exceptional care with the most innovative approaches for expanding access to liver transplantation to reduce the mortality of patients on the waiting list.

Alyson Fox, MD, NewYork-Presbyterian/ Weill Cornell Medical Center

Alyson Fox, MD

Alyson Fox, MD

Dr. Alyson Fox earned her BA in Public Health at the Johns Hopkins University prior to attending the Mount Sinai School of Medicine. She completed her residency in Internal Medicine at NY Presbyterian Weill Cornell Medical Center, where she served as assistant chief resident. She completed her Gastroenterology fellowship at the University of Pennsylvania. While at Penn, she completed a Masters in Clinical Epidemiology and served as chief fellow. She completed her advanced fellowship training in Advanced Transplant Hepatology at the University of California, San Francisco and was named clinical fellow of the year by the department of medicine.

Dr. Fox’s clinical practice is focused on the management of patients with a variety of liver diseases including viral hepatitis, alcoholic and non alcoholic fatty liver diseases, inherited liver diseases and liver cancers. As a transplant hepatologist, she has advanced training in the management of end stage liver disease and caring for patients both pre and post liver transplantation. Her research area is focused on issues related to organ allocation and complications of portal hypertension.

Elizabeth Verna, MD, NewYork-Presbyterian/ Columbia University Medical Center

Dr. Elizabeth Verna

Elizabeth Verna, MD

Dr. Elizabeth Verna, Assistant Professor of Medicine, earned her BA in Biology at the University of Virginia prior to attending the Columbia University College of Physicians and Surgeons for medical school. She completed her Internal Medicine residency at Columbia Presbyterian Hospital and then served as a Chief Resident before remaining at Columbia for Gastroenterology and Advanced/Transplant Hepatology fellowships.

While in fellowship, she also completed a Masters in Biostatistics at the Columbia University Mailman School of Public Health.

Dr. Verna’s clinical practice includes the management of patients with a variety of liver diseases with a focus on viral hepatitis and liver transplantation as well as the new emerging therapies for hepatitis C. She treats patients with liver cancer, alcoholic and non-alcoholic fatty liver disease and metabolic liver diseases and has expertise in the management of end stage liver disease. She has an active research program with grant support for the study of hepatitis C in liver transplant recipients and will be actively involved in clinical trials for the treatment of hepatitis C in both the transplant and non-transplant settings.

Julia Wattacheril, MD, NewYork-Presbyterian/ Columbia University Medical Center

Julia Wattercheril, MD

Julia Wattacheril, MD

Dr. Julia Wattacheril graduated magna cum laude from Brandeis University in Waltham, Massachusetts, obtained her MD with high honors from Baylor College of Medicine, did her internal medicine training at the Baylor College of Medicine in Houston, Texas and pursued her fellowship in gastroenterology, hepatology and nutrition as well as her Masters in Public Health at Vanderbilt University School of Medicine. She joined us last year for her training in transplant hepatology while maintaining an adjunct faculty appointment at Vanderbilt.

Her clinical interests include all aspects of transplant hepatology, general hepatology and gastroenterology with emphasis on metabolic liver disease and obesity. She specializes in nonalcoholic fatty liver disease as well as all forms of hepatitis, chronic liver disease, and liver cancer in addition to liver transplantation. Her research interests focus on hepatic steatosis, insulin resistance and metabolic liver disease in adults. Her current grant concentrates on the proteins and lipids that signal the transition from steatosis to steatohepatitis.

Tagged as: cancer, hepatitis, liver, transplant, Verna, Wattacheril

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Stamford CT woman gives husband the gift of life

by Columbia Surgery on January 17, 2012

When Brad Shwidock needed a liver transplant due to primary sclerosing cholangitis, his wife, Carol, was not only eager to donate, but was a good match. The successful living donor transplantation took place at NewYork-Presbyterian/Columbia September 13, 2011.

Living donor liver transplantation is considered one of the most important advances in the treatment of severe liver disease. By improving access to transplantation, living donor transplantation significantly reduces patients’ risk of dying while on the organ donation waitlist. At the Living Donor Liver Transplant program at New York Presbyterian Hospital, which is one of the largest living donor liver programs in North America, approximately 15-20% of the center’s transplant patients currently receive a liver from a living donor.

