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Living Donation in the News / Court case in Massachusetts: Kidney Donor's letter to end recipient of a chain..

« Last post by Clark on September 17, 2023, 02:42:47 PM »

https://www.bloomberglaw.com/public/desktop/document/LarsonvPerryetalDocketNo119cv10203DMassJan302019CourtDocket/2?doc_id=X4C1JG8DIN58IVP76AC7631DIMB

Court document with surprisingly clearly written text explaining why:
1) the donor had copyright protection despite lack of publication,
2) the person who wrote stories inspired by the donor's letter was protected by "fair use", and
3) why the donor's sincere belief that it wasn't "fair use" protected them from a defamation countersuit.

Everyone who has every told their donation story should know about this case. Best wishes, all!

Living Donation in the News / Aborted living-donor liver transplantation in the real-world setting, lessons

« Last post by Clark on September 10, 2023, 06:15:08 PM »

https://www.amjtransplant.org/article/S1600-6135(23)00583-X/fulltext[/color][/font]Aborted living-donor liver transplantation in the real-world setting, lessons from 13 937 cases of Vanguard Multi-center Study of International Living Donor Liver Transplantation Group

Takeo Toshima
Jinsoo Rhu
Young-In Yoon

Sung-Gyu Lee
Toru Ikegami
Kwang-Woong Lee

et al.
American Journal of Transplantation
Published:July 28, 2023
DOI:https://doi.org/10.1016/j.ajt.2023.07.011

Abstract
There are exceedingly uncommon but clearly defined situations where intraoperative abortions are inevitable in living-donor liver transplantation (LDLT). This study aimed to summarize the cases of aborted LDLT and propose a strategy to prevent abortion or minimize donor damage from both recipient and donor sides. We collected data from a total of 43 cases of aborted LDLT out of 13 937 cases from 7 high-volume hospitals in the Vanguard Multi-center Study of the International Living Donor Liver Transplantation Group and reviewed it retrospectively. Of the 43 cases, there were 24 recipient-related abortion cases and 19 donor-related cases. Recipient-related abortions included pulmonary hypertension (n =

, hemodynamic instability (n = 6), advanced hepatocellular carcinoma (n = 5), bowel necrosis (n = 4), and severe adhesion (n = 1). Donor-related abortions included graft steatosis (n = 7), graft fibrosis (n = 5), primary biliary cholangitis (n = 3), anaphylactic shock (n = 2), and hemodynamic instability (n = 2). Total incidence of aborted LDLT was 0.31%, and there was no remarkable difference between the centers. A strategy to minimize additional donor damage by delaying the donor’s laparotomy or trying to open the recipient’s abdomen with a small incision should be effective in preventing some causes of aborted LDLT, such as pulmonary hypertension, advanced cancer, and severe adhesions.

Living Donation in the News / Pure laparoscopic donor hepatectomy: Experience of 556 cases at Seoul National U

« Last post by Clark on September 10, 2023, 06:12:38 PM »

https://www.amjtransplant.org/article/S1600-6135(23)00531-2/fulltext

Pure laparoscopic donor hepatectomy: Experience of 556 cases at Seoul National University Hospital

Suk Kyun Hong

Jae-Yoon Kim
Jaewon Lee

Nam-Joon Yi
Kwang-Woong Lee
Kyung-Suk Suh

et al.
American Journal of Transplantation
Published:June 13, 2023
DOI:https://doi.org/10.1016/j.ajt.2023.06.007

Abstract
Pure laparoscopic donor hepatectomy (PLDH) has become a routine procedure at Seoul National University Hospital, and the pure laparoscopic method is now being applied to liver recipients as well. This study aimed to review the procedure and outcomes of PLDH to identify any areas that required improvement. Data from 556 donors who underwent PLDH between November 2015 and December 2021 and their recipients were retrospectively reviewed. Among these, 541 patients underwent pure laparoscopic donor right hepatectomy (PLDRH). The mean hospital stay of the donor was 7.2 days, and the rate of grade I, II, IIIa, and IIIb complications was 2.2%, 2.7%, 1.3%, and 0.9%, respectively, without any irreversible disabilities or mortalities. The most common early and late major complications in the recipient were intraabdominal bleeding (n = 47, 8.5%) and biliary problems (n = 198, 35.6%), respectively. Analysis of the PLDRH procedure showed that operative time, liver removal time, warm ischemic time, Δhemoglobin%, Δtotal bilirubin%, and postoperative hospital stay decreased significantly as the number of cases accumulated. In conclusion, the operative outcomes of PLDRH improved as the number of cases increased. However, continuous caution is needed because major complications still occur in donors and recipients even after hundreds of cases.

