PBS Watch - Has China really stopped obtaining organs from executed prisoners?

Has China really stopped obtaining organs from executed prisoners?

For decades, China obtained human organs such as kidneys and livers from executed prisoners, a practice condemned by human rights activists and medical ethicists. China says they no longer do this and have built a new system for organ transplants that now relies on volunteers, not prisoners. Hari Sreenivasan reports.

Read -  Transcript



Related Article

One doctor’s war against global organ trafficking
BY Ryan Connelly Holmes and Dan Sagalyn 
May 29, 2017 at 5:18 PM EDT
In late 2016, Dr. Francis Delmonico saw an unknown number coming up on his phone. The Vatican was calling.

“One minute please for the foreign minister,” said the voice on the other end of the line.
A controversy was brewing. Delmonico, a leading voice on ethical organ transplantation, had planned a February 2017 summit in Rome for representatives of more than 40 countries to discuss the ethics of transplanting organs and to sign a pledge to uphold high standards.

But there was a hitch: A key invitee to the forum was Dr. Jiefu Huang, who has led reform of China’s organ donation practices. Critics, including some in the Vatican, wanted at the summit no representatives of China, which for years sold and transplanted organs from executed prisoners.
Continue reading....

UK patients who have liver transplants abroad get poorer management

UK patients who have liver transplants abroad get poorer management      

News Type: Clinical News

     

A small number of UK citizens are undergoing liver transplants abroad but their management is of a lower standard than in the UK.

These were the conclusions of researchers at Sheffield’s Royal Hallamshire Hospital, who sent questionnaires to all seven UK liver transplant units enquiring about liver patients receiving transplant abroad. Six of the seven centres responded.

A total of 12 patients were identified as having undergone liver transplantation overseas. The top destinations were India, China and Egypt.

Four units responded to questions regarding pre-transplant screening. One unit reported HBV and HCV screening not taking place. Four units responded to questions regarding post-transplant antimicrobial therapy. This revealed examples of patients inappropriately not receiving valganciclovir, co-trimoxazole, anti-fungal treatment and HBV immunoglobulins.

The researchers add that information transfer between overseas and UK based transplant teams is poor.

Reference

A questionnaire based assessment of numbers, motivation and medical care of UK patients undergoing liver transplant abroad. Winter BK, Odedra A, Green S. Travel Med Infect Dis. 2016 Sep 14 [Epub ahead of print]

Source - https://www.basl.org.uk/index.cfm/news/list/cid/8/nid/2

Abstract

A questionnaire based assessment of numbers, motivation and medical care of UK patients undergoing liver transplant abroad.

Travel Med Infect Dis. 2016 Sep 14. pii: S1477-8939(16)30122-3. doi: 10.1016/j.tmaid.2016.09.004. [Epub ahead of print]

A questionnaire based assessment of numbers, motivation and medical care of UK patients undergoing liver transplant abroad.
Kerr Winter B1, Odedra A2, Green S2.

1Department of Infection and Tropical Medicine, Royal Hallamshire Hospital, Sheffield, S10 2JF, England, UK. Electronic address: Ben.kerrwinter@gmail.com.
2Department of Infection and Tropical Medicine, Royal Hallamshire Hospital, Sheffield, S10 2JF, England, UK.

Abstract
BACKGROUND:
Medical tourism, where patients travel abroad intentionally to access medical treatment, is a growing trend. Some of these patients travel to undergo organ transplantation. This study aims to quantify the number of UK patients who undergo liver transplantation abroad, assessing their motivations and management.

METHODS:
Questionnaires were sent to all seven UK liver transplant units enquiring about liver patients receiving transplant abroad. Included were questions on destination, motivation, and pre and post-transplant care.

RESULTS:
Responses were received from six of the seven transplant centres (86%). A total of 12 patients were identified as having undergone liver transplantation overseas. The top destinations were India, China and Egypt. Four units responded to questions regarding pre-transplant screening. One unit reported Hepatitis B and C screening not taking place. Four units responded to questions regarding post-transplant antimicrobial therapy. This revealed examples of patients inappropriately not receiving valganciclovir, co-trimoxazole, anti-fungal treatment and Hepatitis B immunoglobulins.

CONCLUSIONS:
UK patients are undergoing liver transplant abroad, albeit in small numbers. Pre and post-transplant management of these patients is of a lower standard than that provided to those undergoing transplantation in the UK. Information transfer between overseas and UK based transplant teams is poor.

Copyright © 2016. Published by Elsevier Ltd.

KEYWORDS:

Hepatology; Infectious diseases; Medical tourism; Transplantation
PMID: 27640117 DOI: 10.1016/j.tmaid.2016.09.004

EU in Kosovo says Turk, Israeli trafficked organs

PRISTINA, Kosovo —

By NEBI QENA; Associated Press

Published: 06/13/11 9:51 am | Updated: 06/13/11 1:12 pm

A European Union prosecutor in Kosovo has indicted a Turkish and an Israeli national for involvement in an international network that falsely promised poor people money for their kidneys and then transplanted the organs into rich buyers, the bloc's rule of law mission said Monday.