Read the Shwidock’s story as reported by the couple’s local paper, The Hour Online.
Learn more about living donor liver transplantation at livermd.org or by calling 1.877.LIVERMD (1.877.548.3763).

Tagged as: liver, sclerosing cholangitis, transplant

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NewYork-Presbyterian/Columbia Surgeons Are First in NYC Area to Implant Total Artificial Heart

by Columbia Surgery on December 14, 2011

Yoshifumi Naka, MD, PhD

Yoshifumi Naka, MD, PhD

Total Artificial Heart Improves Patient Survival to Transplant While Reducing Some Risks of Transplant Surgery

Surgeons at NewYork-Presbyterian Hospital/Columbia University Medical Center performed the first Total Artificial Heart implant in the New York City area to replace a patient’s dying heart.

“For patients who will die without a heart transplant, the Total Artificial Heart helps them survive until they can get one. By replacing the heart, we are eliminating the symptoms and the source of heart failure,” said lead surgeon Dr. Yoshifumi Naka, director of Cardiac Transplantation and Mechanical Circulatory Support Programs at NewYork-Presbyterian/Columbia and associate professor of surgery at Columbia University College of Physicians and Surgeons.

Similar to a heart transplant, the SynCardia temporary Total Artificial Heart replaces both failing heart ventricles and all four heart valves. Once implanted, the Total Artificial Heart provides immediate blood flow of up to 9.5 liters per minute. This high volume of blood flow helps speed the recovery of vital organs, including the brain, liver, kidneys, and GI tract, helping make the patient a better transplant candidate.

During the surgery, Dr. Naka and his team remove the patient’s heart; sew “quick connects” into the atria, aorta and pulmonary artery; then attach the Total Artificial Heart. According to surgeons, the Total Artificial Heart makes the subsequent transplant less demanding because the patient’s heart has already been removed and the device is easily detached via the quick connects, thus reducing risk for surgical bleeding.

“The artificial heart does more than improve a patient’s chances of surviving to transplant. It reduces some of the risks of the transplant surgery itself. When we implant the device, we are already preparing for transplant,” says Dr. Naka.

For patients who have already had a heart transplant and are rejecting their donor heart, there is another advantage to using the Total Artificial Heart: Since their donor heart is removed, they can be taken off immunosuppressive drugs, reducing risk for infections and other side effects such as kidney failure.

Despite increased demand, there are only approximately 2,000 donor hearts available annually in the United States. It is estimated that each year, as many as 100,000 people in the U.S. alone could benefit from mechanical circulatory support devices.

The Total Artificial Heart, manufactured by SynCardia Systems Inc., was first introduced in the mid-1980s, and more than 950 patients have been implanted with the device since. A 10-year clinical study led by the University of Arizona, Tucson, and published in the Aug. 2004 New England Journal of Medicine showed that 79 percent of patients receiving the Total Artificial Heart survived to transplant, representing the highest bridge-to-transplant rate for a heart device. Later that year, the device received FDA approval.

Artificial hearts represent the next stage in the evolution from left ventricular heart assist devices (LVADs), introduced in the 1990s, and biventricular assist devices (BiVADs), introduced in the 2000s.

NewYork-Presbyterian/Columbia performs more than 1,600 open-heart procedures annually, including a nation-leading 84 heart transplants in 2010. U.S.News & World Report has ranked NewYork-Presbyterian/Columbia in the top 10 for Cardiology & Heart Surgery among “America’s Best Hospitals” for eight years running. The Hospital has more than 30 years of experience in caring for cardiac transplant patients and developing new treatments that extend their lives.

Tagged as: cardiac, heartfailure, LVAD, mechanicalcirculatorysupport, Naka, transplant

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Tim Sweeney’s Story

by Columbia Surgery on November 28, 2011

At age 31, cystic fibrosis patient Timothy Sweeney needed a double lung transplant. Less than one year later, he ran the New York City Marathon with his transplant surgeon, Joshua Sonett, MD.