Living Donation in the News / The first successful case of ABO-incompatible living-donor lobar lung transplant

« Last post by Clark on September 10, 2023, 06:10:25 PM »

https://www.amjtransplant.org/article/S1600-6135(23)00457-4/fulltext

CASE REPORT| VOLUME 23, ISSUE 9, P1451-1454, SEPTEMBER 2023

The first successful case of ABO-incompatible living-donor lobar lung transplantation following desensitization therapy

Daisuke Nakajima

Itsuki Yuasa
Hidenao Kayawake

Shiro Baba
Hidefumi Hiramatsu
Hiroshi Date
et al.
American Journal of Transplantation
Published:May 04, 2023
DOI:https://doi.org/10.1016/j.ajt.2023.04.031

Abstract
ABO-incompatible (ABO-I) living-donor lobar lung transplantation (LDLLT) was successfully performed in a 14-year-old girl who suffered from bronchiolitis obliterans due to graft-versus-host disease following hematopoietic stem cell transplantation. In the ABO-I LDLLT procedure, the blood type O patient received a right lower lobe donated from her blood type B father and a left lower lobe donated from her blood type O mother. Desensitization therapy, using rituximab, immunosuppressants, and plasmapheresis, was implemented for 3 weeks prior to transplantation to reduce the production of anti-B antibodies in the recipient and prevent acute antibody-mediated rejection after ABO-I LDLLT.

Living Donation in the News / Lithium and the living kidney donor: Science or stigma?

« Last post by Clark on September 10, 2023, 06:08:28 PM »

https://www.amjtransplant.org/article/S1600-6135(23)00489-6/fulltext

PERSONAL VIEWPOINT| VOLUME 23, ISSUE 9, P1300-1306, SEPTEMBER 2023

Lithium and the living kidney donor: Science or stigma?

Rachel A. Davis

Tyler Branagan
Christopher D. Schneck
Jesse D. Schold
Thida Thant
Bruce Kaplan
American Journal of Transplantation
Published:May 24, 2023
DOI:https://doi.org/10.1016/j.ajt.2023.05.022

Abstract
Nearly 10 000 people are removed from the kidney transplant waiting list each year either due to becoming too ill for transplant or due to death. Live donor kidney transplant (LDKT) provides superior outcomes and survival benefit relative to deceased donor transplant, but the number of LDKT has decreased over the past few years. Therefore, it is of paramount importance that transplant centers employ evaluation processes that safely maximize LDKT. Decisions about donor candidacy should be based on the best available data, rather than on processes prone to bias. Here, we examine the common practice of declining potential donors based solely on treatment with lithium. We conclude that the risk of end-stage renal disease related to lithium treatment is comparable to other generally accepted risks in LDKT. We present this viewpoint to specifically challenge the carte blanche exclusion of individuals taking lithium and highlight the importance of using the best available data relevant to any risk factor, rather than relying on biases, when evaluating potential living kidney donors.

Living Donation in the News / Short- & long-term complications after living donor ileal (intestinal) resection

« Last post by Clark on September 10, 2023, 06:06:36 PM »

https://www.amjtransplant.org/article/S1600-6135(23)00056-4/fulltext

ORIGINAL ARTICLE| VOLUME 22, ISSUE 12, P3053-3060, DECEMBER 2022Short- and long-term complications after living donor ileal resection

Guosheng Wu

Chaoxu Liu
Xile Zhou

Mian Wang
Qingchuan Zhao
Tingbo Liang

et al.
American Journal of Transplantation
DOI:https://doi.org/10.1111/ajt.17193

Intestinal transplantation from deceased donors is the established procedure for patients with irreversible intestinal failure. However, a living-donor intestinal transplant has not been routinely performed yet because of undefined surgical risks to the donor. In this report, we reviewed our experience with living-donor ileal resection from May 1999 to December 2021. A total of 40 living-donor ileal resections were performed for 40 intestinal transplant recipients. Clinical data were prospectively collected and analyzed for postoperative complications after ileal procurement. None of the donors experienced life-threatening complications or mortality. Six (15%) of 40 donors experienced minor operative complications. Transit intestinal graft inadequacy including weight loss, diarrhea, and vitamin B12 deficiency was common early following surgery, but was manageable and disappeared in most cases within a year. All donors had significant reductions in total plasma cholesterol and low-density lipoprotein cholesterol concentrations after donation as compared with the baseline levels. With an average follow-up of 67.8 months, bilateral kidney stones occurred in one donor and gallstones in the other. All the donors have regained their normal capacity for work. Living-donor ileal resection is associated with minimal short- and long-term morbidity and remains an attractive alternative for potential recipients when suitable deceased donors are unavailable.

