Australia looks to Europe for organ donation model

http://www.abc.net.au/news/stories/2008/07/08/2298088.htm

Donor experts are in Adelaide to work out how to get more Australians to sign up to donate their organs. (ABC News)

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• Map: Adelaide 5000

Australia’s medical sector is looking to Europe for ways to address alarmingly low levels of organ donations.

The nation lags behind most developed countries, with international experts claiming a better system and approaches to grieving families is critical.

Donor experts are in Adelaide to work out how to get more Australians to sign up to donate their organs.

South Australia has the highest donation rate, the example of cricketer David Hookes is thought to have sparked a recent surge in numbers.

Nationally there are only nine donors per million people, meaning many Australians die on waiting lists.

Professor Rafael Matesanz from the Spanish National Transplant Organisation says the Spanish rate is 35 donors per million.

“We have a coordinated structure at a national, regional and hospital level which can be perfectly transferred to the whole country in Australia,” he said.

Spain also has trained doctors to approach families to seek donations.

The Federal Government recently announced it will establish a national organ donation authority.

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Govt hopes to boost low numbers of organ donors

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The Federal Government says it is looking at a range of measures to boost the low number of people who register to donate their organs.

The Government has received a report by a taskforce of experts that makes 51 recommendations to improve Australia’s rate of donation.

The Parliamentary Secretary for Health, Senator Jan McLucas, says many Australians support organ donation, but the number who actually sign up is among the lowest in the Western world.

Senator McLucas says she hopes tomorrow’s launch of Organ Donor Awareness Week in Melbourne will help.

“We can commit as Australians to put our names on the register to ensure that we talk with our families so all of us, all Australians work together to increase that organ donation rate and save children’s, people’s lives right across the country,” she said.

“We still have one of the lowest rates of organ donation in the world and that is something that the Rudd Labor Government is committed to turning around.”

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Australia ready for ‘opt out’ organ donation: charity

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Charity organisation Gift of Life is calling for a radical rethink of organ donation and a new system requiring people to opt out of the practice.

The organisation’s spokeswoman Anne Cahill Lambert says three people die in Australia every day waiting for an organ.

Ms Cahill Lambert says Australia needs to consider setting up a register for people to opt out of organ donation.

“Some community leaders are saying that, in fact, Australia is not ready for that yet, ” she said.

“I think I might move in different circles because I hear the community say that they are ready for it.

“So I think we need some leadership in fostering community discussion to see whether in fact Australia is ready for an opt out system.”

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Brain bank a ‘big boost’ in MS research

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• Map: Sydney 2000

People with multiple sclerosis (MS) are being asked to consider donating their organs to a new research facility being launched at the University of Sydney today.

The Multiple Sclerosis Brain Bank will collect brain and other tissue from sufferers, as well as from those who died free from the disease.

It is hoped the facility will allow advanced research into the degenerative disease, which affects about 18,000 Australians.

The bank’s director, Professor Simon Hawke, says other similar programs have been successful.

“There are a number of brain banks that have been set up in Australia to research things like alzheimer’s, parkinson’s, schizophrenia and motor neurone disease,” he said.

“This recent addition for studying multiple sclerosis will be a big boost to furthering new discoveries there.”

Professor Hawke says people who do not have MS can also contribute to the research.

“We also would urge people generally to consider donating their brain for these types of studies, which can not only benefit people with MS in the future but also in other neurological diseases.”

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Aust doctors hail teen’s transplant ‘miracle’

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By Sean Rubinsztein-Dunlop

Liver transplant recipient Demi-Lee Brennan with (l-r) Dr Stephen Alexander and Dr Stuart Dorney at Westmead Hospital in Sydney. (AAP: Paul Miller)

• Video: Dr Julie Curtin explains the phenomenon (ABC News)
• Video: Demi-Lee Brennan discusses life as a ‘one-in-six-billion’ girl (ABC News)
• Audio: Dr Michael Stormon talks to NewsRadio host Mike Gardiner (ABC News)
• Audio: Doctors optimistic after miracle transplant (PM)
• Map: Westmead 2145
• Related Story: Teen takes on donor’s immune system
• Related Link: Chimerism and Tolerance in a Recipient of a Deceased-Donor Liver Transplant (journal subscription required for full text)

Transplant patients and immune disease sufferers have received new hope from a 15-year-old Sydney girl hailed as a “one-in-six-billion miracle” when her body took on her liver donor’s immune system.

