Transplantation

Approximately three million people in the US have hepatitis C. In some cases, hepatitis C can be completely cured. However, many with the condition may be asymptomatic for decades and thus are not diagnosed until the disease has progressed into later stages. This is problematic, because when hepatitis C advances, it may cause scarring of the liver. When should liver transplant be considered for these patients? And what is the rate of recurrence and necessity for re-transplantation? Dr. Paul Kwo, medical director of the adult liver transplant program at Indiana University Health, discusses treatment options for patients with various stages of hepatitis C, as well as the evaluation process for those with advanced hepatitis C who are liver transplant candidates. Dr. Aaron Carroll hosts.

Patients needing transplantation have two options--receiving an organ from a deceased donor or a living donor. In which cases might living organ donation be a viable option, and what are the advantages to this procedure? Dr. Tim Taber, medical director of the kidney and pancreas transplant program at Indiana University Health, discusses the issue of organ shortages, how organs are allocated and the process of living organ donation. Dr. Aaron Carroll hosts.

Fifty percent of patients living with diabetes will require some sort of renal replacement therapy. What percent will go on to renal transplantation and what are the recommendations for the management of these patients? Join host Dr. Steven Edelman and his guest, transplant dietitian at the University of California, San Diego, Linda Raynes Mahony, as they discuss medications, nutrition and overall management of renal transplant patients.

In April, 1969, the first artificial heart was implanted as a bridge until a human heart could be implanted. It was hailed as a milestone medical treatment, but the ethical implications were widely debated as well. The heart surgeon who performed this ground-breaking surgery, in addition to devising pioneering surgical treatments for infants and children and founding the Texas Heart Institute, Dr. Denton Cooley, is Dr. Martin Samuels' guest.

Now in his 80s, Dr. Thomas E. Starzl is actively pursing his latest research interests and gives no indication of slowing down. He is widely known as the father of transplantation. But what is not widely known is that his early work was in neurophysiology. What made him choose surgery? What was it like when he was doing his pioneering transplantation work? What is he researching now? Host Dr. Martin Samuels and Dr. Thomas Starzl discuss.

The face transplant is a relatively new, experimental procedure still in its early stages. This operation is comparable to a hand transplant, in that the patient’s quality of life may be improved with the procedure, but the condition is not immediately life-threatening. How can physicians discuss the risk-benefit ratio of this procedure with potential face transplant patients? What happens if the procedure fails? How does a multidisciplinary team prepare a patient considering this procedure, from the psychological to the financial aspects? Tune in to hear Dr. Stuart Finder, director of the center for healthcare ethics at Cedars-Sinai Medical Center, discuss these and other ethical considerations of the face transplant procedure with host Dr. Maurice Pickard.

In an issue of the Journal, Boucek et al. reported on three cases of heart transplantation from infants who were pronounced dead on the basis of cardiac criteria. Moderator Atul Gawande, of Harvard Medical School; George Annas, of the Boston University School of Public Health; Arthur Caplan, of the University of Pennsylvania; and Robert Truog, of Harvard Medical School discuss key ethical aspects of organ donation after cardiac death.

Nobel Prize winner Dr. Joseph E. Murray discusses performing the first successful human kidney transplant, the value of teamwork, the future of the physician-scientist, and the patient side of the equation, in this far-ranging conversation led by host Dr. Martin Samuels.

Recently, scientists were able to engineer for the first time a trachea developed from a patient's own stem cells, wherein a donor's trachea was lined with the patient's stem cells to prevent transplant rejection. Immunosuppressive therapy was not necessary, and the patient remains in good condition months after the surgery. Dr. Paolo Macchiarini, head of thoracic surgery at Hospital Clinic in Barcelona, Spain, delves into the details of this breakthrough surgery with host Dr. Lee Freedman.

What are the barriers in science that keep us from reaching the lofty goal of limb and organ regeneration? Host Dr. Leslie Lundt is joined by Dr. Dennis Steindler, the Joseph J. Bagnor/Shands Professor of Medical Research and the executive director of the McKnight Brain Institute at the University of Florida, to learn about the work of the Regeneration Project, a partnership of the McKnight Brain Institute and the Program in Stem Cell and Regenerative Medicine at the University of Florida. Find out how the study of salamanders could lead us to the next steps in regeneration.