Turkish citizen Yusuf Sonmez, and Israel's Moshe Harel were charged last week for "trafficking in persons, organized crime and unlawful exercise of medical activity," the mission, known as EULEX, said in a statement.

A European Union prosecutor in Kosovo has indicted a Turkish and an Israeli national for involvement in an international network that falsely promised poor people money for their kidneys and then transplanted the organs into rich buyers, the bloc's rule of law mission said Monday.

Sonmez and Harel are considered at large by EU authorities and Interpol has issued a warrant for their arrest.

The indictments are part of a larger investigation into allegations that an organized criminal group conducted operations in a clinic outside of the capital Pristina where the victims' organs were transplanted into the buyers.

EU prosecutor Jonathan Ratel - who brought the charges in 2010 - said victims were promised up to $20,000 (euro14,000) for their kidneys, but were never paid, while recipients were required to pay between euro80,000 and euro100,000 euros ($115,000-$143,000).
The victims came from Moldova, Kazakhstan, Russia and Turkey, and lived in "extreme poverty or acute financial distress," EULEX said.

Kosovo law forbids the removal and transplant of organs.
The case was brought to the attention of authorities in 2008 when Kosovo police acted upon information from a Turkish national who said his kidney had been stolen.
Since then seven Kosovars, including doctors and a senior official in the Health Ministry, have been charged and are standing trial.

Sonmez and Harel were indicted separately after EU investigators located Harel in Israel and an EU prosecutor interviewed Sonmez in Turkey earlier this year. Harel was detained in 2008, but later allowed to leave Kosovo upon the promise of return pending legal proceedings.


Read more:
http://www.thenewstribune.com/2011/06/13/1704263/eu-in-kosovo-says-turk-israeli.html#ixzz1PCdRDHh6

Hang On-Hepatitis C News: Boceprevir,Telaprevir, and ACH-1625

HCV Protease Inhibitor Boceprevir Improves Response for Treatment-Naive and Non-responders
SUMMARY: Merck's investigational hepatitis C virus (HCV) protease inhibitor boceprevir improved sustained response rates when combined with pegylated interferon plus ribavirin in both previously untreated patients and those who were non-responders or relapsers after prior therapy, according to 2 Phase 3 studies presented at the 18th Conference on Retroviruses and Opportunistic Infections (CROI 2011) this month in Boston...Continue reading...

CROI:
The Effect of Low-dose Ritonavir on the Pharmacokinetics of the Investigational HCV Protease Inhibitor Telaprevir in Healthy Volunteers -


Little Overlap of Sexually Transmitted HCV between U.S. and Europe
SUMMARY: A phylogenetic analysis of more 200 hepatitis C virus (HCV) strains from HIV positive gay and bisexual men revealed extensive clustering of related viruses within U.S. cities, but little overlap between the East and West coasts, or between the U.S. and Europe or Australia, according to findings presented at the at the 18th Conference on Retroviruses and Opportunistic Infection (CROI 2011) this month in Boston...Continue reading..

Information;FDA Advisory Committee Meeting On Boceprevir and Telaprevir
The Food and Drug Administration will convene its Antiviral Drugs Advisory Committee on April 27 and 28, 2011 to provide advice and recommendations to the Agency on two drugs intended to treat hepatitis C.On April 27, 2011, from 8 a.m. to 5 p.m., the Committee will discuss a new drug application (NDA) 202–258, boceprevir (a hepatitis C virus protease inhibitor), manufactured by Merck & Co., Inc., with a proposed indication for the treatment of chronic hepatitis C genotype 1 infection, in combination with peginterferon alfa and ribavirin (two medicines approved to treat chronic hepatitis C infection) in adult patients with compensated liver disease who are previously untreated or who have failed previous therapy.

n April 28, 2011, the committee will discuss a new drug application (NDA) 201–917, telaprevir (a hepatitis C virus protease inhibitor), manufactured by Vertex Pharmaceuticals, Inc., with a proposed indication for the treatment of chronic hepatitis C genotype 1 infection, in combination with peginterferon alfa and ribavirin (two medicines approved to treat chronic hepatitis C infection) in adult patients with compensated liver disease who are previously untreated or who have failed previous therapy.Compensated liver disease is a stage in which the liver is damaged but maintains ability to function..........continue reading..

March 16, 2011

Telaprevir, Boceprevir for Hep C Approaching FDA Finish Line

Two experimental hepatitis C virus protease inhibitors are scheduled to undergo approval review by the U.S. Food and Drug Administration’s Antiviral Drugs Advisory Committee at the end of April, according to a report from Dow Jones Newswires.

Approval applications for Merck’s boceprevir will be reviewed by the committee April 27, whereas documentation supporting Vertex’s telaprevir will be reviewed April 28. Upon completing its review of each new drug application (NDA) and hearing from researchers, hepatitis C community advocates and the drugs’ sponsors, the committee will recommend to the FDA whether or not to approve the drugs.

Both drugs are expected to come to the market at similar times and to be widely used, according to the Dow Jones report. The report adds that Merck was granted an expedited six-month review by the FDA in 2011; Vertex is expecting an approval decision by May 23.

