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Fecal Transplants Benefit IBS Patients: Study

Oct. 21, 2019 — Fecal transplants from a “super-donor” reduced symptoms of irritable bowel syndrome (IBS) in many patients, a new study says.

It’s estimated that 10-15% of Americans have IBS, according to the American College of Gastroenterology. Abdominal cramping, bloating, constipation and diarrhea are among the symptoms. The condition doesn’t damage the intestines.

The cause of IBS hasn’t been pinpointed but some researchers believe it’s linked to abnormalities in the population of microorganisms in the gut. Fecal transplants — in which stool from a donor is processed and then transplanted into a patient’s gut — are meant to repopulate the gut with a healthier range of microorganisms, NBC News reported.

This study included 164 IBS patients who received either lower- or higher-dose fecal transplants or a placebo, which were delivered to the small intestine through a tube inserted into the mouth and down the throat.

Moderate symptoms improvement was reported by 23.6% of patients in the placebo group, 76.9% of those in the lower-dose fecal transplant group, and 89.1% of those in the higher-dose group, NBC News reported.

Symptoms went away entirely in 5.5% of patients in the placebo group, 35.2% of those in the lower dose group, and 47.3% of those in the higher dose group, according to the study presented at the annual United European Gastroenterology Week in Spain.

One year after the study, the benefits of fecal transplant appear to have lasted, noted lead researcher Magdy El-Salhy, a professor in the Department of Clinical Medicine at the University of Bergen, in Norway.

“The preliminary results [suggest] most, 90-95%, of the responded patients are still well and about 50% are still ‘cured,'” he told NBC News.

The donor was healthy, had been breast-fed, had a nutritious diet, took no regular medications, was a nonsmoker and had taken antibiotics only a few times, El-Salhy noted.

The fact that the study used a so-called super donor raises questions, experts said.

“These are very promising results that will certainly generate a lot of interest and attention because there is a great interest in these kinds of therapeutics for IBS,” Dr. Alexander Khoruts, medical director of the Microbiota Therapeutics Program at the University of Minnesota, told NBC News.

“But it’s not clear how you could find another ‘super donor’ to reproduce these results,” Khoruts added.

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AHA News: Women and Men Tolerate Heart Transplants Equally Well, But Men May Get Better Hearts

FRIDAY, Oct. 11, 2019 (American Heart Association News) — Women are just as likely as men to survive after a heart transplant despite often getting poorer-quality donor hearts, new research shows.

The findings, published this week in the American Heart Association journal Circulation: Heart Failure, sought to shed new light on what role, if any, gender plays in surviving a heart transplant. Past research on post-transplant survival rates and gender have told conflicting stories.

For the new study, researchers looked at data from 34,198 international heart transplant recipients from 2004 to 2014 and, after adjusting for recipient and donor factors, they found “no significant survival difference” between men and women.

“That’s a pretty novel finding,” said study author Dr. Yasbanoo Moayedi, a postdoctoral medical fellow at Stanford University in California. “We already know that women are hugely under-represented as recipients of heart transplants, but the striking thing about the new findings is there’s no difference in survival when matched to their male counterparts.”

The study also found women who get heart transplants appear to have lower-risk features than male recipients, with fewer instances of diabetes, high blood pressure, smoking, peripheral vascular disease and past cardiovascular surgery. Yet, women appear to receive higher-risk hearts than men.

“We need to better understand the matching of risk with recipient,” Moayedi said. “We hypothesize that women tend to deteriorate more acutely, and they’re sicker, so they take any heart that’s available.”

She said the findings suggest women with advanced heart failure need to be referred a bit earlier for transplant.

“One takeaway of the study is that maybe we’re missing the optimal window [for women],” she said. “Many factors may determine access to transplant, but gender should not be one of the them.”

The study was limited by its observational nature and its lack of data on waitlist mortalities, donor race and information about how sick patients where when they received a transplant.

Dr. Monica Colvin, a heart failure-transplant cardiologist who was not involved in the research, called it “a contemporary analysis” because it included newer devices and current medical therapy.

“There have been anecdotes of women having worse survival than men after heart transplant and studies have been conflicting,” said Colvin, director of the Heart Failure Network Strategy at the University of Michigan. “This study should dispel that myth and inform doctors that there really is no difference. We should not delay or defer referral for this lifesaving treatment based on concern for differential survival in women.”

