The American Liver Foundation (ALF), in partnership with the University of Pittsburgh Medical Center (UPMC), launched “The Greatest Gift Initiative” to raise awareness about lifesaving living-donor liver transplantation. This initiative teaches Americans with end-stage liver disease strategies for finding a living donor and inspires more people to consider donating a part of their liver.
VA Pittsburgh Healthcare System (VAPHS) and UPMC partnered to perform VA’s first living-donor liver transplant, in which a portion of a healthy person’s liver is transplanted to someone in need of a liver.
Inspired by a tactic cancer cells use to evade the immune system, University of Pittsburgh researchers have engineered tiny particles that can trick the body into accepting transplanted tissue as its own. McGowan Institute for Regenerative Medicine affiliated faculty members involved in the research team include:
“Children are the world’s most valuable resource and its best hope for the future,” President John F. Kennedy told the U.S. Committee for UNICEF in 1963. That same year, Dr. Thomas Starzl, my mentor, performed the world’s first pediatric liver transplant.
Living-donor liver transplant offers numerous advantages over deceased-donor transplant, including better three-year survival rates for patients and lower costs, according to new research from the UPMC Thomas E. Starzl Transplantation Institute and the University of Pittsburgh School of Medicine.
Hepatitis C is a liver disease caused by the hepatitis C virus (HCV), which is carried in the blood of infected people. According to various estimates, anywhere from 3 to 10 million people in the United States are carriers of the virus. One reason for this is because the virus wasn’t even diagnosed until the late 1980s. In fact, a majority of carriers are still unaware of their HCV status.
If you follow transplant news, you probably know the grim facts: Worldwide, there is an enormous and widening gap between the number of people who need transplant organs and the number of donor organs available. According to the United Network for Organ Sharing (UNOS), 20 people die every day waiting for a transplant. While UNOS and other organizations work to increase awareness and recruit more donors, researchers and doctors are working hard to find medical solutions that can help close that gap.
Nine patients at Penn Medicine have been cured of the Hepatitis C virus (HCV) following lifesaving heart transplants from deceased donors who were infected with the disease, according to a study published in the American Journal of Transplantation. The results highlight the potential for expanding the use of HCV-infected organs, including hearts, to broaden the donor pool for the more than 100,000 Americans currently on a transplant waitlist. McGowan Institute for Regenerative Medicine affiliated faculty member Christian Bermudez, MD, Director of Thoracic Transplantation at the University of Pennsylvania and Associate Professor of Surgery at the University of Pennsylvania School of Medicine, was a team member on the study.
McGowan Institute for Regenerative Medicine affiliated faculty member Abhinav Humar, MD, Clinical Director of the Thomas E. Starzl Transplantation Institute, Chief, Division of Transplantation in the Department of Surgery at the University of Pittsburgh Medical Center, Professor in the Department of Surgery at the University of Pittsburgh School of Medicine, and a Staff Physician at the Pittsburgh VA Medical Healthcare System, is the principal investigator of the clinical trial entitled, “Safety and Preliminary Efficacy of Donor-derived Regulatory Dendritic Cell (DCreg) Infusion and Immunosuppression Withdrawal in Living Donor Liver Transplantation” (ClinicalTrials.gov Identifier: NCT03164265).
Before the United Network for Organ Sharing, or UNOS, made the heart and lung transplantation organ allocation change in November 2017, the United States was divided into 58 local donor service areas. People on the heart and lung transplant list were first matched with donors within their service areas, even if another potential match was closer geographically.
Ex vivo lung perfusion (EVLP) has developed as a novel organ preservation method in lung transplantation. EVLP allows physicians to evaluate lung graft function and condition prior to transplantation, leading to the possibility to utilize marginal lung grafts and/or high-risk donor lungs including donation after circulatory death (DCD), atelectasis lung, lung with slight edema and functional problem without other concerns, as well as the lung grafts met to normal criteria. Also, EVLP allows reconditioning of such lung grafts on ex vivo prior to transplantation using various options for treatment including high dose drug administration, stem cell transplantation, gene transfection, ex vivo surgery, and so on.
The following is an excerpt from an article published in The Conversation and authored by McGowan Institute for Regenerative Medicine affiliated faculty member Abhinav Humar, MD, Clinical Director of the Thomas E. Starzl Transplantation Institute and the Chief, Division of Transplantation in the Department of Surgery at the University of Pittsburgh Medical Center. He is also a Professor in the Department of Surgery at the University of Pittsburgh School of Medicine and a Staff Physician at the Pittsburgh VA Medical Healthcare System. Read the entire article here.
Per the United Network for Organ Sharing, every ten minutes, someone is added to the national transplant waiting list in need of a kidney, liver, pancreas, heart, lung, or intestine, the most needed organs of 2017. As of the end of January 2018, there were 114,883 people needing a lifesaving organ transplant (total waiting list candidates) with 74,722 of those people being active waiting list candidates. Tragically, on average, 20 people die each day while waiting for a transplant. More than 7,000 candidates died in 2016 while on the wait list, or within 30 days of leaving the list for personal or medical reasons, without receiving an organ transplant.
