In this issue

Jonathan Tobin: Defending the Right to a Jewish State

Heather Hale: Compliment your kids without giving them big heads

Megan Shauri: 10 ways you are ruining your own happiness

Carolyn Bigda: 8 Best Dividend Stocks for 2015

Kiplinger's Personal Finance editors: 7 Things You Didn't Know About Paying Off Student Loans

Samantha Olson: The Crucial Mistake 55% Of Parents Are Making At Their Baby's Bedtime

Densie Well, Ph.D., R.D. Open your eyes to yellow vegetables

The Kosher Gourmet by Megan Gordon With its colorful cache of purples and oranges and reds, COLLARD GREEN SLAW is a marvelous mood booster --- not to mention just downright delish
April 18, 2014

Rabbi Yonason Goldson: Clarifying one of the greatest philosophical conundrums in theology

Caroline B. Glick: The disappearance of US will

Megan Wallgren: 10 things I've learned from my teenagers

Lizette Borreli: Green Tea Boosts Brain Power, May Help Treat Dementia

John Ericson: Trying hard to be 'positive' but never succeeding? Blame Your Brain

The Kosher Gourmet by Julie Rothman Almondy, flourless torta del re (Italian king's cake), has royal roots, is simple to make, . . . but devour it because it's simply delicious

April 14, 2014

Rabbi Dr Naftali Brawer: Passover frees us from the tyranny of time

Greg Crosby: Passing Over Religion

Eric Schulzke: First degree: How America really recovered from a murder epidemic

Georgia Lee: When love is not enough: Teaching your kids about the realities of adult relationships

Cameron Huddleston: Freebies for Your Lawn and Garden

Gordon Pape: How you can tell if your financial adviser is setting you up for potential ruin

Dana Dovey: Up to 500,000 people die each year from hepatitis C-related liver disease. New Treatment Has Over 90% Success Rate

Justin Caba: Eating Watermelon Can Help Control High Blood Pressure

The Kosher Gourmet by Joshua E. London and Lou Marmon Don't dare pass over these Pesach picks for Manischewitz!

April 11, 2014

Rabbi Hillel Goldberg: Silence is much more than golden

Caroline B. Glick: Forgetting freedom at Passover

Susan Swann: How to value a child for who he is, not just what he does

Cameron Huddleston: 7 Financial Tasks You Should Tackle Right Now

Sandra Block and Lisa Gerstner: How to Profit From Your Passion

Susan Scutti: A Simple Blood Test Might Soon Diagnose Cancer

Chris Weller: Have A Slow Metabolism? Let Science Speed It Up For You

The Kosher Gourmet by Diane Rossen Worthington Whitefish Terrine: A French take on gefilte fish

April 9, 2014

Jonathan Tobin: Why Did Kerry Lie About Israeli Blame?

Samuel G. Freedman: A resolution 70 years later for a father's unsettling legacy of ashes from Dachau

Jessica Ivins: A resolution 70 years later for a father's unsettling legacy of ashes from Dachau

Kim Giles: Asking for help is not weakness

Kathy Kristof and Barbara Hoch Marcus: 7 Great Growth Israeli Stocks

Matthew Mientka: How Beans, Peas, And Chickpeas Cleanse Bad Cholesterol and Lowers Risk of Heart Disease

Sabrina Bachai: 5 At-Home Treatments For Headaches

The Kosher Gourmet by Daniel Neman Have yourself a matzo ball: The secrets bubby never told you and recipes she could have never imagined

April 8, 2014

Lori Nawyn: At Your Wit's End and Back: Finding Peace

Susan B. Garland and Rachel L. Sheedy: Strategies Married Couples Can Use to Boost Benefits

David Muhlbaum: Smart Tax Deductions Non-Itemizers Can Claim

Jill Weisenberger, M.S., R.D.N., C.D.E : Before You Lose Your Mental Edge

Dana Dovey: Coffee Drinkers Rejoice! Your Cup Of Joe Can Prevent Death From Liver Disease

Chris Weller: Electric 'Thinking Cap' Puts Your Brain Power Into High Gear

The Kosher Gourmet by Marlene Parrish A gift of hazelnuts keeps giving --- for a variety of nutty recipes: Entree, side, soup, dessert

April 4, 2014

Rabbi David Gutterman: The Word for Nothing Means Everything

Charles Krauthammer: Kerry's folly, Chapter 3

Amy Peterson: A life of love: How to build lasting relationships with your children

John Ericson: Older Women: Save Your Heart, Prevent Stroke Don't Drink Diet

John Ericson: Why 50 million Americans will still have spring allergies after taking meds

Cameron Huddleston: Best and Worst Buys of April 2014

Stacy Rapacon: Great Mutual Funds for Young Investors

Sarah Boesveld: Teacher keeps promise to mail thousands of former students letters written by their past selves

The Kosher Gourmet by Sharon Thompson Anyone can make a salad, you say. But can they make a great salad? (SECRETS, TESTED TECHNIQUES + 4 RECIPES, INCLUDING DRESSINGS)

April 2, 2014

Paul Greenberg: Death and joy in the spring

Dan Barry: Should South Carolina Jews be forced to maintain this chimney built by Germans serving the Nazis?

Mayra Bitsko: Save me! An alien took over my child's personality

Frank Clayton: Get happy: 20 scientifically proven happiness activities

Susan Scutti: It's Genetic! Obesity and the 'Carb Breakdown' Gene

Lecia Bushak: Why Hand Sanitizer May Actually Harm Your Health

Stacy Rapacon: Great Funds You Can Own for $500 or Less

Cameron Huddleston: 7 Ways to Save on Home Decor

The Kosher Gourmet by Steve Petusevsky Exploring ingredients as edible-stuffed containers (TWO RECIPES + TIPS & TECHINQUES)

Jewish World Review

80 percent of organ donors' lungs are rejected, resulting in certain death for those waiting

By Marie McCullough

How newly developed technology aims to reverse that

JewishWorldReview.com |

PHILADELPHIA — (MCT) More than any other vital organ offered for transplant, the lung is susceptible to injury that is difficult to prevent, detect and predict.

