Long-term transplant survival: An answer to a 24-year-old question

January 11, 2012

Edith Helm (left) got a kidney from her identical twin Wanda in 1956 in OK

A quick history lesson before we tell you about Cindy Conrad:

Organ transplant was first attempted in the 1950s. At first, the only transplants performed were living donor kidney transplants between identical twins, who, being genetically identical, were automatically a perfect match.

In the 1960s and 1970s, surgeons tried other types of transplants. But steroids, like prednisone, were the only immunosuppressants available. Though these drugs suppressed the immune system, the doses needed to prevent organ rejection often caused very unpleasant and dangerous side effects. As a result, transplants were regarded as experimental.

But in 1983, cyclosporine, or Sandimmune, the first effective immunosuppressant drug with relatively few side effects hit the market.

Suddenly, organ transplant took off.

The former Barnes Hospital (now Barnes-JewishHospital) had been doing kidney transplants since 1963. In 1985, it established a heart transplant program. Later that year, it became the 16th hospital in the country to start a dedicated liver transplant program. By 1987, that program was firmly established.

The thing is, in 1987 people had no idea how long an organ transplant recipient could live. Yes, they’d come through the surgery. Yes, they’d return to a near-normal life. But how long would they eventually survive?

Some of the early identical twin transplant patients were still alive almost 20 years later. But they had living donor organs and didn’t have to take immunosuppressants.

Doctors thought it was reasonable to expect these post-Sandimmune patients would make at least five years after transplant if they had no complications. Beyond that? Who knew?

Enter Cindy Conrad.

 A young mother in the last trimester of her second pregnancy, Cindy had been feeling a little “off.” That “off” feeling turned out to be a rare complication of pregnancy that caused her liver to fail. In a matter of days, she delivered her baby, fell into a coma and had an emergency liver transplant.

She recovered from the transplant, but doctors secretly wondered if she’d see her children grow up.

Did she ever! Cindy is 24 years post-transplant and going strong (although she later had a tremendous hurdle to surmount – but, that’s another story).  Her hepatologist , Dr. Jeffrey Crippin, calls Cindy an example of  “the triumph of the human will.”

Read a blog post by her daughter, who was just a toddler at the time of the transplant: http://intheorangehouse.blogspot.com/2011/12/liver-girl.html

Lung recipient tells a story of persistence and defying the odds

November 28, 2011

Here’s a great story about a Barnes-Jewish patient who reminds us that

Trina Shepperd

transplant patients, themselves,  may play the biggest role in how a transplant story turns out.

Sometimes that story can have unexpected twists and dark moments, when a happy ending seems unattainable.  At those times, the transplant patient has to have the will and inner strength to keep going.

Sometimes, the story drags on and on with no end in sight, and all that patient can do is persist and hope.

That’s especially true of lung transplant, where transplant candidates have to take an active role every day to keep themselves in the best physical shape possible for an operation that might never happen.

Pryor, OK, resident Trina Shepperd was used to persisting and hoping, even before she was on the list for a lung transplant. So, enjoy Trina’s story.

And if you’re a transplant recipient, take a moment to appreciate your own contribution to your transplant success.


-Kathy Holleman

A mom tells why donation was the “right thing to do”

November 15, 2011

Our partners at Mid-America Transplant Services, the region’s organ procurement organization, have a video by  donor mom June Laschober in their newest online newletter.

She talks about her son, Scott Laschober, a “teddy bear” of  a young man, who died  just as his life was starting to come together. June tells how in the face of this tragedy, making the decision to donate her son’s organs and tissue was “the right thing to do.” 

For anyone wondering what it’s like to make the decision to donate, this video answers that question. For organ or tissue recipients who may feel survivor’s guilt about getting the chance to live because someone else died, this video should be comforting.

Click here to take a look.

BTW, I had a ♥ tx. LOL!

October 19, 2011

If you can read the headline on this post, you obviously know how to text, and you’re   probably a Gen Xer, or younger. If you’ve also had an organ transplant,  you’re in a select group.

As a group,  transplant patients tend to be older adults. For instance, in 2010, Washington University physicians at Barnes-Jewish Hospital performed  413 organ transplants, while  St. Louis Children’s Hospital performed 59.

It makes sense – adults get diseases or their organs are damaged or wear out for various reasons. Children don’t have the time for this to happen. Most transplants in children happen because of congenital problems (and most of these transplants are successful).

But what happens when a child who has a transplant grows  into an adult? Obviously, these patients have to transition to follow up care at an adult transplant center. That can be a rough transition, and we don’t just mean that you no longer get a SpongeBob sticker and a lollipop after a successful blood draw.

Transplant social workers at Barnes-Jewish are currently developing a program to help patients transition from care at a pediatric hospital to an adult transplant center. Their transplant mentor program includes several people who have already made the transition.