An estimated 6.2 million U.S. adults have heart failure. In 2018, there were 3,408 heart transplants, according to the federal Organ Procurement and Transplantation Network.

Moayedi would like to see future studies explore why more women don’t undergo heart transplants and how a doctor’s gender might play into that decision.

“Is it that women don’t see themselves worthy enough for a heart transplant? As a patient, should I be more of an advocate for my symptoms? These things need to be looked at more systematically to learn how to best help the patient,” Moayedi said.

Colvin advises women with advanced heart failure to be seen at an advanced heart failure center “and seek out as much information as they can. It’s important to know what all your options are.”

© 2019 HealthDay. All rights reserved.

Posted: October 2019

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FDA: Infections, 1 Death After Fecal Transplants

By Steven Reinberg

HealthDay Reporter

FRIDAY, June 14, 2019 (HealthDay News) — Fecal transplants — transferring fecal matter from a healthy person into an ill person with a compromised “microbiome” — is an increasingly used new treatment for a variety of ills.

But on Thursday federal health officials announced that a patient died after such a procedure, highlighting the potential for severe infections linked to fecal transplants.

“While we support this area of scientific discovery, it’s important to note that fecal microbiota for transplantation does not come without risk,” said Dr. Peter Marks, director the Center for Biologics Evaluation and Research at the U.S. Food and Drug Administration.

After reports of serious, antibiotic-resistant infections linked to the procedures, the FDA wants “to alert all health care professionals who administer FMT [fecal microbiota transplant] about this potential serious risk so they can inform their patients,” Marks said in an agency news release.

Fecal microbiota transplant is a still-experimental procedure, as yet unapproved by the FDA. It’s been primarily used to treat serious infections of antibiotic-resistant forms of the Clostridium difficile (C. difficile) bacterium.

The transplant involves taking stool from a healthy donor and placing it in the ill patient’s colon. The aim is to help replace an unhealthy “microbiome” — the trillions of bacteria that reside in the human gut — with a more robust, disease-fighting microbiome from the donor.

Once delivered via the fecal transplant, this new microbiome repopulates the patient’s microbiome with healthier microorganisms, which effectively crowd out dangerous C. difficile.

Researchers are also looking into the use of fecal transplants to treat chronic gastrointestinal illnesses such as ulcerative colitis or irritable bowel syndrome.

But every therapy comes with risks, and the FDA said that two patients who received fecal microbiota transplants as part of a clinical trial developed life-threatening infections from multidrug-resistant bacteria delivered in the transplants. One of the patients has died.

Both patients had weakened immune systems, making them more vulnerable to germs that are resistant to multiple antibiotics. So, the FDA is now mandating that special screening and testing of the stool used in these procedures be done, to ensure that no drug-resistant bacteria are in the donated material.

Continued

Also, when fecal microbiota transplants are used, doctors need to have adequate informed consent from the patient, the FDA said. Patients need to be warned of any potential risks associated with the treatment and be told that the treatment is still considered experimental.

Marks stressed that the FDA still supports research into fecal transplant therapy.

“The medical community is actively engaged in exploring the potential uses of fecal microbiota for transplantation,” he said. Although the therapy isn’t approved by the FDA, the agency supports the use of this treatment and is looking to “strike a balance between assuring patient safety and facilitating access to unapproved treatments for unmet medical needs,” Marks said.

To that end, “we will continue to aggressively monitor clinical trials to ensure patients are protected when safety concerns arise,” Marks said.

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Sources

SOURCE: U.S. Food and Drug Administration, June 13, 2019, press release

Copyright © 2013-2018 HealthDay. All rights reserved.

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Organ Transplants Linked to Higher Skin Cancer Risk

Organ Transplants Linked to Skin Cancer Risk

Experts say all recipients should have full-body skin evaluations after transplant surgery

WebMD News from HealthDay

By Mary Elizabeth Dallas

HealthDay Reporter

WEDNESDAY, Sept. 21, 2016 (HealthDay News) — People who have an organ transplant may be more likely to develop skin cancer, new research suggests.

The finding applies to all transplant patients, even those who are nonwhite and dark-skinned, according to Dr. Christina Lee Chung, an associate professor of dermatology at Drexel University in Philadelphia, and colleagues.