To err on the side of caution, 80 percent of organ donors' lungs are rejected as unsuitable, a waste lamented by doctors and patients alike.

Now, the University of Pennsylvania and five other medical centers are testing technology aimed at improving the situation. It involves cleaning and refurbishing donor lungs while the organ "breathes" in a specially designed machine. Lungs that would normally be discarded can be tuned up, evaluated and, in many cases, reused.

In a recently published clinical study in Canada, 86 percent of risky lungs became acceptable for transplant.

Penn transplant surgeon Edward Cantu believes the advance, made by Sweden-based XVIVO Perfusion Inc., could save thousands of lives a year.

"We could reduce the number of people who die waiting for lungs, and reduce the number who die" because their new lungs fail soon after surgery, he said.

Similar technology, developed by TransMedics of Andover, Mass., is being tested internationally. It keeps donated lungs warm and functioning during transport to a transplant center; normally, lungs are preserved and carried in a cooler. The University of California, Los Angeles, in November performed the nation's first transplant using the new system.

Jay K. Bhama, associate director of lung and heart transplantation at the University of Pittsburgh Medical Center, said such innovations "have a lot of potential in terms of improving the utilization of donor lungs, and helping us assess lungs that may not be optimal. It's still in the early phases, so it's going to take some more time to determine what percent of (marginal) lungs can be used."

Lung transplantation remains daunting almost 30 years after the first successful operations in Toronto by transplant pioneer Joel Cooper, who is now at Penn.

Donors' lungs must meet certain criteria, including a limited smoking history, and undergo evaluation with X-rays and other standard tests. But this isn't enough to ensure good outcomes.

Lungs may be injured by physical trauma, cardiac arrest, resuscitation efforts, mechanical ventilation, pneumonia or the irreversible shutdown of the brain, called brain death. (Most donated organs come from patients who are declared brain-dead.)

The United States has about 8,000 organ donors a year, but only about 20 percent of their lungs are used, national transplant data show. As a result, 15 percent to 30 percent of wait-listed patients die before getting lungs. (International rates are similar.)

Even with this high rejection rate, many of the 1,700 U.S. patients who do get lungs suffer a sometimes fatal, little-understood complication called "primary graft dysfunction." The transplanted lungs just don't work properly, perhaps partly because of the physiological shock of having circulation abruptly restored.

This catastrophe can happen despite a technically flawless surgery. It occurs in about 10 percent of cases at Penn; rates at some centers are two to three times higher.

"This is one of the most painful things for me as a transplant surgeon," Cantu said. "You can do everything absolutely perfectly. You take the patient to the ICU. You talk to the family. Everybody's happy. And 12 hours later, the patient is critically ill."

Cooper was among the first researchers to try to improve out-of-body lung preservation. He developed a cell-free solution that could be pumped through the lung to protect it after removal from the donor.

The XVIVO system being tested at Penn uses a patented solution named for the final developer, Swedish surgeon Stig Steen. Steen Solution helps to cleanse the lung, reduce fluid buildup and prevent clot formation.

Between 2006 and 2009, Steen Solution was approved for use in Europe, Canada, and Australia. It is circulated through the lung using equipment similar to a standard heart-bypass machine. The organ is continuously evaluated for several hours and then, if the function is satisfactory, transplanted.

In the Canadian clinical study of the process, called "ex vivo lung perfusion," 50 of 58 risky lungs became suitable for transplant. Serious graft dysfunction occurred in 2 percent of them, compared with 9 percent of untreated lungs in a control group. Patients with reconditioned lungs did not have longer hospital stays or worse survival rates. Chris Jaynes, XVIVO's transplant project manager, said Canadian transplant centers that were using the technology had more than doubled the pool of usable organs. "They've gone to using 45 percent of donated lungs," he said. In the United States, regulators wanted additional steps to ensure "safety and consistency," Jaynes said. So in 2007, the Food and Drug Administration directed XVIVO to develop a customized machine that transplant centers would have to use with Steen Solution.

The $250,000 result is now at Penn: a 5-foot-high device with a ventilator, pump, filters, a computer, and a plastic dome-covered tray for the lungs.

It's not clear how much reconditioning will add to the cost of a lung transplant — Cantu guessed $10,000 to $20,000 — but the hope is that health costs before and after the operation would be reduced.

"Maybe no one dies waiting," Cantu said. "Maybe our lung-transplant outcomes become as good as for kidneys and hearts."

That would be good, indeed. Federal data show that three-year patient survival is about 90 percent for kidney transplants, 80 percent for hearts, but only 68 percent for lungs.


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George Schwab, 66, a retired Jenkintown architect who in November became the first recipient of a reconditioned lung at Penn, is thrilled with his outcomes so far.

Chronic obstructive pulmonary disease — suffered by 12 million Americans — had so eroded his lung function that every breath was an exertion. The organ he received normally would have been rejected because it was swollen with fluid, called edema. Instead, the tune-up removed the edema and reassured his surgeons.

Schwab now runs on a treadmill with weights on his hands and feet. "I was one bout of pneumonia away from death" before the transplant, he said. "My recovery has been amazing."

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© 2013, The Philadelphia Inquirer. Distributed by McClatchy-Tribune Information Services.