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HOUSE CALL WITH DR. SANJAY GUPTA
Many Donate Organs To Strangers; Liver Donation Riskier Than Kidney Donation; Chinese Government Plans On Smoke-Free Olympics In 2008; Fitness Playgrounds Are Latest Trend
Aired June 3, 2006 - 08:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
BETTY NGUYEN, CNN ANCHOR: Now in the news, a developing story out of Iraq. One Russian diplomat killed, four others kidnapped after gunmen opened fire on the car they were riding in. It happened in a Baghdad neighborhood of Mansour near the Russian embassy. For complete coverage of this developing story, you'll want to stay with CNN, the most trusted name in news.
In other news, police are still looking for 28-year-old Desmond Turner. He is their prime suspect in the killings of seven members of one family in Indianapolis Thursday night. Police say they have arrested a man they believe to be an accomplice. We'll stay on top of this story as well.
Now to Canada. A major police sweep in the Toronto area nets at least ten people. They've been arrested on terrorism-related charges. A news conference is scheduled for 10:00 a.m. Eastern. We're going to bring that to you live when it happens.
I'm Betty Nguyen. Those are the headlines. HOUSE CALL with Elizabeth Cohen, starts right now.
ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: Good morning and welcome to HOUSE CALL. I'm Elizabeth Cohen sitting in for Dr. Sanjay Gupta.
This morning, we're talking about life-saving transplants. Did you know that more than 78,000 people act as living organ donors, donating a kidney or part of a liver, or a lung, and more? We're going to meet some of those people and hear both the successes and the complications when someone gives the gift of life.
UNIDENTIFIED MALE: We all take a moment now to extend our hand towards our sister Kathleen.
ELIZABETH COHEN, HOST (voice-over): In the depths of winter, a woman prays. In the midst of summer, her prayers are finally answered.
UNIDENTIFIED MALE: Lord, we ask you to be with her every day of her life, but most especially this Tuesday.
COHEN: Tuesday is the day Kathleen Sampson has been praying for.
UNIDENTIFIED MALE: Amen.
UNIDENTIFIED FEMALE: You might feel a warm sensation going up your arm.
COHEN: After months of testing, she's giving her kidney to someone who would die without it, someone she's never met.
UNIDENTIFIED MALE: OK. Great.
KATHLEEN SAMPSON, DONOR: Basically, here's my kidney to do with, you know, whatever's best. Give it to the best person. And this is just something that I want to do. And I'm hoping that it will hold great results.
COHEN: She's not alone. There are 78,000 living donors. And nearly 400 of them are like Kathleen, giving to complete and total strangers.
DR. ROBERT MONTGOMERY, JOHNS HOPKINS TRANSPLANT CENTER: They realize that, hey, I've got two kidneys and really, my body will function perfectly well with one kidney.
COHEN: Dr. Robert Montgomery will be performing her surgery at Johns Hopkins in Baltimore. Kathleen's son Conner died several years ago when he was five. Conner died at Johns Hopkins Hospital.
Kathleen is now here to give life where she lost it. Thousands of people would love to get Kathleen's kidney. Some are so desperate, they beg on Web sites.
This huge demand has some people worried. In the rush to help those who need organs, will doctors be too quick to take them from generous people like Kathleen? Our investigation found that surgeons have approved donors who some believe are highly questionable: children as young as 10, drug addicts, even people who were mentally ill.
ARTHUR CAPLAN, BIOETHICIST: I've seen anorexics give organs. I've seen people who are clearly depressed give organs. I've seen people come, who have been accepted at programs who are morbidly obese. I've seen people come to programs who have had a long history of drug and alcohol abuse.
COHEN: There's a huge need for transplants. At last count, there were more than 66,000 people on the kidney waiting list alone. On average, more than 100 people are added to waiting lists every day. That's about one every 13 minutes.
In that same 24 hours, 18 people die waiting. Last year, that equaled about 6,000 deaths.
So are people so desperate for an organ, that they and their doctors will accept people who aren't good candidates? Here to answer that question and more is Dr. Kenneth Newell. He's a transplant surgeon and director of the living donor kidney transplant program at Emory University Hospital in Atlanta. Welcome, doctor.
DR. KENNETH NEWELL, TRANSPLANT SURGEON: Hello.
COHEN: Now each center has their own criteria. They won't accept just anyone as a living donor. What's the criteria at your center at Emory?
NEWELL: At our center, we basically use criteria that are probably used all over the country, weighted perhaps a bit differently. The most important thing is that people be healthy. We want them to be free of diseases that would cause kidney problems in the future or jeopardize their life.