Living Donation in the News / Impact of having potential living donors on ethnic/racial disparities in access

« Last post by Clark on September 10, 2023, 06:03:00 PM »

https://www.amjtransplant.org/article/S1600-6135(22)29946-8/fulltext

BRIEF COMMUNICATION| VOLUME 22, ISSUE 10, P2433-2442, OCTOBER 2022

Impact of having potential living donors on ethnic/racial disparities in access to kidney transplantation

Elisa J. Gordon

Jungwha Lee
Raymond Kang
Juan Carlos Caicedo
American Journal of Transplantation
DOI:https://doi.org/10.1111/ajt.17090

Racial/ethnic disparities persist in patients’ access to living donor kidney transplantation (LDKT). This study assessed the impact of having available potential living donors (PLDs) on candidates’ receipt of a kidney transplant (KT) and LDKT at two KT programs. Using data from our clinical trial of waitlisted candidates (January 1, 2014–December 31, 2019), we evaluated Hispanic and Non-Hispanic White (NHW) KT candidates’ number of PLDs. Multivariable logistic regression assessed the impact of PLDs on transplantation (KT vs. no KT; for KT recipients, LDKT vs. deceased donor KT). A total of 847 candidates were included, identifying as Hispanic (45.8%) or NHW (54.2%). For Site A, both Hispanic (adjusted OR = 2.26 [95% CI 1.13–4.53]) and NHW (OR = 2.42 [1.10–5.33]) candidates with PLDs completing the questionnaire were more likely to receive a KT. For Site B, candidates with PLDs were not significantly more likely to receive KT. Among KT recipients at both sites, Hispanic (Site A: OR = 21.22 [2.44–184.88]; Site B: OR = 25.54 [7.52–101.54]), and NHW (Site A: OR = 37.70 [6.59–215.67]; Site B: OR = 15.18 [5.64–40.85]) recipients with PLD(s) were significantly more likely to receive a LDKT. Our findings suggest that PLDs increased candidates’ likelihood of KT receipt, particularly LDKT. Transplant programs should help candidates identify PLDs early in transplant evaluation.

Living Donation in the News / The living kidney donor profile index fails to discriminate allograft survival:

« Last post by Clark on September 10, 2023, 06:00:45 PM »

https://www.amjtransplant.org/article/S1600-6135(22)24775-3/fulltext

ORIGINAL ARTICLE| VOLUME 23, ISSUE 2, P232-238, FEBRUARY 2023

The living kidney donor profile index fails to discriminate allograft survival: implications for its use in kidney paired donation programs

Georgina L. Irish
Lachlan C. McMichael
Matthew Kadatz

Edward Sharples
John S. Gill

Philip A. Clayton
et al.

American Journal of Transplantation
Published:December 05, 2022
DOI:https://doi.org/10.1016/j.ajt.2022.10.001

Abstract
The inclusion of blood group– and human leukocyte antigen–compatible donor and recipient pairs (CPs) in kidney paired donation (KPD) programs is a novel strategy to increase living donor (LD) transplantation. Transplantation from a donor with a better Living Donor Kidney Profile Index (LKDPI) may encourage CP participation in KPD programs. We undertook parallel analyses using data from the Scientific Registry of Transplant Recipients and the Australia and New Zealand Dialysis and Transplant Registry to determine whether the LKDPI discriminates death-censored graft survival (DCGS) between LDs. Discrimination was assessed by the following: (1) the change in the Harrell C statistic with the sequential addition of variables in the LKDPI equation to reference models that included only recipient factors and (2) whether the LKDPI discriminated DCGS among pairs of prognosis-matched LD recipients. The addition of the LKDPI to reference models based on recipient variables increased the C statistic by only 0.02. Among prognosis-matched pairs, the C statistic in Cox models to determine the association of the LKDPI with DCGS was no better than chance alone (0.51 in the Scientific Registry of Transplant Recipient and 0.54 in the Australia and New Zealand Dialysis and Transplant Registry cohorts). We conclude that the LKDPI does not discriminate DCGS and should not be used to promote CP participation in KPD programs.