According to clinical trial data reported by researchers thus far, both drugs substantially increase the likelihood of sustained virologic responses (SVRs)—defined as HCV viral loads that remain undetectable after treatment is discontinued—in both patients starting hepatitis treatment for the first time and those who did not respond favorably to treatment in the past.

Both telaprevir and boceprevir must be combined with pegylated interferon and ribavirin for the first three months of treatment.
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Nonsurgical Hepatic Decompression In Budd-Chiari
16 March 2011Budd-Chiari syndrome (BCS) results from hepatic venous outflow obstruction at any level from hepatic venules to the right atrium. Few patients respond to medical treatment (anticoagulation with or without thrombolytic therapy, diuretics)...Continue reading

HBV
Hepatitis B Vaccination Dramatically Lowers Prevalence among U.S. Children
SUMMARY: Children and adolescents in the U.S. today have a very low likelihood of hepatitis B virus (HBV) infection thanks to widespread vaccination, according to an epidemiological study described in the March 1, 2011, Annals of Internal Medicine. Many adults remain vulnerable, however, underlining the importance of vaccination for at-risk groups.

HIV
18th Conference on Retroviruses and OpportunisticInfections (CROI 2011)
February 27 - March 2, 2011, Boston, MA

Healthy You
Cirrhosis:Importance Of Monitoring Vitamin D
The Importance Of Monitoring Vitamin D Levels In All Patients With Cirrhosis
Vitamin D deficiency is a well reported complication in chronic cholestatic liver disease such as primary biliary cirrhosis. While the prevalence and treatment of this deficiency has been addressed in many articles over the last decades, little is known of the vitamin D status in alcoholic liver cirrhosis.......Continue reading..

Perilous Infection Control Practices with Needles, Syringes, and Vials Suggest Stepped-up Monitoring is Needed
Posted: 03/14/2011; ISMP Medication Safety Alert © 3011
Institute for Safe Medication Practices

Posted: 03/14/2011; ISMP Medication Safety Alert © 3011 Institute for Safe Medication PracticesA recent online survey of 5,446 healthcare practitioners reveals an alarming lapse in basic infection control practices associated with the use of syringes, needles, multiple-dose vials, single-use vials, and flush solutions.[1] Survey respondents primarily included registered nurses (89.5%) who worked in hospitals. While the majority of nurses and other healthcare practitioners appear to follow infection control practices consistent with current recommendations,[2] some survey respondents clearly place patients at risk for transmission of blood-borne diseases, according to information we received from the survey sponsor, Premier Healthcare Alliance, while highlighting publication of the survey by Pugliese et al. in the American Journal of Infection Control (www.premierinc.com/injectionpractices).[1]

Pharmaceuticals
,

Achillion Pharmaceuticals receives key US patent for Hep C drug

10:07 am

by Deborah Sterescu

Drug developer Achillion Pharmaceuticals (NASDAQ:ACHN) said Wednesday that it has received a US patent for ACH-1625, an investigational drug designed to treat the hepatitis C virus. The new patent, which covers composition of matter and method of use, has a term until 2029, the company said. "This key patent grant provides a cornerstone for Achillion's intellectual property portfolio for ACH-1625 and a number of structurally related compounds," said president and CEO Michael D. Kishbauch. The company is expecting phase 2 clinical trial results for ACH-1625 in the next months, and is also planning to move two other compounds into phase 1 trials during the first half of the year.

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A wild ride in Hepatitis C treatment
A wild ride in Hepatitis C treatment: Vertex stock gives investors whiplash

March 14th, 2011 5:56 pm ET

Elisabeth MorrisBoston Health News Examiner

Has anyone noticed that Vertex Pharmaceuticals, Cambridge MA (VRTX, Nasdaq) stock has been bouncing around like a ping pong ball during the last months? Traders have been consistently excited about the positive news from Vertex’s Hepatitis C virus (HCV) treatment telaprevir. And some news about a treatment for cystic fibrosis pushed the stock to it’s 52 week high on March 4. But investors reacted (or should we say over-reacted) quite strikingly to some extremely early, positive (but as yet unpublished) results from a very short and small study testing efficacy of Pharmaset’s Hepatitis C treatment, and Vertex’s stock lost 12% of it’s value abruptly last week. Now Vertex stock is undergoing a small uptick based on positive results from it’s anti-inflammatory to treat epilepsy. What a roller coaster ride! It is really very unlikely that any of these results justify such large changes in the value of the company’s stock.

Let’s go back to telaprevir, the treatment for Hepatitis C that is the foundation of Vertex’s value at this point. Hepatitis C virus is a leading cause of chronic liver disease in the United States, and it is estimated that 170 million people worldwide have clinical signs from Hepatitis C virus infection. HCV can cause acute liver disease with severe symptoms, but about 75% of patients develop chronic HCV which can vary from asymptomatic to chronic liver failure and cirrhosis over a course of 10-20 years. HCV is a enveloped, single stranded RNA virus which infects liver cells, proliferates in the cell and then goes on to infect many more cells with each replication process. The end result is destruction of the liver. The viral replication process requires the virus to make an enzyme called NS3/4A. When telaprevir is in the circulation, it binds to the NS3/4A enzyme and prevents the virus from proliferating in the liver cell. ...Continue reading..