Beyond that, we try to look and say are they psychologically well suited to donate? Are there social considerations that, you know, donation might pose real problems for them and their family down the road? So you're trying to look at medical issues first, but the whole individual.
COHEN: Now are there advantages to the recipient of using an organ from a living person, rather than a cadaver?
NEWELL: There are very clearly advantages to the recipient. So for them, it's all upside. The organs last much longer as a whole. They work better sooner and they last longer.
Also, it gives them the opportunity to perhaps be transplanted before they're on dialysis, which is another important predictor for how long the kidney would survive.
COHEN: Well, we have an e-mail question for you next. Let's go to Mary from Kentucky who writes, "I was told that as a breast cancer survivor I could not be a donor." Is that correct? Does having breast cancer mean you can't donate an organ later in life?
NEWELL: The bottom line is yes. There are very, very rare situations where with a certain very low-grade tumor that's totally removed, maybe, but the simple answer is yes. You probably should not be considered as an organ donor.
COHEN: And what about some other conditions? Can you name some other conditions that would just -- you'd say no matter how much you want to donate, you cannot be a living organ donor?
NEWELL: Certainly people who have high blood pressure or diabetes probably shouldn't be outside a special very, very rare circumstances, considered because those are a couple of the leading causes of kidney disease.
People who have had recurrent bad kidney infections or had any impaired kidney function. People who had other life-threatening illnesses, such as strokes or heart attacks. Those types of things that probably make it not as safe to be a living donor.
COHEN: Well, when HOUSE CALL returns, we'll meet a woman who saved her sister's life. Plus, we'll get straight talk about possible complications.
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UNIDENTIFIED FEMALE: I took one look at him. He didn't even look like a human being. He was swollen from his head to his toes.
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UNIDENTIFIED FEMALE: The gift of life cost this man his. Get the real facts about the risk and rewards of donation.
And later, one neighborhood's fight to stay fit for life. That's coming up on HOUSE CALL.
COHEN: Kidney transplants are the most common transplants. Liver transplants are next in line, but they are dramatically fewer, just over 300 living donor liver transplants last year. This procedure wasn't performed until 1989. And it's a lot more complicated than most kidney transplants with more risks.
COHEN: Who was looking out for your husband?
RHONDA BOONE, WIDOW: Me. No one was looking out for my husband except for me.
COHEN (voice-over): Danny Boone was 41 when he gave a section of his liver to his brother, who would have died without it. A liver donation is far riskier than kidney donation. According to the federal government's Advisory Committee on Organ Transplantation, up to one-third of donors suffer complications. Immediately after the surgery, Rhonda Boone noticed something was very wrong.
BOONE: When I took one look at him, he didn't even look like a human being. He was swollen from his head to his toes. He was unrecognizable.
The first words I said to the nurse that was taking care of him, I said do all of the transplant patients look this way? She said I don't know. This is the first time I've ever taken care of one. I thought, oh, no. That's not a good sign. And let me tell you, it went from bad to worse right there.
COHEN: Danny was in liver failure. And ironically, he now needed a liver transplant. Over the course of three weeks, surgeons operated on him five more times.
By the time they put him on the transplant list to receive the liver transplant himself, it was the day before he died. And it was only a token.
COHEN: Danny Boone died July 16, 1999. What his widow learned later made her furious. BOONE: My husband's death was very preventable, very preventable. Post-op care was horrible. It was a nightmare. The list of complications Danny suffered are so numerous.
COHEN: An expert testified that based on medical records, too much of Danny's liver was removed. What's more, before the surgery, his doctors knew he had a condition called celiac stenosis, which restricts the blood flow to the liver. Rhonda says his doctors brushed it aside.
BOONE: Danny was told that would be no problem.
COHEN: The doctors from the hospital where Danny had his surgery declined to be interviewed for this story. They settled out of court with Rhonda. She and her son, Justin, now live on a farm in Boone, North Carolina.
BOONE: There's a lot of things that happened from the time you're 15 until you're 21 that you need your father for. And Justin didn't have that.
COHEN: You'll hear more of Rhonda's story this weekend on my special, "Body Parts," airing at 8:00 and 11:00 p.m. We're talking now with Dr. Kenneth Newell, director of the Living Donor Kidney Transplant Program at Emory University Hospital in Atlanta.
Doctor, we just heard a story about a living liver donor who unfortunately died. How risky is it to donate a part of your liver?
NEWELL: As they pointed out in your statistics, it's much more risky than a kidney. The risks are probably somewhere in the magnitude of 10 times more -- or what am I saying -- somewhere around the order or magnitude of 100 times more risky to have a serious complication.
