Organ Transplants

Ephram Nehme was gravely ill when Anthem Blue Cross of California agreed to pay for a liver transplant his physician said he needed to survive. Then, his condition went downhill fast. The news from his doctor was bad. The word from his insurer was worse. Nehme's doctor told him he could die waiting for an organ in California and urged him to go to Indiana, where the waiting list was shorter. But Anthem Blue Cross said no. It would not pay for a transplant in Indiana. Nehme, a Lebanese immigrant with a rags-to-riches story, could afford to buy himself a new lease on life and did -- going to Indiana and paying $205,000 for a liver transplant there.

At 8:25 Thursday morning, Dr. Peter Schulam extracted a healthy kidney from a 60-year-old woman, slipped it into a bowl of sterile ice and wheeled it into the operating room next door. The donor, Nancy Seruto, a San Dimas mother, had never met the recipient, a 67-year-old retired flight attendant from Santa Ana. Less than two hours later, Seruto's husband was on the same operating table at Ronald Reagan UCLA Medical Center. Another stranger, a 53-year-old Chatsworth mother of two, was giving him a kidney.

Fifteen years ago, during a family vacation in southern Italy, my 7-year-old son, Nicholas, died after being shot in a botched robbery. I knew then that I could never be really happy again. Maggie -- my wife -- and I are not gloomy people. And with three other lively children, our home is not a mournful place. But, as I sensed then, the realization that Nicholas' radiant life was snuffed out still colors all my thinking. I think of all the books he will never read, the friends he will never meet, the sunsets and mountains and starry skies he will never see. What I never expected was the emotional upsurge around the world that followed our decision to donate his organs and corneas to seven very sick Italians, four of them teenagers.

No one in the courtroom Wednesday suggested that Ruben Navarro could have avoided death for long. But whether the severely retarded, comatose 25-year-old was nudged into it by an impatient transplant surgeon is at the core of a legal proceeding unprecedented in the United States. Dr. Hootan Roozrokh, 34, has been charged with three felonies in Navarro's 2006 death.

A transplant surgeon accused of illegally hastening the death of a prospective organ donor acted properly when he ordered sizable doses of pain and anxiety medication for the comatose man, the physician's attorney suggested in court Thursday. Gravely ill, Ruben Navarro "was going to die shortly, whether in minutes or in hours," said attorney M. Gerald Schwartzbach as he asked a question of a witness. "In that situation, you err on the side of ensuring that he's pain-free."

He sits quietly at the corner cafe, a gold watch flickering on his wrist. If you need a liver, or want to sell a piece of yours, grab a chair and get acquainted with Mustafa Hamed, a 24-year-old ex-bus driver who fell unexpectedly into a life as a broker in human organs. Hamed's 4-year-old son, Mohamed, was dying of cancer and needed an artery transplant that cost $5,000. The only savings Hamed had was what he fished from his pockets at the end of the day.

An influential U.S. senator sent a series of letters Friday seeking additional details about four liver transplants at UCLA Medical Center involving patients who were suspected members or associates of Japanese organized crime groups. "While surgeons do not seek to pass moral judgment on the patients they treat, Americans hope at the very least that foreign criminal figures wait in line along with the rest of us," Sen. Charles E.

When you're lying in bed and can't keep food down, muscle metabolizes first. Dr. Zhaoping Li, my UCLA clinical nutritionist, says the rate is two to three pounds of muscle wasted for every pound of fat. Bug-eyed and big-bellied with fluid after four months' hospitalization for liver failure, I had legs and arms like matchsticks. I could walk no farther than one block. Me, the lifelong athlete, former aerobics instructor and dancer -- now wait-listed for a transplant.

Heart transplant patients are as much as 25% more likely to survive if the sex of the donor is the same as the patient's, researchers said Wednesday. The results surprised experts because, for most types of transplants, sex differences are irrelevant as long as a good immunocompatability is achieved.

A woman being treated at the Cleveland Clinic has an almost entirely new face following the most extensive facial transplant ever performed, the medical center said Tuesday. The surgery was the first face transplant in the U.S. and the fourth in the world. Few details about the patient have been released in advance of a news conference scheduled for today. About 80% of the patient's face was replaced with skin and muscles harvested from a cadaver.