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Mar 15, 2011 07:42AM
FDA: Overseas manufacturing puts U.S. at risk
So many of the drugs approved in the U.S. are manufactured overseas that the FDA is having a hard time keeping up with inspections in the supply chain. The result could be another tainted-drug disaster just waiting to happen. This is not an FDA watchdog with an agenda sounding the alarm; the agency itself came out with the dire warning.

"The safety of America's food and medical products is under serious challenge," warned senior FDA official John Taylor, who was speaking at a Pew Health Group meeting. He raised the specter of "another public health crisis like Heparin." In 2008, contaminants in the blood thinner Heparin produced in China led to more than 100 deaths in the U.S.

Pharmalot's Ed Silverman puts the problem in perspective. The number of foreign manufacturing plants grew to more than 3,500 in 2008--up from roughly 1,200 in 2001, he writes. That's a 185 percent increase. Yet the number of FDA inspections rose 23 percent, leading to a 57 percent drop in the inspection rate.
Some of the solutions the FDA has mentioned include more partnering with foreign counterparts and hiring of private inspectors.
- read Silverman's report on Pharmalot- and another report on CNNMoney
Related Articles:FDA to contract out more foreign inspectionsFDA needs to refocus plant inspections, GAO saysDems float bill to boost FDA's foreign powers

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Mar 15, 2011 08:02AM
Portrait of an Indian Pharma acquisition 'failure'
The Wall Street Journal features a little case study in what can go wrong three years after an acquisition that was once billed as a match made in pharmaceutical heaven.
Back in June 2008, Tokyo-based Daiichi Sankyo acquired India's Ranbaxy, a drugmaker specializing in generics, for $4.6 billion. At the time, Daiichi said the acquisition would help it access the American and Indian markets.
Ranbaxy CEO Malvinder Singh had vowed that the company "was in his genes" and would not jump ship. Fast-forward about a year, and Singh parachuted out, clutching a 4.5 billion rupee severance package, according to the WSJ.
What went wrong? Timing. Three weeks later, the FDA banned imports of 30 of Ranbaxy's generic drugs. What went right? After some initial stumbles, Daiichi has indeed gained some synergies with Ranbaxy's R&D. But the overall verdict from the WSJ is "fail."
"This is a classic example of an acquirer paying top price without looking too closely at the quality of the goods," the analysis concludes.
- read the whole thing in WSJ's Deals India

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Of Interest

Concerns Grow Over Medical Tourism in Asia

One of the fastest growing businesses around the world, particularly in Asia, is medical Tourism.

How fast is medical tourism growing? Dr David Vequist, who heads the Center for Medical Tourism Research in San Antonio, Texas says one medical research organization predicts explosive growth.

“According to Fox and Sullivan, by 2012, it’s expected to be worldwide about a $100-billion business, and it’s growing worldwide from 20 to 30 percent. There was a recent estimate that in Asia alone, it was growing as much as 17 percent," he said.

And Vequist says many of the medical facilities around the world are giving the best medical facilities in the United States a run for their money.

“The Johns Hopkins, the Mayo Clinic, the Texas Medical Center, MD Anderson, Cedar Sinai, these really great facilities in the United States that arguably are among the best in the world are receiving more and more competition from best in class facilities in places like Turkey at Parkway Hospital or Bumrungrad in Thailand or Severance in Korea. These locations around the world are getting very good," he said.

But then there is the down side. Glen Cohen, Co-Director of the Petrie-Flom Center for Health Law Policy, Biotechnology and Bioethics at the Harvard Law School says there is evidence that profitable medical tourism is taking away medical services from the poor in some host countries

“In India, for example, there have been a number of anecdotal claims that the existence of the medical tourism industry has siphoned doctors away from treating poor Indian patients and has basically resulted in a net loss for India’s poor. There are others who say no, it’s quite the opposite, that there is an infusion of technology, there is trickledown economics. Again, it’s a contested empirical claim. But beyond that, there is an ethical claim about whether you’ve done something wrong," he said.

Much of China’s medical tourism industry has focused on organ transplants, reportedly about 10,000 of them a year, mostly kidney and organ transplants. The Chinese government has admitted that some of the organs for transplantation have come from executed prisoners.

Nancy Scheper-Hughes, a professor of medical anthropology at the University of California at Berkley and a co-founder and director of the medical rights organization Organs Watch says many of those have lead to very bad results.

“I am in touch [with] a number of families who have had disastrous transplants in China because it was so unregulated. A family named the McGalkers, in Israel, they were of Indian background, went to China in 2009. It was just a horror show. The father had a botched transplant with a 15 year old village girl. Mr. McGalker died and as a result had to be air shipped out, the young donor died. This is serious business. Not just using executed prisoners but setting up living liver transplants and no regulation," she said.

That has recently changed as China has enacted new regulations surrounding transplants. One proposed law would give the death penalty to anyone found guilty of illegal organ trafficking. However Scheper-Hughes says the entire process brings up troubling consequences.

