National Donor Sabbath Celebrated in Livermore

By Barbara Costerus

A warm ovation was the reaction to Bob Moss' talk during worship services at Bart and Barbara's church, First Presbyterian, at our third annual commemoration of National Donor Sabbath on November thirteenth. The congregation was clearly impressed by Bob's description of his experiences during the long five-year wait as a very ill person, and then the excitement of the heart and kidney transplants. Particularly touching was the account of his reaction to learning that his new lease on life was made possible by the death of a young man, Reuben, and his on-going connection to Reuben's family.　

During coffee hours following the two services, Bob and Cheryl, Bart and Barbara, and Linda O'Hara answered questions　 while everyone enjoyed a piece of "Donate Life" cake provided by church member Sue Miller, mother of a kidney-pancreas recipient. We are grateful for our church's enthusiastic support of organ donation and thankful to Bob and Cheryl for the time they devoted to this event.

Medical News

Kidney recipients freed from immunosuppresant drugs

Excerpted from American Association for the Advancement of Science
STANFORD, Calif. — Investigators at the Stanford University School of Medicine have developed a protocol that allows kidney-transplant recipients to jettison immune-suppressing drugs. The protocol could also spell substantial savings to the health-care system.

Eight of the 12 patients discussed in the small study have now been off of immunosuppressant drugs for at least one year, and in some cases for longer than three years, without any apparent damage to their new kidney. None of the 12 patients has experienced kidney transplant failure or serious side effects. In all 12 cases, recipients were supplied with immunologically matched donor kidneys from close relatives. But the trial, which has been actively enrolling new patients, is now expanding to include imperfectly matched donor-recipient pairs as well.  Samuel Strober MD is a professor of medicine and the new protocol's inventor.

The new technique combines targeted irradiation of a patient's lymph nodes, spleen, and thymus with the administration of stem cells drawn from the kidney donor's blood. It took more than 30 years of mouse research, Strober said, before he finally came up with just the right mix of agents for "avoiding a civil war" among dueling immune systems.

Dialysis is expensive, costing close to $70,000 per patient per year. Failure of a transplanted kidney costs the health-care system $80,000 during the year when the failure occurs. The new protocol carries a total expense estimated to range from $20,000 and $40,000, so it has the potential to pay for itself within a few years. And it requires no additional hospital time.

Under the protocol, the kidney recipient receives radiation treatment and injections of antibodies while still in the hospital a few days after surgery, and additional radiation doses over the next several days on an outpatient basis. About 10 days after surgery, the recipient gets an injection of cells taken from the organ donor. All patients initially are put on two of the same immune-suppressing drugs (plus antivirals and antibiotics) that transplantation patients would normally get.

After a month, one of the drugs is withdrawn; thereafter, the Stanford team, led by Strober, continually monitors numerous parameters including the mixing of donor and recipient immune cells. If that mixing seems in balance six months after surgery, the recipient's second immunosuppressant-drug dose is discontinued. If the mixing hasn't been achieved, the patient remains on the drugs until it is.

The trial has been funded by the National Institutes of Health. The study of perfectly matched pairs is continuing with philanthropic support from the Stanford Institute for Immunity, Transplantation and Infection. Patients considering enrolling can learn more about the study by contacting the study coordinator, Asha Shori, at ashas@stanford.edu.

Drug is shown to cure most hepatitis C cases

Tribute

by Sue Miller

When I finally had the courage to open the FaceBook page with trembling fingers I stared with tear-filled eyes at the images that came up on my computer. I had waited until the total private and quiet calmness of the hours just after midnight. This was what I both longed and dreaded to see and wasn’t sure how I would be affected, so I covered myself with the soothing blanket of deepest night. The light of the computer screen was my only beacon.

When my eyes focused on what I had to see, a long sigh of sadness and a faint moan automatically escaped my lips. There he was: the most powerful and important stranger in my life. Now I had a face to add to everything that brimmed over in a heart and mind filled with him. I was utterly fascinated. The two of us were in a hurricane’s peaceful eye. The storm had come before for both of us and more struggle remained for me and mine, but for this moment I could really see him and know who he was.

His photo was an unusual one. He was sitting in darkness facing his computer screen with the unseen photographer or camera out of the picture. He looked at the screen and light fell on his face. His expression was one of total absorption and almost awe, so much so that it looked ethereally beautiful and at peace. I sobbed slightly as I saw his youth for myself. Even though I knew he was only sixteen, I hadn’t been prepared for the slight, pale, sensitive looking young man who was before me. He looked so much younger than his years.

"Oh, God!" I breathed in anguish, in joy, in prayer. Touching his computer image in a gentle and tender caress, my soul reached out in the darkness to thank his generous one. What would he have been – what could he have been if only he had had the chance? Whispering thank you, I thought of the words, "Goodnight, sweet prince, and flights of angels sing thee to thy rest."

When my computer screen was dark again, I cried tears of sorrow and joy for the young man who gave my daughter her life back with the loss of his. In the short span of his years he was that most rare of all beings, a true savior of another. My daughter’s organ donor…..my greatest hero.