The researchers said the risk increases over time with ongoing exposure to medications that suppress the immune system to prevent organ rejection.

Total-body skin exams should be a routine part of care after transplant surgery, the study authors advised.

For the study, the researchers analyzed medical records of 413 organ transplant recipients, 63 percent of whom were not white.

The investigators found 19 new skin cancers in 15 of the nonwhite patients. That group included six black patients, five Asians and four Hispanics. Among the black patients, all of the skin cancers were caught early on.

Most of the Asian patients developed skin cancers in areas that had been exposed to the sun. Skin cancers were also found on sun-exposed areas and lower legs of the Hispanic patients.

The researchers noted, however, that their ability to draw firm conclusions was limited by the small number of skin cancer patients. And the study did not prove a cause-and-effect link.

“Nonwhite organ transplant patients represent a unique group with specialized medical needs; thus, more knowledge on risk factors, appropriate screening methods and counseling points are essential for providing comprehensive dermatologic care for these patients,” the study authors concluded.

The study was published online Sept. 21 in JAMA Dermatology.

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Cornea Transplants Riskier for Women When They Come From Men?

FRIDAY July 15, 2016, 2016 — Women who undergo a cornea transplant may have a worse outcome if their donor is a man, a new study suggests.

Subtle differences between men and women may increase the risk of failure or rejection for up to five years, the British researchers found. They noted that matching the gender of cornea donors and recipients could help improve transplant outcomes.

The study involved more than 18,100 cornea transplant patients. More than 80 percent still had a working cornea after five years. Of those who had a failed transplant or tissue rejection, more were women who had received a cornea from a male donor.

On average, 180 transplants fail for every 1,000 gender-matched procedures, compared with 220 failures among every 1,000 male-to-female transplants, according to the researchers. They said these results were especially evident among patients with Fuchs endothelial dystrophy — a condition affecting a thin layer of cells that line the back of the cornea.

The findings were published July 14 in the American Journal of Transplantation..

The findings are most likely associated with the male Y chromosome, study leader Dr. Stephen Kaye, an opthalmologist at The Royal Liverpool University Hospital, said in a journal news release.

The authors said more research is needed to confirm their findings and to potentially justify allocating corneas from male donors only to other men. Corneas from female donors may be given to either men or women, the researchers said.

“If confirmed, this would be relatively straightforward to put into place without delay in donor tissue allocation to patients or any significant added cost,” Kaye said. “The long-term impact this could have on patient care may be substantial.”

More information

The U.S. National Eye Institute provides more information on diseases of the cornea.

Posted: July 2016

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Stem Cell Transplants and Tough-to-Treat Crohn’s

High risk of infection is a deterrent, too

WebMD News from HealthDay

By Steven Reinberg

HealthDay Reporter

TUESDAY, Dec. 15, 2015 (HealthDay News) — Stem cell transplants seem no better than conventional therapy for Crohn’s disease that hasn’t responded to other treatments, a new study finds.

The European study also found that for patients who cannot undergo surgery for the condition, stem cell transplants resulted in serious side effects, including infections.

“In this group of the most resistant cases of Crohn’s disease, stem cell transplant was an effective treatment, but it is not a miracle cure that could be applied to anyone with Crohn’s disease, because it only seems to work in a minority of patients and the treatment is challenging and hazardous,” said lead researcher Christopher Hawkey. He is a professor of gastroenterology at Queen’s Medical Centre in Nottingham, England.

For the study, Hawkey and colleagues randomly assigned 45 patients with Crohn’s disease to transplants with their own stem cells or to continued standard medical care. Patients were followed for one year.

Crohn’s disease is a chronic inflammatory condition of the intestinal tract that produces symptoms such as persistent diarrhea, rectal bleeding and painful cramps, according to the Crohn’s & Colitis Foundation of America. The condition can cause lifelong ill health, impaired quality of life and reduced lifespan.

Immunosuppressive drugs are the standard of care, but some patients do not respond to them or stop responding, Hawkey said.

Stem cell transplants represent an attempt to reset the immune system, which turns on itself in Crohn’s disease, Hawkey explained.

“The stem cell treatment involves wiping out the body’s immune system and replacing it with the patient’s own innocent stem cells, a sort of immunological spring clean,” he said.