Doctors at Sydney’s Westmead Children’s Hospital say Demi-Lee Brennan has achieved “the holy grail of transplants” in the only known case of its kind.

Miss Brennan no longer has to take toxic anti-rejection drugs, which transplant patients need to consume for the rest of their lives to stop an internal fight between their new organ and their immune system.

The drugs, known as immunosuppresants, can have toxic effects on organs and cause severe infections.

Miss Brennan had an urgent transplant after a virus caused her liver to fail, potentially fatally, when she was nine years old.

But she became very ill nine months later, suffering pneumolysis – a breakdown of the red blood cells.

When tests came back, her doctors were astonished to find the girl’s blood group had changed from O-negative, the same as her parents, to the donor’s blood type of O-positive.

Further tests revealed stem cells from the donor liver had penetrated Miss Brennan’s bone marrow – a phenomenon her doctors have described as a natural bone marrow transplant.

They say they were even more surprised when they found the girl’s immune system had been almost totally replaced.

Children’s Hospital head of haematology Dr Julie Curtin says Miss Brennan’s few residual immune cells, or white blood cells, had started breaking down her new O-positive red blood cells.

“There was a while there that Demi was very sick,” she said.

“We had her on a lot of medication to try to stop this pneumolysis and we were trying to stop her breaking down her own blood while we were in the process of sorting it all out.”

‘Brave step’

Dr Curtin says they then took the brave step of taking the girl off the anti-rejection drugs to kill her own immune cells three-and-a-half years ago.

“Over a period of time, as we got her right off the immunosuppresion, [there were] no more side-effects, no more breaking down blood, no more tablets to take,” Dr Curtin said.

“The holy grail of transplants was achieved.

“That’s what we were trying to achieve for everybody but Demi’s body had done that herself.”

Other organ transplant patients have been taken off anti-rejection drugs, but nearly only with the aid of a bone-marrow transplant.

Doctors say a rare few can be taken off immunosuppression but are extremely difficult to identify.

The hospital’s director of medicine, who was Miss Brennan’s transplant doctor, says there was one other problem for his patient.

Dr Stuart Dorney says the medical miracle meant she was no longer protected against any diseases she had been immunised for.

“We had to tell Demi one day she was going to have to be totally immunised like a baby again,” he said.

“We did her blood tests and she had no immunity to measles and no immunity to mumps, even though she’d had the immunisations as a baby.”

Searching for answers

Dr Dorney’s colleague, Michael Stormon, says their team is now trying to identify how the phenomenon happened and whether it can be replicated.

“That’s probably easier said than done… I think it’s a long shot,” he said. “I think it’s a unique system of events whereby this happened.

“We postulate there’s a number of different issues – the type of liver failure that she had, some of the drugs that we use early on to suppress the immune system and also that she suffered an infection with a virus called CMV, or cytomegalovirus, which can also suppress the immune system.”

They say successful research would have potential benefits for transplant patients, as well as sufferers of immune diseases like multiple sclerosis and type-1 diabetes.

Despite having defied modern medicine, Miss Brennan says she is merely happy to finally be a “normal girl” after an ordeal she describes as a nightmare.

The teenager has thanked the doctors at the Children’s Hospital – which she calls her “third home” – and her liver donor, a 12-year-old boy who died from a brain injury.

“I’m probably the most grateful person because that has saved my life, that gave me a chance to fulfil my life,” she said.

“I just want to live it the most I’ve got for them and to show them that I’m so grateful.”

The results were published in the New England Journal of Medicine today.

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Skin bank funded by QLD Govt

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Qld Govt funds new skin bank

• Map: Herston 4006

The Queensland Government will spend nearly $1.5 million to re-establish a skin bank in the state.

Queensland has been importing skin from Victoria and overseas for burns patients since its original skin bank closed down in 2003.

State Health Minister Stephen Robertson says burns victims and patients with chronic hard-to-heal wounds will benefit from having a locally-based supply of cultured skin.

Each year up to 50 people with severe burns or wounds are treated in Queensland.

Mr Robertson says the Government will invest the funds to establish the Queensland Skin Bank and the Queensland Skin Culture Centre.

He says Queensland has had to import skin from Australia’s only skin bank in Victoria or from overseas, which has proved costly and unreliable.

“Having a reliable local supply of skin will provide a lifeboat for sick burns patients in whom skin substitutes have failed and wound infection threatens their life,” he said.

“It will assist in improving patient recovery time as well as reducing pain and suffering, scarring and infection rates.”