And I think that it's important to put tragedies like this in perspective, try to learn from them to protect people who, you know, would consider donation in the future, but realize that most people actually have a very positive experience, I think.
COHEN: Well, we want to bring in another perspective now. Donna Luebke will be joining us. She's a nurse on the board of the governing body of organ donation, that's UNOS, and a kidney donor herself to her sister.
Donna, thanks for joining us.
DONNA LUEBKE, UNOS BOARD MEMBER: Oh, thank you, Elizabeth.
COHEN: I wanted to get your thoughts first on being a donor. Tell me about your experience. Have you had any lingering effects from giving away your kidney?
LUEBKE: No. I donated in 1994 to my sister. And that was with the open nephrectomy. They did not do the laparoscopic procedure at that time, but I make sure I see my primary care doctor every year and get urine studies and blood work done to make sure that my lone kidney remains healthy and that I also remain healthy, that I don't suffer effects of, you know, diabetes, high blood pressure, things that can impact my kidney's health.
COHEN: Donna, are you as a donor being tracked at all long term? The doctors who did your surgery, are they looking after you 12 years later or longer than that to see how you're doing? And what's the standard for tracking donors like you?
LUEBKE: No, I was never contacted by the transplant center following the donation. I was passed over to my primary care physician once I had my follow-up appointment with the surgeon. So my primary care doctor knew how to take care of me. But I never did have further contact with the center for any information about my overall health.
COHEN: Now Dr. Newell, this raises an important point and one that is hotly contested in the transplant world. At Emory, you keep track of your living donors for a year after their surgery.
COHEN: And many centers are like that. How do you know if your donors 10 years down the road or 20 years down the road are suffering complications? How would you know?
NEWELL: It would be very hard to know, honestly speaking. I think what we try to do is establish a relationship with our patients and encourage them, as we just heard, to follow up and to let us know should anything happen. And hopefully, they know that we are very invested in their health.
And we do get calls from people often with unrelated questions, but whether they just want to check how the kidney donation affected them. So we try to be available. But in truth, we aren't tracking people at five, 10, or 20 years.
COHEN: Now the person who gets the organ, the recipient, they are tracked long term. Why not track your donors? They're obviously a very precious resource.
NEWELL: Well, yes, I might not say it that way, but they've done a remarkable thing. And we want to protect their health. A lot of times, the way living donation works, people travel in from out of town or they live quite a ways away. And it's almost viewed as an inconvenience, I think, for them to have to come back. Tracking...
COHEN: Or even get a phone call, that would be inconvenient?
NEWELL: Well, no, certainly a phone call, I think, would be useful, but it's just something that has not evolved in transplantation perhaps because we had focused on short-term outcomes and not really begun to think about long term.
COHEN: Well, we're talking now with Dr. Kenneth Newell and organ donor Donna Luebke about living donation. Stay with us.
UNIDENTIFIED FEMALE: You've made the decision, checked with your doctor, but who pays when you're the one donating an organ? Find out after the break.
But first, this week's medical headlines in "The Pulse."
JUDY FORTIN, CNN CORRESPONDENT (voice-over): Changing the habits of 350 million smokers will be difficult, but the Chinese government plans on having a smoke-free Olympics in 2008. Health officials say the ban will be enforced in public places.
A new study reseals some doctors are biased when it comes to referring patients with certain types of cancer. University of Wisconsin researchers found primary care physicians are half as likely to refer patients with advanced lung cancer to an oncologist as they were to refer patients with advanced breast cancer. Researchers also found a general lack of knowledge among the doctors about the benefits of newer and more promising treatments for lung cancer.
Judy Fortin, CNN.
COHEN: Welcome back to HOUSE CALL. We're talking about living donor organ donation with Dr. Kenneth Newell, director of Emory University's Living Donor Kidney Transplant Program and with Donna Luebke. She's on the board of UNOS and a kidney donor herself.
Let's go back to our inbox and question -- a question from Eric in Washington. Eric wants to know, "If I donate an organ for transplant, who bears the expense of the operation?"
Dr. Newell, you do these surgeries all of the time. Let's start with you.
NEWELL: I used to always say that the donors would never see a bill. It turns out that's not always true. Some people actually have insurance benefits that pay for a living kidney donation. In that setting, you would be eligible or you would be responsible for the co- pay just like any other healthcare.
That said, most insurance companies are very willing to work with us to try to make sure all the expenses are borne by the recipient's insurance.
COHEN: And Donna, you have some specific concerns about the possible long-term costs that can be incurred by donors by someone who donates an organ?