Tagged as: cysticfibrosis, lung, Sonett, transplant

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Challenges in Liver Transplantation: Allocation of Donor Organs

by Columbia Surgery on November 16, 2011

Robert S. Brown, Jr., MD, MPH

Robert S. Brown, Jr., MD, MPH

The November 10, 2011 issue of the New England Journal of Medicine features an editorial by Robert S. Brown, Jr., MD, MPH, Director of the Center for Liver Disease and Transplantation, titled Transplantation for Alcoholic Hepatitis — Time to Rethink the 6-Month “Rule.”

In this editorial, Dr. Brown addresses the difficult questions surrounding how to fairly allocate donor organs, which are in far shorter supply than their demand. In the case of patients with alcoholic hepatitis, current guidelines exclude such patients from the liver transplant waiting list unless they have successfully abstained from alcohol for at least six months. Yet as Dr. Brown points out, many die before this required, albeit arbitrary, window elapses. And a new study indicates that if they are permitted to receive liver transplants, such patients may do at least as as well as, if not better than, some other patients who receive transplants far more often.

As Dr. Brown explains in this editorial, the typical recidivism rate among alcoholics is approximately 30%. Yet organs are regularly allocated to patients with hepatitis C, who have a 100% disease recurrence rate, and a much higher rate of graft failure than those with alcoholic hepatitis, at five years. A study by Mathurin et al in this issue found that carefully selected patients with alcoholic hepatitis experienced a 77% survival rate after liver transplantation at six months, and a recidivism rate of 11.5%. Based on these encouraging results, Dr. Brown writes, “…this study highlights the need to rethink our approach to transplantation for alcoholic liver disease, including applying better rules for selecting patients who are at low risk for recidivism that can be applied in a uniform and fair way.”

Tagged as: Brown, hepatitis, liver, transplant

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All in the Family: Woman Donates Left Lobe of Liver to Her Fiancé

by Columbia Surgery on November 9, 2011

When Megan Ellerd and Steven Ferretti met seven years ago, it was “instant love,” she says. Not long after, the young couple found out that Steven had autoimmune hepatitis — but they didn’t worry too much about it, hoping that it wouldn’t affect them until much later in life. In 2008, however, the two were happily engaged when Steven’s condition suddenly took a turn for the worse. His liver was failing, and he needed a transplant.

Although Steven had severe liver disease and was experiencing painful symptoms such as ascites (fluid buildup in the abdomen), he would have had to become deathly ill in order to qualify for a donor organ from the transplant waiting list. For a couple with a wedding to plan and a bright future ahead, the prospect of Steven spending many months, if not years, in progressively worsening health was just not an option. For Megan, the choice was clear. She had known from the beginning that she would donate part of her liver to him if she could — and when testing confirmed she was a good match, that’s exactly what she did.

Megan Ellerd and Steven Ferretti

Steven Ferretti and Megan Ellerd

On January 6, 2011, the team at the NewYork-Presbyterian/Columbia Liver Transplant Program transplanted Megan’s left lobe to Steven, an operation that not only saved his life, but spared him the ordeal of becoming even sicker while waiting for a liver from the organ donor waitlist. Benjamin Samstein, MD, Surgical Director of the Liver Transplant Program, and Lorna Dove, MD, MPH, Medical Director of Adult Liver Transplantation, are happy to report that the transplantation was a success, and that Steven and Megan have both made excellent recoveries.

Both Steven and Megan have been transformed by the experience; they speak of their gratitude for the support they received from their loving families, and of a newfound appreciation for life. Thanks to the team at Columbia, and to each other, they’re now thinking of having kids and possibly starting a new business. Whatever they decide, they’re fortunate to be able to do it in good health, and together.

Tagged as: hepatitis, liver, Samstein, transplant

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Marking an important milestone: Raising money for renal transplant research at NewYork-Presbyerian/Columbia University Medical Center

by Columbia Surgery on October 14, 2011

The best thing about July 26, 2011 was that it was the most ordinary of days. No surprises, just routine.

Above all, a far cry from that same date 10 years ago.