The report was published Dec. 15 in the Journal of the American Medical Association.

One year after treatment, the researchers found no statistically significant difference between the groups in the proportion of patients whose disease was in remission in the past three months — just two in the transplant group and only one receiving standard care.

But 61 percent in the transplant group had been able to discontinue active treatment in the past three months compared with 23 percent in the usual care group, the researchers said.

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Fecal Transplants Work, But Need Tight Regulation

Clinical trial halted early because the treatment was effective

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By Robert Preidt

HealthDay Reporter

WEDNESDAY, Oct. 21, 2015 (HealthDay News) — The growing use of fecal transplants needs to be carefully controlled, experts say.

The therapy is increasingly being used to treat people with life-threatening intestinal infections, such as those caused by the bacterium Clostridium difficile. The procedure involves transferring fecal matter from a healthy donor into the intestine of a patient so that healthy bacteria can re-colonize the bowel.

Researchers analyzed available evidence and found that fecal transplants were 85 percent successful in treating patients, compared with 20 percent for standard antibiotic treatment.

A recent clinical trial was halted early because fecal transplantation proved so effective, with a 90 percent success rate compared to 26 percent for powerful antibiotics, the researchers noted.

After more than 7,000 fecal transplants, few harmful effects have been reported and the transplants seem relatively safe for elderly patients and those with weakened immune systems, the researchers wrote in the Oct. 20 issue of BMJ.

The study was conducted by Dr. Tim Spector, a professor of genetic epidemiology at King’s College London, and Rob Knight, a professor of pediatrics and computer science and engineering at the University of California, San Diego.

More than 500 centers in the United States offer fecal transplants.

Along with treating C. difficule infections, fecal transplantation is being tested to treat other common conditions such as obesity, diabetes, irritable bowel syndrome and colitis, the researchers said.

However, wider use of fecal transplantation needs to be handled carefully, Spector and Knight said.

“We urgently need more expertise and centers, proper screening of donors, and good long-term trials and monitoring procedures in order to provide sensible advice,” they wrote.

Otherwise, patients “may lose patience and take matters into their own hands [using DIY methods] with unpredictable consequences,” the two experts warned.

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Stem Cells, Fecal Transplants Show Promise for Crohn’s Disease


Stem Cells, Fecal Transplants for Crohn’s Disease

But both trials were small and more research is needed

WebMD News from HealthDay

By Amy Norton

HealthDay Reporter

FRIDAY, April 10, 2015 (HealthDay News) — Two experimental therapies might help manage the inflammatory bowel disorder Crohn’s disease, if this early research pans out.

In one study, researchers found that a fecal transplant — stool samples taken from a healthy donor — seemed to send Crohn’s symptoms into remission in seven of nine children treated.

In another, a separate research team showed that stem cells can have lasting benefits for a serious Crohn’s complication called fistula.

According to the Crohn’s & Colitis Foundation, up to 700,000 Americans have Crohn’s — a chronic inflammatory disease that causes abdominal cramps, diarrhea, constipation and rectal bleeding. It arises when the immune system mistakenly attacks the lining of the digestive tract.

A number of drugs are available to treat Crohn’s, including drugs called biologics, which block certain immune-system proteins.

But fecal transplants take a different approach, explained Dr. David Suskind, a gastroenterologist at Seattle Children’s Hospital who led the new study.

Instead of suppressing the immune system, he said, the transplants alter the environment that the immune system is reacting against: the “microbiome,” which refers to the trillions of bacteria that dwell in the gut.

Like the name implies, a fecal transplant involves transferring stool from a donor into a Crohn’s patient’s digestive tract. The idea is to change the bacterial composition of the gut, and hopefully quiet the inflammation that causes symptoms.

And for most kids in the new study, it seemed to work. Within two weeks, seven of nine children were showing few to no Crohn’s symptoms. Five were still in remission after 12 weeks, with no additional therapy, the researchers reported in a recent issue of the journal Inflammatory Bowel Diseases.

Fecal transplants are not yet approved for treating Crohn’s, Suskind said.

They are, however, sometimes used to treat a gastrointestinal infection called C. difficile — with “astounding success,” said Dr. Arun Swaminath, who directs the inflammatory bowel disease program at Lenox Hill Hospital in New York City.

So it’s “logical” to study the therapy for Crohn’s, according to Swaminath, who was not involved in the new research.