Philanthropists Cindy and Rob Citrone, dedicated to improving outcomes for pediatric transplantation across the United States and increasing the number of organ donors, have donated $2 million to Children’s Hospital of Pittsburgh of UPMC. The Citrones will also match up to $1 million in additional donations raised for Children’s transplant program.
In order to make lifesaving liver transplants available throughout central and north Florida, Florida Hospital for Children is partnering with Children’s Hospital of Pittsburgh of UPMC to develop a comprehensive pediatric liver transplant program. This will be the first program of its kind in Orlando, the second in Florida, and is expected to start accepting patients in January.
Each year, the United States suffers an extreme shortage of organ donations, with only a quarter of patients in need receiving a transplant. Many transplantable organs are lost when a donor’s heart fails, and the organs stop receiving vital blood flow. Researchers at the University of Pittsburgh can potentially double the amount of successful organ donations by developing a novel stent to maintain blood flow to organs, even during the donor’s final heart beats.
We are pleased to announce the establishment of an interdisciplinary research program in the science of eye transplantation. This unique program in the science of eye transplantation is a joint effort between the Department of Ophthalmology and the Department of Plastic Surgery, and is led by McGowan Institute affiliated faculty member Kia Washington, MD, the director, in coordination with Dr. Sahel. In addition to leveraging the skills and expertise of members of the Departments of Ophthalmology and Plastic Surgery, this innovative program will also include experts in immunology, transplant surgery, the neurosciences, and other related disciplines.
Researchers at the University of Pittsburgh School of Medicine and the University of Toronto have uncovered the first molecular steps that lead to immune system activation and eventual rejection of a transplanted organ. The findings, published recently in Science Immunology, may be used someday to create better donor-recipient matches and develop new ways to prevent rejection of transplanted tissues.
On December 6, 2016, UPMC marked a major medical milestone for the UPMC Lung Transplant Program: its 2000th lung transplant procedure. The Lung Transplant Program was established in 1982 and has become one of the largest and most experienced centers in the world for lung and combined heart-lung transplantation.
Cardiac arrhythmia is a common complication following lung transplantation, and one that has a significant negative impact on long-term patient survival, reports a team of UPMC researchers—including McGowan Institute for Regenerative Medicine affiliated faculty members Jonathan D’Cunha, MD, PhD, James Luketich, MD, and Christian Bermudez, MD—in the largest study of its kind to date. The results provide critical information that will hopefully lead to better care of transplant recipients.
Although corneal transplants are routinely performed today, whole-eye transplantation has remained an unrealized goal in vision restoration because of challenges related to immune rejection and reestablishing the connectivity of the optic nerve to the visual centers in the brain. The Audacious Restorative Goals in Ocular Sciences (ARGOS) Consortium established at the University of Pittsburgh is the first cross-disciplinary, systematic attempt to explore strategies to enable corneal regeneration, retinal cell survival, long-distance optic nerve regeneration with cortical integration, and whole-eyeball transplantation.
As reported by Mark Roth, Pittsburgh Post-Gazette, McGowan Institute for Regenerative Medicine deputy director Vijay Gorantla, MD, PhD, associate professor of surgery in the Department of Plastic Surgery at the University of Pittsburgh, the administrative medical director of the Pittsburgh Reconstructive Transplant Program at UPMC, and a clinician who has helped pioneer Pitt’s hand and arm transplants, is the first to acknowledge that it will be years before surgeons can attempt whole eye transplants in human patients. But he says the approach has a key advantage over other attempts to repair traumatic injuries to the eye, whether they have come from a roadside bomb, an industrial accident, or a car collision. The eye is so complex that trying to repair its internal parts is an enormous challenge.
Researchers from the University of Pittsburgh’s Thomas E. Starzl Transplantation Institute at UPMC and the McGowan Institute for Regenerative Medicine have developed a new system for organ preservation based on machine perfusion with a cell free oxygen carrier solution at subnormothermic temperatures. This new system provides effective oxygenation to the organ even though it’s outside of the body, a process which alleviates the damage that comes with prolonged storage on ice.
More than 15,000 people are waiting for a liver transplant in the United States, but fewer than 7,000 will receive one this year. The conventional method of storing and transporting organs is not very effective. As a result, approximately 20 to 40 percent of donor livers cannot be transplanted into recipients because of extended injuries stemming from cold storage preservation. The further development of this new system for organ preservation could mean the difference between life and death for thousands of people on the organ donor waiting list if fully approved by the FDA for clinical use.
A new preservation system that pumps cooled, oxygen-rich fluid into donor livers not only keeps the organs in excellent condition for as long as 9 hours before transplantation, but also leads to dramatically better liver function and increases survival of recipients, according to a series of animal studies by researchers at the University of Pittsburgh School of Medicine and the McGowan Institute for Regenerative Medicine. The system could be tested with transplant patients at UPMC later this year.