“It does turn doctors and ministries of health into brokers because you still have to find people and it’s not going to be your children or my children. It’s going to be ethnic minorities, the poor, the desperate, the imprisoned people, the people who are looking for visas, the displaced populations of the world, the refugees," she said.

China is also moving forward on plans to set up and market treatment using stem cell therapy that, for the most part, is unavailable in the United States.

Professor Glenn Cohen of the Harvard law school said, “Many scientists think in the next 50 years or so, many of the breakthroughs in medicine may be related to stem cell therapies. So obviously this is promising and obviously with terminally ill patients who have exhausted all approved therapies or clinical therapies in the U.S., the calculus is quite different in terms of the safety and efficacy. But there are significant risks when you engage in any experimental therapy and stem cells are no different. And I’m not really aware of too many success stories in this regard.”

If you are considering availing yourself of the ever growing medical tourism offerings, Cohen said in addition to ethical concerns, there are at least three concerns that must be addressed.

“One is the quality of service that’s being provided to you abroad. The second concern is that if something does go wrong, what is your ability to recover a medical malpractice by suing the doctors abroad, and the third maybe is the willingness to get a doctor in your home country to engage in follow up care, the availability of health records and what the quality of care will be back home," he said.

Even with all of these concerns, medical tourism continues to expand. Reasons why and some services that are likely to become available, are the subject of the next report.
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Related On The Blog;
'60 percent of liver transplants done in China not successful’
Organ Harvesting In China
Reality Check: The Outsourcing Of Clinical Trials/Drugs
Hepatitis C News; Organs For Sale
Six Kosovar doctors face charges of illegal organ trafficking.

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Journal Citations

Hepatitis C virus infection during pregnancy and the newborn period - are thereopportunities for treatment?

Arshad M, El-Kamary SS, Jhaveri R.J Viral Hepat. 2011 Apr;18(4):229-36.

HCV-related cryoglobulinemic syndrome beginning as isolated gynaecologic vasculitis.

Quartuccio L, Maset M, Di Loreto C, De Vita S.Clin Exp Rheumatol. 2011 Feb 2. .

Survival rates of early-stage HCV-related liver cirrhosis patients without hepatocellular carcinoma are decreased by alcohol.

Yamada M, Shiroeda H, Hayashi R, et alJ Clin Biochem Nutr. 2011 Mar;48(2):167-9.

Hepatic steatosis and insulin resistance are associated with severe fibrosis in patients with chronic hepatitis caused by HBV or HCV infection.

Petta S, Cammà C, Marco VD, et alLiver Int. 2011 Apr;31(4):507-15

Risk of kidney cancer and chronic kidney disease in relation to hepatitis C virus infection: a nationwide register-based cohort study in Sweden.

Hofmann JN, Törner A, Chow WH, et alEur J Cancer Prev. 2011 Mar 6.

Outcomes for adult living donor liver transplantation: Comparison of A2ALL and national experience.

Olthoff KM, Abecassis MM, Emond JC, et alLiver Transpl. 2011 Feb 25.

Adherence to treatment and quality of life during hepatitis C therapy: a prospective, real-life, observational study.

Marcellin P, Chousterman M, Fontanges T, et al Liver Int. 2011 Apr;31(4):516-524

FULL-TEXT ARTICLE

Trouble with Bleeding: Risk Factors for Acute Hepatitis C among HIV-Positive Gay Men from Germany—A Case-Control Study

Axel J. Schmidt AJ, Jürgen K. et alPLoS One.08 Mar 2011

Insurance status and treatment candidacy of hepatitis C patients: Analysis of population-based data from the United States.

Stepanova M, Kanwal F, El-Serag HB, Younossi ZM. Hepatology. 2011 Mar;53(3):737-45

Eradication of Hepatitis C Virus Reduces the Risk of Hepatocellular Carcinoma in Patients with Compensated Cirrhosis.

Velosa J, Serejo F, Marinho R, Nunes J, Glória H.Dig Dis Sci. 2011 Mar 5

Survival rates of early-stage HCV-related liver cirrhosis patients without hepatocellular carcinoma are decreased by alcohol.

Yamada M, Shiroeda H, Hayashi R, et et alJ Clin Biochem Nutr. 2011 Mar;48(2):167-9

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'60 percent of liver transplants done in China not successful’

'60 percent of liver transplants done in China not successful’

By ARAB NEWS

Published: Mar 6, 2011 00:15 Updated: Mar 6, 2011 00:15

RIYADH: There is an alarming increase in the number of failed liver transplants involving Saudis in China, said a leading Saudi expert in liver transplants, Al-Riyadh newspaper reported.
“More than 60 percent of such liver transplants in China involving Saudis have ended in failure,” said Dr. Muhammad Al-Subayyil, head of liver transplants at King Faisal Specialist Hospital and Research Center in Riyadh.

Al-Subayyil made the comments while addressing a conference on the subject organized by King Faisal University students at the King Faisal Charity Foundation in Riyadh on Thursday.
Al-Subayyil said the failures were mainly because of unsuitable organs. “In most cases, the liver that is transplanted has been removed from the donor’s body after his or her heart stops functioning. This produces a direct impact on the liver,” he added.
Referring to the Organ Transplant Program at King Faisal Specialist Hospital, Dr. Al-Subayyil said that about 300 liver transplants have been conducted at the hospital since the launch of the program in 1994.