Living Donation in the News / Genetic evaluation of living kidney donor candidates: Review and...best practice

« Last post by Clark on September 10, 2023, 05:58:23 PM »

https://www.amjtransplant.org/article/S1600-6135(23)00305-2/fulltext

COMPREHENSIVE REVIEW| VOLUME 23, ISSUE 5, P597-607, MAY 2023

Genetic evaluation of living kidney donor candidates: A review and recommendations for best practices

Christie P. Thomas †

Reem Daloul †
Krista L. Lentine

Neetika Garg
Brian K. Lee ‡
Yasar Caliskan ‡
et al.

American Journal of Transpalntation
Published:February 28, 2023
DOI:https://doi.org/10.1016/j.ajt.2023.02.020

Abstract
The growing accessibility and falling costs of genetic sequencing techniques has expanded the utilization of genetic testing in clinical practice. For living kidney donation, genetic evaluation has been increasingly used to identify genetic kidney disease in potential candidates, especially in those of younger ages. However, genetic testing on asymptomatic living kidney donors remains fraught with many challenges and uncertainties. Not all transplant practitioners are aware of the limitations of genetic testing, are comfortable with selecting testing methods, comprehending test results, or providing counsel, and many do not have access to a renal genetic counselor or a clinical geneticist. Although genetic testing can be a valuable tool in living kidney donor evaluation, its overall benefit in donor evaluation has not been demonstrated and it can also lead to confusion, inappropriate donor exclusion, or misleading reassurance. Until more published data become available, this practice resource should provide guidance for centers and transplant practitioners on the responsible use of genetic testing in the evaluation of living kidney donor candidates.

Living Donation Forum / September 2023 Living Organ Donor Anniversaries

« Last post by Clark on September 05, 2023, 09:09:01 PM »

The wheel of the year turns again, summer fades as the daylight shortens, and classrooms and offices, whether downtown or at home, fill up. Harvest time is ‘round the corner.

Remember with us this wonderful collection of folks who have enduring reasons to take stock every September. Donors and recipients, family, friends, strangers. Add your own: https://livingdonorsonline.org/donor-experiences/donation-anniversaries/

Personally, my imagination pulls me toward Christine, the surgical teams, and the family gathered two days after 9/11. All those in 2001 and since have some complex feelings in September. I started on my path to donation that same day, 9/13/2001, getting my first blood draw at the Brigham, where all this started.

Best wishes all, truly, whatever time has done to your memories of extraordinary altruism. We are thinking of you.

Thirty-second anniversary:
Lee donated a kidney to his father on September 11th, 1991

Thirtieth anniversary:
Rory Eckmann donated part of his liver to his niece, Megan, on September 7th, 1993

Twenty-third anniversary:
Cindy Leuty Jones donated a kidney to her brother on September 20th, 2000

Twenty-second anniversary:
Becky Bailey donated a kidney to her daughter, Brittney, on September 5th, 2001
Christine donated a kidney to a stranger on September 13th, 2001
Suzanne Hunter donated a kidney to her son, Ian, on September 17th, 2001. The graft failed four years later and Ian has been back on dialysis.
Marcia Pitlor donated a kidney to her brother on September 18th, 2001
Irene Lewis donated a kidney to her husband's ex's daughter on September 19th, 2001

Twenty-first anniversary:
The Reverend Ronda L. Hawkins donated a kidney to one of her parishioners on September 4th, 2002
Brandi Wittman donated a kidney to a co-worker on September 25th, 2002
Wendy Miller donated a kidney to her sister on September 25th, 2002
Joe Zangara donated a kidney to his mother, Audrey, on September 30th, 2002

Twentieth anniversary:
Beth Wilson donated a kidney to her mother, Lola, on September 16th, 2003
Clay donated a kidney to a stranger on September 26th, 2003
Christopher Yanakos donated part of his liver to his mother on September 28th, 2003

Nineteenth anniversary:
Joyce A. Falsey donated a kidney to a stranger on September 7th, 2004
Emalene Englestad donated a kidney to her sister-in-law on September 9th, 2004
Nancy Foster donated part of her liver to her brother on September 13th, 2004
Debbie Petway donated a kidney to her father, Melvin, on September 21st, 2004
Shelby Humberg Richardson donated a kidney to her brother on September 22nd, 2004