First-Ever Liver Transplant to Treat AHCY Deficiency Performed
S-Adenosylhomocysteine hydrolase (AHCY) deficiency is a rare congenital disorder affecting <1 in 1,000,000 children worldwide. Currently, there have been 8 diagnosed cases, with 6 individuals living with the disorder. With this illness, a genetic mutation in the liver doesn’t allow the body to process protein.
$1.25 Million Received from Defense Department to Make Whole-Eye Transplantation a Reality
University of Pittsburgh School of Medicine researchers co-led by McGowan Institute for Regenerative Medicine faculty members Vijay Gorantla, MD, PhD, associate professor of surgery in the Department of Plastic Surgery at the University of Pittsburgh and the administrative medical director of the Pittsburgh Reconstructive Transplant Program at UPMC, and Joel Schuman, MD, chair of the Department of Ophthalmology, Pitt School of Medicine, and director of the UPMC Eye Center, have been awarded $1.25 million from the U.S. Department of Defense (DOD) to fund two projects that aim to establish the groundwork for the nation’s first whole-eye transplantation program.
Naturally Occurring Antibodies May Be Treatment for BK Nephropathy in Kidney Transplant Patients
A viral infection known as BK that commonly causes kidney transplant dysfunction in patients taking high doses of immunosuppressants may be treated with naturally occurring antibodies that already are widely available, according to UPMC-led research that was presented at the World Transplant Congress in San Francisco. McGowan Institute for Regenerative Medicine affiliated faculty member Ron Shapiro, M.D., Professor of Surgery at the University of Pittsburgh and the Robert J. Corry Chair in Transplantation Surgery at the Thomas E. Starzl Transplantation Institute, was a collaborator on this study.
Surgical, Other Advances Improve Graft Survival of Intestinal, Multi-Visceral Transplant Patients
Innovations in surgical techniques, drugs, and immunosuppression have improved survival after intestinal and multi-visceral transplants, according to a retrospective analysis of more than 500 surgeries done at UPMC over nearly 25 years. Authors of the analysis include McGowan Institute for Regenerative Medicine affiliated faculty members George Mazariegos, M.D., Director of the Hillman Center for Pediatric Transplantation at the Children’s Hospital of Pittsburgh of UPMC and Professor of Surgery, the Jamie Lee Curtis Endowed Chair in Transplantation Surgery, with joint appointments in the Departments of Anesthesiology and Critical Care Medicine at the University of Pittsburgh, and Abhinav Humar, M.D., Clinical Director of the Thomas E. Starzl Transplantation Institute and the Chief, Division of Transplantation in the Department of Surgery at the University of Pittsburgh Medical Center, and a Professor in the Department of Surgery at the University of Pittsburgh School of Medicine.
Dendritic Cell Therapy Improves Kidney Transplant Survival in Preclinical Model
A single systemic dose of special immune cells prevented rejection for almost 4 months in a preclinical animal model of kidney transplantation, according to McGowan Institute for Regenerative Medicine affiliated faculty members (pictured top to bottom)
Eleven years ago, McGowan Institute for Regenerative Medicine affiliated faculty member Ron Shapiro, MD, professor of surgery at the University of Pittsburgh and the Robert J. Corry chair in transplantation surgery at the Thomas E. Starzl Transplantation Institute, performed life-changing kidney transplant surgery on patient, Darian DeLuca of Westmoreland County. This year, Ms. DeLuca graduated from Kiski Area High School and when she received her diploma, she took a little part of her uncle, Greg George, with her. Mr. George was her kidney donor for this life-changing living-donor surgery.
In a paper presented at the American Transplant Congress, Seattle, WA (May 20, 2013), McGowan Institute for Regenerative Medicine affiliated faculty member Paulo Fontes, MD, assistant professor of surgery at the University of Pittsburgh School of Medicine, described the ground breaking results from a study conducted by a multidisciplinary team who designed and assessed the effectiveness of a system to oxygenate harvested livers with a perfusion system so that the condition of the liver can be maintained for an extended period before implantation.
First “Breathing Lung” Transplant on East Coast Using OCS Lung Performed
McGowan Institute for Regenerative Medicine faculty member Christian Bermudez, MD, UPMC’s chief of cardiothoracic transplantation and assistant professor of surgery at the University of Pittsburgh School of Medicine, is the principal investigator of a study where UPMC surgeons performed a “breathing lung” transplant using a portable machine that provides a constant supply of blood and nutrients to the donor organs. Doctors say this has the potential to keep donor lungs healthier and viable for longer than ever before.
Excellence, Strong Research Help UPMC Reach 3,000 Heart, Lung Transplants
William Ferry almost never made it to UPMC for the transplant that would eventually save his life. Nervous about a surgery that had been performed so little in 1980, Ferry contemplated turning the car around and not showing up when word came that a donor heart had been found for him.