“One-third of these transplants were conducted after organs were received from live donors. The number of liver transplants at the hospital has considerably increased over the past few years. We are expected to carry out as many as 70 transplants this year alone,” he said.
Al-Subayyil also said that the proposed King Abdullah Center for Tumors and Liver Diseases is expected to be operational within the coming three years. “The center will be a major boost to treat and prevent liver diseases in the Kingdom,” he said, adding that some 5-10 percent of Saudis suffer from various liver diseases.

Identifying liver diseases as a major national problem, Al-Subayyil said the main challenge lies in a lack of donors. “About 10 percent of patients who died in the Kingdom last month were those waiting for liver transplants,” he said.

Farouq Al-Zouman, the first Saudi to climb Mt. Everest, also attended the conference. Al-Zouman delivered a lecture on the development of human resources and self esteem.

http://arabnews.com/saudiarabia/article302465.ece

Hepatitis C News; Organs For Sale

The Philippines is among several developing countries which are said to be major sources of goods involved in transnational crimes, a study of the anti-corruption group Transparency International (TI) showed.
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For organ sale, the Philippines is among the "common donors" of these organs together with China, India, Turkey, Egypt, Moldova, Romania, Brazil, Bolivia, and Peru for buyers coming from developed countries like the United States, Canada, Japan, Italy, and Australia, as well as the wealthy classes from developing countries such as Saudi Arabia, Israel, and Oman.

Kidney is the most commonly transplanted organ, with a global estimate of 68,500 transplants performed per year, followed by the liver (20,100), heart (5,200), lung (3,250), and pancreas (2,800).
Illicit trade in kidney and liver alone is estimated to reach between $600 million and $1.2 billion per year.

"As with other forms of trafficking, the illegal kidney trade generally ‘flows from poor, underdeveloped countries to rich, developed ones’... Recently China, Pakistan, and the Philippines have taken steps to prohibit ‘transplant tourism,’ which the United Network for Organ Sharing defines as ‘the purchase of a transplant organ abroad that includes access to an organ while bypassing laws, rules, or processes of any or all countries involved.’ These efforts have dramatically slowed the practice of open transplant tourism, but experts believe that the practice continues as ‘an underground criminal activity,’" TI said.
For oil, TI estimated the average yearly value of illicit trade from 2003 to 2010 was $10.8 billion..........
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Health chief to keep ban on kidney sale
by Macon Araneta
HEALTH Secretary Enrique Ona on Friday vowed to win over Senator Miriam-Defensor Santiago and explain his position on the commercial sale of kidneys and other human organs – issues that the lawmaker raised in blocking his appointment.
A day after Santiago threatened to veto Ona’s confirmation, the health chief said he would try and hold a meeting with Santiago before the bicameral Commission on Appointments resumes its confirmation hearing on Wednesday.
Santiago had demanded from Ona a written assurance of his adherence to the administrative order issued by his predecessor Esperanza Cabral which imposed a ban on the donation of kidneys from non-related donors.
The feisty senator said she was bothered by Ona’s stand on the policy on kidney transplants. She noted that allowing kidney transplants between unrelated and living patients will open the poor to the exploitation of the poor who sell their kidneys.
During the hearing, Ona recalled that Santiago wanted a definite statement from him that he will not revoke or change Cabral’s order until there is a law defining it.
Ona, former director of the National Kidney Transplant Institute, said he had no intention of revoking or replacing Cabral’s order.
Cabral’s ban stays, said Ona, who was one of the highest-paid kidney transplant surgeons before he assumed the Health portfolio.
Cabral’s ban imposed total ban on the sale of kidney to foreigners. It was part of the Philippine commitment to the 2008 Istanbul Declaration on Organ Trafficking and Transplant.
“We will not make any changes in the (Cabral) order at this time. I have no intentions of changing it,” Ona said.
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Also See; Organ Harvesting In China
Six Kosovar doctors face charges of illegal organ trafficking.
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HIV-Infected Men at Ongoing Risk for HCV Seroconversion, Study Finds
February 7, 2011 — Even with conscientious care and state-of-the-art medication, HIV-infected men are at risk for hepatitis C virus (HCV) seroconversion and should have access to ongoing HCV surveillance, the authors of a new study say. Their findings were published online January 31 and appear in the February print issue of Clinical Infectious Diseases.
HCV has become "a leading cause of non-AIDS related morbidity and mortality for HIV-infected persons in the highly active antiretroviral therapy (HAART) era," lead author Lynn E. Taylor, MD, from Brown University, Providence, Rhode Island, and coauthors write. They estimate that up to 30% of HIV-infected people in the United States are coinfected with HCV....

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Gates Foundation Awards 2 Grants Totaling $5.45M For Cutting-Edge Laboratory Research: Team To Create Advanced Devices For Testing Malaria Drugs
09 February 2011The University of South Florida received $5.45 million in grants from the Bill & Melinda Gates Foundation. The first grant is to create advanced devices that mimic the human liver to better study the life cycle of the...