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Timing of Kidney Transplants Doesn’t Affect Pregnancy Chances

MONDAY Feb. 2, 2015, 2015 — Pregnancy outcomes are similar for women who received a kidney transplant whether they were a child or an adult when they got their transplant, a new study says.

“This work has shown that outcomes for childhood transplant mothers are similar to outcomes for adulthood transplant mothers and should provide comfort to such mothers and their physicians that their early onset of kidney failure and longer period of posttransplant exposure to immunosuppression do not adversely affect their pregnancy outcomes,” the researchers wrote.

Researchers reviewed data on women in Australia and New Zealand who received a new kidney and got pregnant at least once between 1963 and 2012.

There were 101 pregnancies among 66 women who had a childhood kidney transplant, defined as getting a transplant before they were 18. There were more than 600 pregnancies among 401 women who had an adulthood kidney transplant.

At the time of pregnancy, those in the childhood transplant group were an average age of 25 with a functioning transplant for 10 years. Those in the adulthood transplant group were an average age of 31 with a functioning transplant for six years, according to the study.

Live births occurred in 76 percent of pregnancies in the childhood transplant group and 77 percent of pregnancies in the adulthood transplant group. The study found that rates of preterm birth (less than 37 weeks pregnancy) were 45 percent in the childhood transplant group and 53 percent in the adulthood transplant group.

The percentage of preterm babies who were small for their gestational age was 22 percent in the childhood transplant group and 10 percent in the adulthood transplant group, the researchers found.

Rates of full-term babies who were small for gestational age were 57 percent in the childhood transplant group and 38 percent in the adulthood transplant group. Those rates were much higher than in the general population, the researchers noted.

The study was published online Feb. 2 in the journal JAMA Pediatrics.

More information

The National Kidney Foundation has more about kidney disease and transplants and pregnancy.

Posted: February 2015

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Outcomes Improving for Kids With Kidney Transplants

MONDAY March 10, 2014, 2014 — U.S. children in need of a kidney transplant are faring better now than a couple of decades ago, but there is still plenty of room for improvement, a new study finds.

Kidney failure is relatively uncommon in children — affecting five to 10 kids per million each year, according to study background information. But when it happens, the optimal treatment is a kidney transplant, which about 800 U.S. children undergo each year.

And the outlook for those kids has been steadily improving over the past 25 years, finds the new study published online March 10 and in the April print issue of Pediatrics.

Researchers found that among U.S. children who received a donor kidney in 2001, just over 90 percent were still alive 10 years later. That compared with a 10-year survival rate of 78 percent among kids who had a transplant in 1987.

The donor kidneys, themselves, were surviving longer, too. Among kids who received a transplant in 2001, 60 percent still had a functioning donor organ 10 years later, the findings showed. That was true for only 47 percent of kids who had a transplant in 1987.

“Things are better than they used to be, but there’s still a long way to go,” said Dr. Heung Bae Kim, director of the Pediatric Transplant Center at Boston Children’s Hospital.

For older adults with kidney failure, a donor kidney that survives for a decade may be adequate. But for kids, that is far from enough, said Kim, who was not involved in the study.

The major obstacle, he explained, is so-called chronic rejection.

“Rejection” refers to the immune system’s reaction against the donor organ. People who undergo a transplant have to take immune-suppressing drugs to thwart an attack that would damage or destroy the new organ. Doctors have made much progress in preventing and treating single episodes of “acute” rejection, which can happen any time, but is most likely to happen soon after the transplant.

Chronic rejection happens slowly, with the donor organ gradually losing function over the years, despite immune-suppressing drugs.

“We haven’t solved that problem yet,” Kim said.

Dr. Kyle Van Arendonk, lead researcher on the study, agreed that much of the progress that’s been made in pediatric kidney transplants shows up in the first year after the procedure.

His team found that back in 1987, 15 percent of children’s donor kidneys lasted fewer than 90 days — versus 3 percent in 2011. And for kids who had a transplant in 2010, 97 percent still had a functioning kidney one year later, compared with only 81 percent in 1987.

The likely reasons? Better immune-suppressing medications, infection prevention and improved surgical techniques probably play important roles, according to Van Arendonk, a surgeon at Johns Hopkins Hospital, in Baltimore.