Emergency response

Mr Robertson says the new bank will ensure Queensland Health has a banked supply of skin available to respond in the event of a natural disaster, major industrial accident or terrorism incident.

He says the skin bank will be divided into two services – one to grow “cultured” skin from patient skin samples and the other to store “allograft” skin from deceased tissue donors.

Cultured allogenic skin will be grown by the Royal Brisbane and Women’s Hospital burns unit for the Queensland Skin Culture Centre based at the Herston hospital campus.

Donated allograft skin will be stored at the Queensland Skin Bank based at the new Queensland Transplant Tissue Service facility at Coopers Plains on Brisbane’s southside.

Mr Robertson said currently the only source of allograft skin in Australia is the Donor Tissue Bank of Victoria, which is not capable of providing a consistent or sufficient supply of skin to meet Queensland’s needs.

“Allograft skin is considered the gold standard technique for burn wound management and is useful for the treatment of large scale burns while improving patient recovery time and reducing scarring and infection rates,” he said.

“Local supplies of allograft skin will enable doctors to treat severe burn patients with real skin instead of skin substitute products which don’t offer the same level of clinical outcome and are generally more expensive.

He says cultured skin can be used for patients with small or moderate burns who require multiple treatments.

“[It] may also assist patients with chronic long-term wounds like diabetic foot ulcers,” he said.

He says the Queensland Skin Bank and the Queensland Skin Culture Centre will be operational by 2008.

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Teens have short films to help teach life skills

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Short films to help teach life skills for teens

By Youth affairs reporter Michael Turtle

The producers of the DVD are now hoping it will be used as a resource by schools across Australia [File photo]. (ABC)

 

• Audio: Short films to help teach life skills for teens (PM)
• Map: Melville 6156

A new campaign has been launched based around a series of new, hard-hitting realistic short films that aim to get teenage boys to talk about issues like depression and sexuality.

The new resources will help the efforts of teachers, given some of the educational material they had to use still featured 1970s actors wearing flares.

The simple things, like asking someone out on a date, can become all-consuming when you are young.

“I was doing that thing when you repeat the last word out of every sentence and hope to God that it makes sense somehow,” one boy said.

Young men can also face more serious concerns, like drugs, crime and sexuality and the new DVD called 6 addresses some of these issues through short films about six mates.

It was produced by the city of Melville in Western Australia and the driving force was health promotion officer Janet Armarego.

“What we’re trying to do is we’re trying to give young men that insight into the fact that things may seem really bad in your life at any point in time but it always gets better, it doesn’t stay like that,” she said.

Irrelevant ‘joke’ material

Mrs Armarego started work on the DVD when she discovered that the current educational material was old and irrelevant and there was nothing to help get young men talking about their feelings.

“A lot of the resources that they watch at schools these days are probably made about 20 years ago and are more of a joke than they are actually sort of credible in terms of what young men do these days,” she said.

The music used in 6 is modern and the language is realistic with plenty of swearing.

To try to get it right, the film-makers did consultations with young people about their lives.

“So we asked about their own … group of friends – what do they look like and give us some of the character profiles and tell us a bit more about what sort of stuff you do?” Mrs Armarego said.

The DVD is now being launched nationally with the help of Headspace, the federally-funded youth mental health initiative.

Headspace chief executive officer Chris Tanti says it is important because young men are facing serious issues.

“We know that guys – generally right throughout the lifespan – don’t talk about emotional issues,” he said.

“But particularly young men are pretty embarrassed about talking about what they are going through and some of the challenges they face and some of the stuff that causes them problems.”

Males account for 80 per cent of suicides in Australia and young men are twice as likely as women to have substance abuse problems.

“There is a lot of peer pressure for young men around alcohol use and substance use generally but certainly with young men there is considerable risk taking behaviour and I think 6 covers that very well,” Mr Tanti said.

The producers of the DVD are now hoping it will be used as a resource by schools across the country.

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What is West Nile Fever

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Lomu pleads for organ donation

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New Zealand rugby union great Jonah Lomu is campaigning for more Australians to consider becoming organ and tissue donors.

The former All Blacks winger was forced to end his career because of a kidney disease and he was fortunate to receive an organ donation from a friend in 2004.

Lomu has today become an ambassador for The Zaidee Rainbow Foundation, named after seven-year-old Zaidee Turner, whose organs and tissues assisted seven people after she died.

He said the importance of talking about organ donation with family members could not be overstated.

“It’s a touchy subject with a lot of people, I know – it pushes boundaries and families, but it is something that is dear to me and it makes a big life change for a lot of people,” he said

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