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Novel Cancer Surgery Enabled By NOTES Tools
09 February 2011Surgeons at UC San Diego Health System have identified a new application for "scarless" surgery tools that are normally used for natural orifice translumenal endoscopic surgery (NOTES
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Prevalence of Hepatitis B surface antigen (HBsAg) among visitors of Shashemene General Hospital voluntary counseling and testing center.
Hepatitis B virus (HBV) infection is significant health problem, as it can lead to chronic hepatitis, liver cirrhosis, and hepatic carcinoma. Due to shared routes of transmission, HBV and human immunodeficiency virus (HIV) co-infection is common and is an emerging concern in the clinical management of patients because of increased mortality, accelerated hepatic disease progression, and the frequent hepatotoxicity caused by anti-retroviral therapy.The aim of this study was to determine the prevalence of Hepatitis B surface antigen (HBsAg) and its risk factors, among individuals visiting Shashemene General Hospital VCT center.FindingsInstitution based cross-sectional study was performed from November 3, 2008 to December 29, 2008 and 384 voluntary counseling and testing (VCT) clients were investigated. Data on socio-demographic and HBV risk factors was collected using structured questionnaires.Blood samples were collected and screened for hepatitis B surface antigen (HBsAg) and HIV by commercially available rapid test kits.

The prevalence of HBsAg in this study group was 5.7%.Fourteen percent of HIV positive subjects (8/57) and 4.3% (14/327) of HIV negative subjects were positive for HBsAg. Significantly high prevalence of HBsAg was observed among individuals who had history of invasive procedures, like tooth extraction, abortion and ear piercing; history of hospital admission, history of unsafe inject and HIV positives. Conclusions: Although HBsAg prevalence is much higher among subjects who are HIV positive (14.0% versus 4.3%), the prevalence of HBsAg in HIV negative subjects is high enough to warrant a recommendation to screen all clients at VCT centers irrespective of HIV status.Author: Asfaw NegeroZufan SisayGirmay MedhinCredits/Source: BMC Research Notes 2011, 4:35
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Healthy You
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Hepatitis C treatment
Warning issued to Fuzeon, Pegasys, Viraferon Peg and Intron A users
The US Food and Drug Administration has issued a warning to users of four injectable drugs that may be used by people with HIV and/or hepatitis C regarding microbial contamination of alcohol ...
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Liquid drugs 'more prone to error'
9-Feb-2011 By The Press Association
Liquid medication is four times more likely to be taken wrongly by care home residents than capsules or tablets, according to a study.

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State urges testing of well water in Woodstock area
Illinois officials are urging residents who get their drinking water from private wells in the Woodstock area to test it for possible contamination.Routine testing by the Illinois Environmental Protection Agency near the McHenry County community show possible contaminants.A product of an industrial solvent was detected at levels lower than the standard at which experts usually express concern, an EPA spokeswoman said. But it's possible the levels could be higher in other areas where people draw their drinking water.Long-term exposure to high levels of such a contaminant could result in increased health risk to the liver and kidneys.The Illinois Department of Public Health is encouraging residents in the area to have their water tested at a private laboratory.
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Public Release: 9-Feb-2011 Journal of Renal Care
Experts call for greater awareness of the links between diabetes and kidney disease
Experts are calling for greater awareness of the kidney problems that diabetics can face, after research found that awareness was low among white and South Asian patients. The first time that many patients realized that diabetes could affect their kidneys was when they were referred to renal services.
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Dr. Jeff Hersh: Understanding blood tests
By Dr. Jeff Hersh
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GateHouse News Service
Posted Feb 08, 2011 @ 12:11 PM
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Q: I had a routine blood test, and my doctor told me my white blood cell count was low. Should I be worried?

A: Several different types of white blood cells fight bacterial, fungal, viral and/or parasitic infections, as well as serving other functions. In adults, a white blood cell count less than 3,500 cells per microliter is considered low; the normal threshold in children varies with age.
White blood cells are made in the bone marrow and are released into the blood stream. They then circulate in the blood stream or take up residence in the vascular endothelium system or certain body tissues/organs. Old white blood cells are cleared from the blood stream by the spleen and liver.

The white blood cell count is measured by evaluating the concentration of white blood cells in the bloodstream. Falsely low measurements can occur due to clumping of the white blood cells or from other factors.

A truly low white blood cell count can be from a congenital cause or it can be acquired. There are many different congenital conditions that cause low white blood cell counts. An acquired low white blood cell count can be due to:

Decreased bone marrow production: This may be due to infections (viral infections are the most common cause), medication reactions (the second most common cause), certain congenital conditions, medication effects (such as from chemotherapy agents) or from cancer/infections/other conditions that infiltrate the bone marrow "crowding out' its ability to produce normal white blood cells. In addition, certain autoimmune conditions can affect the hormones that trigger white blood cell production, hence "turning off the switch" that tells the bone marrow to produce white blood cells. There are also many conditions that may directly affect the cells that make the white blood cells, causing ineffective production of normally functioning cells. High thyroid levels and/or certain vitamin or mineral deficiencies (such as B-12 or folate deficiencies) can cause inadequate white blood cell production as well.
Increased destruction of white blood cells in the bloodstream: This may be due to autoimmune conditions (possibly triggered by medication reactions) or many other conditions.
Increased clearance of white blood cells (even normally functioning ones): This may be due to an enlarged spleen (from whatever cause).