Some kids seem to fare better than others, though. Donor organ survival improved to a lesser degree in female patients versus male, and in teens versus younger children.

The reasons aren’t clear, Van Arendonk said. But when it comes to teenagers and young adults, he noted, one problem is that some fail to stick with their post-transplant medication regimen.

Dr. Susan Furth, chief of nephrology at Children’s Hospital of Philadelphia, said that several studies there are looking at ways to improve teens’ outlook after a kidney transplant — through better medication adherence and “peer support.”

Beyond that, she said, “we are also working to better understand how to balance immunosuppression, so that kidney transplant recipients avoid both rejection — from too little immunosuppression — and infection, from over-immunosuppression.”

Because children who receive a donor kidney usually have decades of life ahead, nearly all will face chronic rejection at some point, said Kim at Boston Children’s Hospital. They may be able to have repeat transplants, but often they end up having to turn to their only other option: dialysis, which does the work of the kidneys, filtering waste products and excess water from the body.

So it will be vital to keep improving donor-kidney survival for kids, Kim said. The good news, he added, is that “a lot of researchers are working on that.”

As an example, Kim said researchers are developing approaches to “tolerance induction” — sophisticated ways of essentially tricking the immune system to accept a donor organ, without immune-suppressing drugs.

For now, study author Van Arendonk said teens and young adults need a lot of support from their health care providers, family and friends as they take on more responsibility for their own care.

More information

The United Network for Organ Sharing has more on pediatric kidney transplant.

Posted: March 2014

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Stem Cell Transplants May Harm Recipient’s Sex Life

THURSDAY Oct. 24, 2013 — Blood and bone marrow stem cell transplants may put a damper on the sex lives of cancer patients, a new study suggests.

This type of stem cell transplant is an increasingly effective form of treatment for patients with blood cancers such as leukemia, lymphoma and myeloma. Writing in the Oct. 24 issue of Blood, researchers say that while stem cell transplant was once tied to a high risk of death, survival rates have steadily risen and there’s now more focus on the patients’ quality of life, including their sexual well-being.

“It is not often that the transplant team and patient will have a conversation about how this procedure could impact their sex life, even after recovery,” study lead author F. Lennie Wong, of City of Hope in Duarte, Calif., said in a journal news release. “However, we hope these findings will help encourage patients and their doctors to openly discuss concerns related to sexual dysfunction and address them with specialists who can help.”

The new study included 152 men and 125 women averaging 48 years of age, who underwent stem cell transplants between 2001 and 2005, and were followed-up for three years.

The percentage of men who said they were sexually active fell from 61 percent before the procedure to 54 percent afterwards, but rose from 37 percent to 52 percent among women, according to the study.

Among men who received total body radiation, there was a nearly 18 percent decline in sexual function, a 32 percent decrease in sexual satisfaction, a 26 percent drop in both sexual behavior/experience and quality of orgasm, and a 17 percent decrease in sex drive/relationship. Radiation treatment did not appear to affect women in these areas, the study authors noted in the news release.

Men who developed stem cell transplant rejection — where the body’s immune system fights the new cells — had a 21 percent decrease in sexual thoughts/fantasy and a 24 percent decline in the quality of orgasm, the findings showed. Women who experienced transplant rejection had a 27 percent decline in both sexual satisfaction and sexual arousal.

Overall, women experienced significantly worse sexual effects than men, despite the fact that their sexual activity increased after their transplant, the investigators concluded.

The researchers believe that nearly half of people who undergo stem cell transplant are sexually inactive three years after their transplant. Patients may benefit from speaking with their doctors about their sexual health, the authors suggested.

More information

The American Cancer Society outlines the types of stem cell transplants used to treat cancer.

Posted: October 2013

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China to phase out use of prisoners’ organs for transplants

BEIJING | Thu Aug 15, 2013 8:28am EDT

(Reuters) – China will start phasing out its decades-long practice of using the organs of executed prisoners for transplant operations from November, a senior official said on Thursday, as it pushes to mandate the use of organs from ethical sources in hospitals.

China remains the only country in the world that still systematically uses organs extracted from executed prisoners in transplant operations, a practice that has drawn widespread international criticism. Many Chinese view the practice as a way for criminals to redeem themselves.

But officials have recently spoken out against the practice of harvesting organs from dead inmates, saying it “tarnishes the image of China”.