Also, there are blogs by people who have grown up with their transplant. One we found one by a young heart transplant patient, “@hearttxxx,” is funny and frank. It discusses topics such as telling your boyfriend/girlfriend where you got your scar, getting busted by a doctor for skipping your anti-rejection meds, bizarre questions about your transplant, and more.

For instance, here’s @hearttxxx on being growing up and taking meds:

Once you leave the children’s hospital, the hardest part about going to the adult hospital is that you have to be an adult. I think I got the heart of Peter Pan. I don’t want to grow up!

Now, I have to order my pills, pay for my pills, layout my daily pills and then finally take those pills. There’s no adult to tell you to do that because you’re the adult now. Sure, the pills keep us alive, but when you’re this healthy, it’s easy to take it for granted. Life just got so awesome that I often forget to be an adult about it and take my damn pills. Who’s to tell me that the chest pain I feel is something to worry about?  Who’s to remind me to put on sunscreen?

The adult. And now, I’m the adult. It’s gratifying, but it’s a lot of responsibility.

Here’s the link for “Life after Transplant.”

Tell us what useful and entertaining transplant blogs you’ve found.

-Kathryn Holleman

Should transplant patients get flu shots?

October 17, 2011

Roll up your sleeves, transplant patients! You need your flu shot – maybe more than other folks.

This comes from Dr. Ramsey Hachem, Washington University pulmonologist at Barnes-Jewish Hospital.

People seem to have excuses every year as to why they don’t need a flu shot – flu shots make them feel sick, they never get the flu, it’s inconvenient, they’re just tired of getting stuck.

Sorry, we aren’t buying any of it.

Influenza is a deceptively devastating illness. For many of its victims, it’s ends up being a week or two of fever, aches, chills, sore throat, coughing and general misery. 

But for people with weakened immune systems, it can be much worse, says Dr. Hachen.  Transplant patients, this means YOU.

People on immunosuppressants are more likely to catch the flu, he says. Then, in these patients, the flu is more likely to lead to complications  including sinus and ear infections and pneumonia. These complications, in someone whose immune system is impaired, are more likely to be severe and lead to hospitalizations.

The Centers for Disease Control’s flu information site recommends that EVERYONE over age six months get vaccinated.

The only caveat, says Dr. Hachem, is that transplant patients, ideally, should get a vaccine with a dead virus. Flu vaccines work by using dead influenza viruses to  trick the body into making antibodies against the flu. The only exception is inhaled vaccine, or FluMist, which uses a weakened live virus.

The problem with FluMist is that in rare cases, it can actually cause flu symptoms. Although it’s unlikely to cause the actual illness, transplant patients and others with weak immune systems shouldn’t take the chance.

S0, if you haven’t already, get that shot and stay healthy through this flu season.

There are still opportunities to get free flu shots supplied by the Foundation for Barnes-Jewish Hospital. Check here for dates and times.

Stanford study shows promise in weaning patients off anti-rejection drugs

October 7, 2011

It’s a given. Immunosuppressant medication is the cornerstone to successful organ transplant. Without it, a patient’s body would reject the transplanted organ, causing it to fail.

A new study shows that might not always be the case.

A short letter in the Oct. 6 issue of the New England Journal of Medicine tells of a small study at Stanford in which eight out of 12 kidney transplant patients were successfully weaned off of their immunosuppressants.

The patients were given a post-transplant regimen of radiation and donor stem cells, which temporarily blinded the body to the foreign tissue transplanted into it.

While the study is small, it gives hope that, eventually, transplant patients will no longer have to rely on daily medications (some of which can cause severe side effects, themselves) to keep them healthy.

Among those who would welcome a breakthrough in immune suppression therapy is Washington University nephrologist Daniel Brennan, MD, the medical director of kidney transplant at Barnes-Jewish Hospital.  Dr. Brennan is known in the transplant community as an innovator in the field of immunosuppression. Hear his take on his role in the transplant process.

-Kathryn Holleman

Physician of the week: Dr. Jeffrey Lowell

September 27, 2011

Here’s a little test. Which of the following does not apply to Washington

Biker Dr. Jeff Lowell (right) with fellow transplant surgeons at the MS150

University transplant surgeon Dr. Jeffrey Lowell?

a. He’s a Navy reservist who recently completed a six-month tour in Germany, operating on soldiers evacuated from combat zones.

b. He’s a black belt in karate.

c. He was a member of the St. Louis City Police hostage negotiation team.

d. He was medical emergency preparedness advisor to then-Homeland Security Secretary Tom Ridge.

d. He has a brother who’s not a doctor, but has played on TV (as a guest star on “Bones.”)

e. One time, he did something only halfway.

If you picked “e,” you’re correct.  Dr. Lowell never does things halfway.

That includes saving lives by transplanting livers and kidneys at both Barnes-Jewish and St. Louis Children’s Hospital.

We could keep listing his accomplishments – like director of the regional medical emergency response team, fencer, runner, husband and father, etc. – but space is limited.

So watch the video and hear about how he approaches his “day job.”


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