Using them up faster than they can be replaced: Overwhelming infections can do this.
Migration of the cells out of the bloodstream: In some conditions white blood cells can migrate to the vascular endothelium or other tissue pools/organs.

The type, risk and severity of any clinical problem from low white blood cells depends on the type of white blood cells that are affected and how severe the deficit is. Many of the conditions that cause a low white blood cell count are benign, causing minimal or no clinical problems. However, since white blood cells are one of the main ways the body fights infections, a low white blood cell count can lead to an increased risk of infection.

Polymorphonuclear cells (PMNs) are the most common type of white blood cells and, hence, low white blood cells almost always implies a low PMN count. Since PMNs fight bacterial infections, overall this is the most common infection from low white blood cells.
Low white blood cell count is more common in African Americans; 5 percent to 10 percent of black Americans have low neutrophil counts, as opposed to less than 1 percent of white Americans. Thankfully, this is usually due to a benign inherited condition, so most of these patients do not have clinical problems.

In patients with a mildly decreased white blood cell count noted on a routine blood test who do not have a history of infections, other testing may not be required. However, in patients with a history of infections, or those with other concerning results of their blood test, other testing may be indicated.

For example, if transient neutropenia is suspected (a condition where a patient's PMNs drop for several days every few weeks, predisposing them to infection) blood tests to check their white blood cell count may be required several times per week for several weeks. If decreased cell production is suspected, a bone marrow biopsy may be required. If an autoimmune condition is suspected screening tests for a collagen vascular disease or other testing may be needed. If a chronic infection is suspected -- for example, HIV infection -- other tests may be indicated.
Many patients with low white blood cells do not require treatment. However, good dental care (since this can be a source of infection) and increased vigilance when they have a fever or appear ill is indicated.

Depending on the cause of the low white blood cells, some patients may benefit from antibiotics to minimize their risk of acquiring an infection. For example, certain HIV patients are put on specific types of antibiotics.
For some patients -- like those receiving chemotherapy for certain cancers -- medications that stimulate the bone marrow to increase production of white blood cells may be beneficial.
A low white blood cell count should trigger a discussion with your health care provider. He or she can evaluate your history and risk factors, as well as the other details of the test results, and determine what other testing and/or treatments may be required.
Jeff Hersh, Ph.D., M.D., F.A.A.P., F.A.C.P., F.A.A.E.P., can be reached at DrHersh@juno.com.
MetroWest (Mass.) Daily News
Copyright 2011 The Milford Daily News. Some rights reserved

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Off The Cuff
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Goldman Sachs Suggests Buying Calls on Vertex Pharmaceuticals
Goldman Sachs is out with a research report this morning, where its analysts suggest that traders buy calls on Vertex Pharmaceuticals (NASDAQ: VRTX) ahead of several catalysts.
The analysts expect shares to be especially volatile around seven upcoming catalysts, most relating to TVR (Telaprevir), a new drug for HCV (hepatitis C infection) which could represent over 80% of VRTX sales by next year.
TVR is at the leading edge of a paradigm shift for the treatment of HCV, a market that is expected to grow to $10-$12bn from $3bn following the introduction of new oral drugs, with improved cure rates and shorter treatment durations.
They suggest buying the July $41.00 call for $3.50.
Vertex Pharmaceuticals Incorporated is engaged in the business of discovering, developing and commercializing small molecule drugs for the treatment of serious diseases.
(c) 2011 Benzinga.com. All rights reserved. This material may not be published in its entirety or redistributed without the approval of Benzinga.

Six Kosovar doctors face charges of illegal organ trafficking.

Kosovo physicians accused of illegal organs removal racket

Paul Lewis in Pristina
guardian.co.uk, Tuesday 14 December 2010 15.17 GMT
Article history

Medicus clinic linked in Council of Europe report to alleged Kosovo Liberation Army organ harvesting atrocities

The story of how Kosovo hosted an illegal market in human organs began to unfold today in a district court in the capital, Pristina. As armed special forces stood outside, the court heard how desperate Russians, Moldovans, Kazakhs and Turks were lured into the capital "with the false promise of payments" for their kidneys.
EU prosecutor Jonathan Ratel told the court the organs had been illegally removed from victims and transplanted into wealthy recipients in the clinic, known as Medicus. Those who paid up to €90,000 (£76,400) for the black-market kidneys included patients from Canada, Germany, Poland and Israel, Ratel said.

Huddled in the centre of the room, in overcoats, were seven defendants alleged to have played some role in the racket. Among them were some of Kosovo's most respected physicians, including a former permanent secretary of health who is accused of abusing office to grant Medicus a false licence, and Dr Lutfi Dervishi, a urologist at the university hospital alleged to have set up the operation.
Two of their co-accused are fugitives wanted by Interpol: Moshe Harel, an Israeli said to have matched donors with recipients, and Yusuf Sonmez, perhaps the world's most renowned organ trafficker.. Continue Reading.......................

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