The health ministry will begin enforcing the use of organs from voluntary donors allocated through a fledging national program at a meeting set to be held in November, former deputy health minister Huang Jiefu, who still heads the ministry’s organ transplant office, told Reuters.

“I am confident that before long all accredited hospitals will forfeit the use of prisoner organs,” Huang said.

The first batch of all 165 Chinese hospitals licensed for transplants will promise to stop using organs harvested from death row inmates at the November meeting, he added. Huang did not specify the exact number.

MEETING “ACCEPTED ETHICAL STANDARDS”

An Australian-trained liver transplant surgeon, Huang said the China Organ Transplant Committee will ensure that the “source of the organs for transplantation must meet the commonly accepted ethical standards in the world”.

That effectively means the use of prisoner organs at approved hospitals will come to an end, but the timeframe remains indefinite, he added.

China has launched pilot volunteer organ donor programs in 25 provinces and municipalities with the aim of creating a nationwide voluntary scheme by the end of 2013.

By the end of 2012, about 64 percent of transplanted organs in China came from executed prisoners and the number has dipped to under 54 percent so far this year, according to figures provided by Huang.

At a meeting in August last year, Huang, deputy health minister at the time, told officials that top leaders had decided to reduce dependency on prisoners’ organs, according to a transcript of the meeting obtained by Reuters.

Rights groups say many organs are taken from prisoners without their consent or their family’s knowledge, something the government denies.

So far, more than 1,000 organ donors have come through the new system, benefiting at least 3,000 patients, Huang said.

Voluntary organ donation in China has already risen from 63 cases in all of 2010 to a current average of 130 per month so far this year, Huang added.

However, not all donated organs are currently allocated through the new program, leaving room for human interference, one of the main challenges the reform faces.

Supply still falls far short of demand due in part to the traditional Chinese belief that bodies should be buried or cremated intact. An estimated 300,000 patients are waitlisted every year for organ transplants and only about one in 30 ultimately will receive a transplant.

The shortage has driven a trade in illegal organ trafficking and in 2007 the government banned organ transplants from living donors, except spouses, blood relatives and step or adopted family members.

(Editing by Sui-Lee Wee and Ron Popeski)


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Type 1 Diabetes Hope: Animal-to-Human Cell Transplants


Type 1 Diabetes: Animal-to-Human Cell Transplants?

Researchers working with rodents say they’re one step closer

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Researchers report two drugs currently used to

By Robert Preidt

HealthDay Reporter

FRIDAY, July 12 (HealthDay News) — U.S. scientists who successfully transplanted insulin-producing islet cells from rats to mice say it is the first step toward animal-to-human transplant of islet cells for people with type 1 diabetes.

The researchers at Northwestern Medicine in Illinois developed a method that prevented the mice from rejecting the rats’ islet cells without the use of drugs to suppress their immune system.

The study was published online July 12 in the journal Diabetes.

“This is the first time that an interspecies transplant of islet cells has been achieved for an indefinite period of time without the use of immunosuppressive drugs. It’s a big step forward,” co-senior study author Stephen Miller, a research professor of microbiology and immunology at the Northwestern University Feinberg School of Medicine, said in a Northwestern news release.

Their ultimate goal is to be able to transplant pig islets into humans, said the other co-senior author, Dr. Xunrong Luo. “But we have to take baby steps,” said Luo, medical director of the human islet cell transplantation program at Northwestern Memorial. “Pig islets produce insulin that controls blood sugar in humans.”

People with type 1 diabetes don’t produce insulin. A transplant of insulin-producing islets from a deceased donor can help control type 1 diabetes, but there is a severe shortage of islet cells from deceased donors. Many patients on waiting lists don’t receive the transplant or suffer heart, nerve, eye and kidney damage while they wait.

Using islets from another species would enable more people to receive transplants. However, concerns about controlling rejection of transplants from a different species have made that approach seem impossible until now.

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No Trace of HIV After Stem-Cell Transplants, Researchers Say


No HIV After Stem-Cell Transplants: Researchers

Two more patients undergo ‘sterilizing cure,’ advancing understanding of the process

WebMD News from HealthDay

Analysis of patients who received human growth

By Dennis Thompson

HealthDay Reporter

WEDNESDAY, July 2 (HealthDay News) — Two HIV-positive patients show no trace of virus after receiving chemotherapy and stem-cell transplants as treatment for lymphoma, according to new research.