When a cheery postcard inviting our family to New York Presbyterian/Columbia University Medical Center’s Circle for Life: Renal 3,000, Celebrating 3,000 Kidney Transplants, landed from the mail slot on my kitchen floor, I was suddenly back in the pre-op rooms, recalling the early morning hours of July 26, 2001. Was it simply that the place was meat-locker cold that I could barely control my shaking?

There is no parenting manual to prepare you how to reassure your teenager she will one day look like herself again. That she will survive transplant surgery, that her father’s kidney will work in her body. That her two years of hemodialysis and peritoneal dialysis will really be behind her. That it won’t be long before she can once again take her ballet class, audition for the school play, and hang out with her friends, without feeling exhausted all the time.

There is no marriage handbook guiding you how to maintain your sense of humor – and his – when you see your husband shivering in a thin hospital gown, a large purple X marking the spot for the cut to remove a vital organ.

Jane's daughter, with her father and kidney donor, two years before the illness that caused end stage renal disease and led to her transplant in 2001.

Jane's daughter, with her father and kidney donor, two years before the illness that caused end stage renal disease and led to her transplant in 2001.

What a luxury, as the 10th anniversary of my middle child’s transplant approached, to be able to gaze in the rear-view mirror. Do I need to mention she has a smile that lights up a room? That her observations challenge me to think, that she also makes me laugh all the time?

As I reflected on this milestone, I knew I wanted to find a meaningful way to mark it. Fundraising is not generally my “thing.” So it was with some trepidation that I reached out last January to family and friends with a very personal appeal. I asked them to join me in supporting renal transplant research and a Department of Surgery fund to assist indigent patients with the cost of medications and travel to the medical center for follow-up care. The donations, I explained, would be in honor of the surgeons, nephrologists, transplant coordinators and other professional staff involved in our family’s transplant experience.

The result, I’m thrilled to share, was more than $12,000 raised, more than $2,000 over our goal.

It’s no secret that the limited supply of organs for transplant is the biggest obstacle to treating end-stage renal disease. But thanks to continuing research, about 250 renal transplants take place at NewYork-Presbyterian/Columbia every year, compared to the handful performed when Mark Hardy, MD, my daughter’s transplant surgeon, began the program in 1975. More recently, to increase access to transplantation, NYP/Columbia has been proactive in arranging donor swaps among unrelated living donors, and in researching ways to increase the chances of successful transplant between incompatible donor-recipient pairs. To alleviate the shortage long-term, alternative sources of organs for transplant (stem cells, xenografts) are already being investigated. These are among the scientific frontiers yet to be conquered, but possible within my daughter’s lifetime.

There have also been important changes in immunosuppressive therapies, minimizing the chances of rejection and the side effects of medication. Donor surgeries, too, have improved. My husband’s impressive scar is a relic. Since around 2002, laparoscopic, minimally invasive, surgery, to remove a kidney, with minimal scarring, has been the norm.

These advances have meant that every year, more and more people reach the milestone 10th anniversary after transplantation. What a cause for celebration. And what an opportunity: I would love to help other families like mine launch similar campaigns.

There is no telling what is on the horizon, what a difference our collective efforts can make to our loved ones and to so many others. It reminds me of my favorite quote, a reaction by the sculptor Alexander Stirling Calder to his son Alexander’s “new-fangled” brand of art, mobiles and stabile sculptures: “One must never stop moving in a world so full of wonders.”

Jane R. Calem is a communications consultant to non-profit organizations in New York City.

Tagged as: Hardy, kidney, transplant

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New YouTube Video about Pancreas Transplantation

by Columbia Surgery on August 22, 2011

Lloyd Ratner, MD, Director of Renal and Pancreatic Transplantation at New York-Presbyterian Hospital/Columbia University Medical Center, has released a highly informative YouTube video regarding pancreas transplantation. The direct and engaging presentation is addressed to prospective patients, and provides an easy-to-understand overview of the procedure.

More specifically, Dr. Ratner discusses how pancreas transplantation can restore glycemic control and reverse secondary complications of kidney disease in patients with type 1 diabetes and kidney failure, patients with brittle diabetes, those with hypoglycemic unawareness, and certain patients with type 2 diabetes. The full twenty-one-minute video can be seen here:

Tagged as: pancreas, Ratner, transplant

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