Transplantation

At 84, Juan Guano would seem an unlikely candidate for a kidney transplant. But the kidney he received was 69. Until recently, that kidney would not have been eligible for use in a transplant. But this summer, surgeons at Northwestern Memorial Hospital placed it into Guano, making him among the nation's oldest organ recipients. His surgery illustrates intersecting trends in transplant medicine: People 60 and older represent the fastest-growing age group on transplant waiting lists, and kidneys increasingly are being accepted from "expanded-criteria donors" -- older people and those who had health problems.

Re "Transplant monitor lax in oversight," Oct. 22 I want to assure readers, particularly those on a transplant waiting list, of the vigilance that the United Network for Organ Sharing takes to ensure the safety of patients awaiting transplantation. Most transplant programs perform well and comply with the rules that govern transplantation. When the United Network identifies a program that has not complied with those rules or has lower-than-expected outcomes, we cannot simply "act first, ask later."

Andrew McKelvey, the billionaire founder and former chief executive of Monster Worldwide Inc., died early Thursday morning in New York after a long battle with pancreatic cancer, his family said. He was 74. In 1967, McKelvey founded a yellow-pages advertising business called Telephone Marketing Program. Later known as TMP Worldwide, the company acquired The Monster Board and Online Career Center in 1995, and four years later the job-recruitment Web site Monster.com was launched to great success.

A climate of "fear and retribution" existed within the now-shuttered liver transplant program at St. Vincent Medical Center, keeping staff members from speaking up about a major breach in national transplantation standards and prompting them to falsify documents as part of a coverup, according to a new federal report. The U.S. Centers for Medicare and Medicaid Services, in its stinging 99-page report, found serious deficiencies at St.

A strong exception is taken to the article in the Oct. 14 Orange County edition ("New to the Joint: Cartilage Growth Method Offers Knee Patients Relief") regarding joint cartilage transplantation. This article touted the positive aspects of this procedure, in which defects in cartilage of the knee have been filled with laboratory-grown cartilage cells but failed to point out the experimental nature and possible negative aspects of the treatment. The hype for this procedure stems from a Swedish study in which 16 cases were performed.

In a medical breakthrough that could one day lead to limb transplants in humans, researchers at UC Irvine College of Medicine announced Monday that they have performed leg transplants on laboratory rats that have survived long-term without rejecting the leg tissue. The long-term survival of the transplanted limbs was achieved using a drug called cyclosporine, an immunosuppressant that has become increasingly popular among surgeons performing organ transplants in humans, officials said.

Breathe in, breathe out — it may seem simple, but lungs are devilishly complicated structures, boasting more than 40 different cell types and an intricate network of tiny blood vessels and air sacs. It's no wonder, then, that engineering lungs in the lab, either for transplantation or study, has been extremely challenging. Now two research groups have made major strides in attacking the problem. One has successfully engineered a lung that can sustain a living rat and the other has created a lung-mimicking device for toxicology studies that acts more like a real lung than any earlier efforts, the groups reported Thursday in the journal Science.

West Nile virus infections have been confirmed in three transplant patients in Florida and Georgia--one of whom died of encephalitis--and a similar infection is suspected in a fourth patient. All received organs from a Georgia woman who died from injuries suffered in an automobile accident in late July, and federal officials now think it is likely that her organs transmitted the virus to the four patients.

In the end, the religious faith that could have killed William Jennings saved his life. The 44-year-old computer programmer was suffering from liver failure when doctors told him his only hope of living longer than six months was a transplant. Such operations are notoriously difficult and messy, however--sometimes requiring up to 80 pints of donated blood. And Jennings is a devout Jehovah's Witness whose beliefs prohibit a single drop of another person's blood from entering his body.

For the last seven years, Rajesh Gupta has spent 12 hours a week in a hospital bed, hooked up to a hemodialysis machine. He would prefer a kidney transplant. But India has no national organ waiting list, few registered organ donors and a legal system that bars transplants from most living donors except for close family members. That means Gupta, with no donor matches in his family, must pay about $900 a month for dialysis for life. Still, he counts himself lucky: In a nation where about 150,000 people suffer kidney failure each year and the average monthly per capita income is $63, options are limited.