These patients have become the second and third known cases of a “sterilizing cure,” in which medical treatment removes all traces of HIV — the virus that causes AIDS — from the body. They have remained virus-free even though doctors months ago took them off their HIV-targeted medications.

“We have been unable to detect virus in either the blood cells or the plasma of these patients,” said lead researcher Dr. Timothy Henrich, of Harvard Medical School and Brigham and Women’s Hospital in Boston. “We also biopsied gut tissue from one of our patients, and we were unable to detect HIV in the cells of the gut. Essentially, we do not have any evidence of viral rebound.”

The findings are scheduled for presentation Wednesday at the International AIDS Society Conference in Kuala Lumpur, Malaysia.

The patients had been receiving long-term antiretroviral therapy for HIV when they developed lymphoma, a type of blood cancer involving white blood cells, Henrich said.

Both underwent chemotherapy followed by bone marrow transplants to cure their lymphoma. Afterward, Henrich could not detect any HIV infection in their bodies.

Henrich presented preliminary findings on the research at the International AIDS Conference last July. Since then, he and his research team withdrew the patients’ antiretroviral therapy to see how completely the cancer treatment had rid them of HIV. One patient has been off treatment with no detectable virus for about 15 weeks, and the second patient for seven weeks.

Henrich warned that it is too soon to declare the patients completely cured of HIV. “Although we cannot detect HIV, it’s possible it’s there but in extremely low amounts,” he said. “We’re going to watch and wait, and see where it goes with these patients.”

Unfortunately, this type of cure is not something that can be put into widespread practice for all people infected with HIV. “Transplantation is not a scalable, affordable or even safe treatment for HIV patients,” Henrich said.

The so-called “Berlin patient,” Timothy Brown, is the first documented case of a sterilizing cure for HIV. An American man living in Germany who received a bone marrow transplant for leukemia, Brown has remained HIV-free even after discontinuing his antiretroviral drug therapy. The transplanted bone marrow cells came from a donor who had a rare genetic mutation that increases immunity against the most common form of HIV, and researchers believe that helped protect Brown from re-infection.

In Mississippi, a baby born with HIV nearly three years ago is the first case of a “functional cure,” in which early treatment eradicates the virus. Immediate treatment with antiretroviral medications rid the child of all traces of HIV within the first month of life, and she has remained virus-free even after discontinuing drug therapy at 18 months of age.

WebMD Health

Many Kids Who Undergo Stem Cell Transplants Must Return to Hospital

WEDNESDAY April 24, 2013 — Nearly two-thirds of children who received stem cell transplants were readmitted to the hospital within six months for treatment of problems such as infections and unexplained fevers, a new study finds.

Children who were given stem cells donated by other people were twice as likely to be readmitted as those who received their own stem cells, said the researchers at Dana-Farber/Children’s Hospital Cancer Center in Boston.

“No one had ever looked at these data in children,” Dr. Leslie Lehmann, clinical director of pediatric stem cell transplantation, said in a cancer center news release. “This is very important information and will allow us to counsel families appropriately, as well as try to devise interventions that reduce the rate of readmissions.”

Lehmann and Harvard Medical School student David Shulman analyzed the medical records of 129 children who had stem cell transplants from 2008 to 2011 and found that 64 percent of them had at least one hospital readmission within 180 days after their transplant.

Fever without a known cause accounted for 39 percent of readmissions, infections for 24 percent, and gastrointestinal problems for 15 percent, the study found.

“Most of the patients went on to be successfully treated and ultimately did very well,” Lehmann said.

The researchers also found that 79 percent of children who received stem cells from a related or unrelated donor were readmitted, compared with 38 percent of those who received their own stem cells.

The findings are scheduled for presentation at the annual meeting of the American Society of Pediatric Hematology Oncology, taking place this week in Miami. Study data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

“We hope these findings can eventually lead to identifying a group of low-risk children who could be managed at local hospitals rather than transplant centers, reducing costs and inconvenience to families,” Lehmann said.

The goal is to identify which patients could be safely treated without requiring hospital admission, she said.

More information

The Nemours Foundation has more about stem cell transplants and children.

Posted: April 2013

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