LUEBKE: Right, Elizabeth, I've joined with another nurse who was a kidney donor, Kimberly Tracey in Dayton. And she has formed the Living Organ Donor Advocate Program. And we are aware that some insurances only cover complications up to seven days following the donation. Some will cover 30-day period of complications.
And so there are donors occurring bills a result of the complications of the donation surgery. And that's our concern is to help these donors get bills paid, but also look at who's going to bear long-term costs of care.
There are two young liver donors out there that are going to need transplants. And my concern for them is who is going bear the cost of their long-term care? One is uninsured.
COHEN: Well, we'll have to take a quick break now. What you need to know if you're considering being a donor. That's just ahead.
COHEN: For more on living donation, go to www.transplantliving.org. That's the Web site for the United Network for Organ Sharing, where you can find research hospitals, procedures, costs, and plus, find support groups.
We're talking with transplant surgeon Dr. Kenneth Newell and donor and UNOS board member Donna Luebke today.
We've heard the successes and the complications. Donna, what's the one piece of advice you have for someone who's considering becoming a living donor?
LUEBKE: I think it's important that the person do their research in terms of looking for a surgeon and center-specific information. And do they have a focus living donor program and a living donor team? And there's a wealth of information on a Web site called livingdonorsonline.org. And that's where a person can start.
COHEN: And Dr. Newell, what would be your one piece of advice for someone who's thinking about being a living donor?
NEWELL: I would say the same thing, to take your time, to think about it carefully, to talk to other people who've actually been through the experience, so that you know what to expect.
COHEN: Well, thank you, Dr. Newell very much. We're out of time for today. Dr. Newell was here with us this morning from Emory. And thank you also to Donna Luebke for bringing your perspective.
LUEBKE: You're welcome.
COHEN: More HOUSE CALL after the break.
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UNIDENTIFIED FEMALE: Just because you're over 50 doesn't mean you don't want to look good and feel great.
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UNIDENTIFIED FEMALE: Find out how these adults are taking over the playground. Why and how they did it, coming up.
COHEN: Welcome back to HOUSE CALL. It's time for our weekly check in on the nation's fight against obesity. Dr. Sanjay Gupta recently found one community so concerned for their fitness and health, that they fought for a fitness playground of sorts.
DR. SANJAY GUPTA, CNN SENIOR MEDICAL CORRESPONDENT (voice-over): Strike up the band and a drum roll on a drum anyway, please. One Atlanta neighborhood was so excited about the latest fitness trend for parks, the community held a ribbon cutting and a parade.
All of it to welcome new exercise equipment.
UNIDENTIFIED FEMALE: It is fun.
GUPTA: Playgrounds aren't just for kids anymore. Mrs. R.R. Harris, the neighborhood planning unit chair and her crew noticed the community was getting older, but it wasn't necessarily getting fitter.
MRS. R.R. HARRIS, NEIGHBORHOOD PLANNING CHAIR: We're going to make sure we're off the bench and we're out doing a light trail out walking.
GUPTA: So the group raised enough money to put in a playground for young kids and for the young at heart.
UNIDENTIFIED MALE: We need to get these men out here and get these bellies off like mine.
GUPTA: Park Pride, that's one agency that helped fund the equipment, says this is a growing trend with area parks, one that'll be a huge help for older Americans.
GEORGE DUSENBURY, PARK PRIDE DIRECTOR: When people have access to places to exercise, they're significantly more likely to exercise.
GUPTA: The light trail exercise stations are designed to help seniors concentrate on key areas, like balance, flexibility, and strength. Experts say even moderate exercise is important for healthy aging, because it helps reduce the risk of heart disease, diabetes, and strokes.
But you won't find many seniors sitting around at the park unless it's to get in some extra stretching. Even residents who say they never used to exercise can't wait to hit the trail.
Barbara Leath is in her 60s.
BARBARA LEATH, EXERCISING SENIOR: Because it helps me to start today. And I feel good. And I can run for the rest of the day and do things I might not normally be able to do because I'm tired.
GUPTA: And that's music to the ears of Mrs. Harris.
HARRIS: And just because you're 50 doesn't mean you don't want to look good and feel great.
GUPTA: Dr. Sanjay Gupta, CNN, Atlanta
COHEN: Thanks, Sanjay. Tune in every weekend for the facts and stories behind the fight against obesity. And make sure to watch my "CNN PRESENTS" special called "BODY PARTS." We follow the ethical dilemmas, medical successes, and complications of living organ donation. That's this weekend at 8:00 p.m. and 11:00 p.m.
Thanks for watching. I'm Elizabeth Cohen. Stay tuned for more news on CNN.
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