Eighteenth anniversary:
Chaya Lipschutz donated a kidney to a stranger in September 2005
Cindy Fox donated part of her liver to her husband, Victor, on September 1st, 2005
Jenn donated a kidney to her brother on September 20th, 2005
Lisa Branting donated a kidney to her best friend's husband on September 25th, 2005
Suzanne Weiner donated a kidney to a friend on September 26th, 2005
Lillie donated a kidney to an unrelated recipient on September 27th, 2005
Rose Crawford donated a kidney to her brother on September 30th, 2005

Seventeenth anniversary:
Janice Kost donated a kidney to her nephew on September 5th, 2006
Christina Dobosiewicz donated a kidney to her stepfather, John Fattorusso, now deceased, on September 6th, 2006
Kelvin Hockstock donated a kidney to his wife on September 8th, 2006
Kathie Jackson donated a kidney to Ken Singer, no relation, on September 26th, 2006
Malkah Buchweitz donated a kidney to her brother on September 28th, 2006

Sixteenth anniversary:
Kimberly Hill donated a kidney to her brother, Tim Edgar, on September 5th, 2007
Kim Alice donated a kidney to her stepfather on September 12th, 2007
Ray Vidic donated a kidney to his friend, Troy Kahklen, on September 13th, 2007
Stacey Canas donated a kidney to her best friend's mom on September 13th, 2007
Gabrielle Benson donated a kidney to her husband on September 24th, 2007

Fifteenth anniversary:
Ailey donated a kidney to a church associate on September 16th, 2008
Carmen Spanglers donated a kidney to her friend's husband on September 22nd, 2008
Diane donated a kidney to her brother-in-law, Mark, on September 23rd, 2008
Margaret Florence donated a kidney to her cousin on September 23rd, 2008
Krystal Star Garcia donated a kidney to her husband, Manuel, on September 24th, 2008
Jill Andahazy donated a kidney to her husband's cousin Katie on September 25th, 2008
Carla Giampaglia donated a kidney to an unrelated person on September 26th, 2008
Angi Kaltenbach donated a kidney to a friend on September 30th, 2008
Jeff Hill donated a kidney to Eric Miller on September 30th, 2008
Tammy Stickney donated a kidney to her father on September 30th, 2008

Fourteenth anniversary:
Tom Stalsitz donated a kidney to his friend, Joseph R. Brugger, on September 4th, 2009
Cathleen Aliberti donated part of her liver to her sister, Maureen Manning, on September 9th, 2009
Melissa Foskett Goleno donated a piece of her liver to her then 12 year old niece on September 10th, 2009
Leonard Spogis donated part of his liver to his brother-in-law, Michael Olson, on September 23rd, 2009
Terri O'Brien donated her left kidney to her cousin's wife on September 29th, 2009

Thirteenth anniversary:
Julie Coronel donated a kidney to her husband, Ruben, on September 7th, 2010
Brett Hartmann donated a kidney to a friend's son on September 18th, 2010
Andria donated a kidney to her son, Daniel, on September 28th, 2010
George Taniwaki made a non-directed kidney donation on September 10th 2010

Twelfth anniversary:
Michelle Wortman donated a kidney to her sister on September 1st, 2011
Angela Stimpson became a non-directed kidney donor on September 22nd, 2011
Tori Neese Bergstrom donated "Billy the Kidney" to her friend on September 6th, 2011

Eleventh anniversary:
Pam donated part of her liver to her brother, Edwin Dudley, on September 4th, 2012
Sue donated a kidney to her husband, Jeff, on September 4th, 2012
Sara Stallings donated a kidney to her son, Mac Yeida, on September 12th, 2012
Dawn donated a kidney to her daughter, Mandy, on September 27th, 2012

Tenth anniversary:
Brian Hartung donated a kidney to his brother, Brad, on September 9th, 2013
Sally Obrien donated a kidney to her friend, Sally Busset, on September 18th, 2013
Patty Hogan Jack donated part of her liver to her sister on September 24th, 2013
Terry Hunter made a non-directed kidney donation on September 30th, 2013

Eighth anniversary:
Julianne Bancroft made a non-directed kidney donation on September 16th, 2015
Archie White donated a kidney to his daughter, Carrie, on September 30th, 2015

Seventh anniversary:
Susan Huizenga donated a kidney to Buddi Subba, found through their church bulletin, on September 12th, 2016
Natasha Richards donated a kidney to her step-father, Bernardo Bermudez, on September 20th, 2016

Fourth anniversary:
Constance M. Smith made a non-directed donation to Connie Cull on September 27th 2019