Wills, Trusts & Estates Prof Blog

Panel urges changes to make US organ transplants more fair

According to an influential scientific advisory panel, "the U.S. transplant system needs an overhaul to stop wasting organs and give more patients a fair chance at the life-saving surgery. . ." 

Last year, the U.S. performed more than 41,000 transplants of kidneys, livers, and other organs, a record number—most of which came from donations from the dead. According to everythingLubbock, "[m]ore than 106,000 patients are on the nation's list for a transplant from a deceased donor and at least 17 die every day waiting." 

Due to the astounding numbers, the Panel has set a five-year deadline to turn things around. According to Dr. Kenneth Kizer, a well known expert in health care quality who chaired the panel, "A lot of things can be done to make the system work better for people." 

Among other things, the Panel concluded that the Department of Health and Human Services should set national performance goals "that include ranching at least 50,000 transplants each year by 2026, although a speedup is necessary to achieve national performance goals" and  "hospitals should reduce organ waste and be candid with patients about the option of a less-than-perfect offer. . ." 

See Lauren Neergaard, Panel urges changes to make US organ transplants more fair, EverythingLubbock, February 25, 2021. 

Surgeon transplants a pig's kidney into a brain-dead human in groundbreaking surgery

Robert Montgomery, a New York transplant surgeon, "conducted a successful surgery that transplanted a pig's kidney into a brain-dead human." 

US surgeons say that the successful transplant could ultimately be the key to solving donor organ shortages. The recipient of the kidney was brain-dead, and was on artificial life support "with no prospect of recovering." 

The kidney came from a pig that had been genetically modified to stop the organ being recognized by the body as "foreign" and being rejected. 

Although the work has not been peer-reviewed or published, there are plans to do so, and experts say it is the "most advanced experiment in the field so far." 

See Michelle Roberts, Surgeon transplants a pig's kidney into a brain-dead human in groundbreaking surgery, BBC, October 21, 2021. 

Special thanks to David S. Luber (Florida Probate Attorney) for bringing this article to my attention.

Earlier Diabetes Onset Could Raise Dementia Risk

The younger the age of a Type 2 diabetes diagnosis, the higher the risk for Alzheimer's disease and other forms of dementia. 

Type 2 diabetes, a chronic and progressive illness, has the power to create a plethora of health complications—dangerous complications. These complications include, hearing loss, blindness, heart disease, stroke, kidney failure and vascular damage so severe as to require limb amputation. A new study has just added dementia to that long list. 

Given the prevalence of Type 2 diabetes in America, this added complication is quite alarming. "Once referred to as “adult-onset diabetes” to distinguish it from the immune-related “juvenile-onset” Type 1 disease that begins in childhood, Type 2 diabetes is seen in younger and younger people, largely tied to rising rates of obesity."

It is important to note that the study does not provide conclusive evidence that diabetes causes dementia. However, "[t]he researchers controlled for many factors that affect the risk for dementia, including race, education, heart conditions, stroke, smoking and physical activity, and the diabetes-dementia link persisted."

See Nicholas Bakalar, Earlier Diabetes Onset Could Raise Dementia Risk, N.Y. Times, May 3, 2021. 

Special thanks to Lewis Saret (Attorney, Washington, D.C.) for bringing this article to my attention.  

How Doctors Die

One would expect medical professionals to obtain treatment when faced with a mental illness. However, surprisingly, medical professionals often don't seek treatment. 

Charlie, a respected orthopedist, found a lump in his stomach, which he had a surgeon check out. The lump turned out to be pancreatic cancer. The surgeon was one of the best in the country and had invented a new procedure for pancreatic cancer that could "triple a patient's five-year-survival odds—from 5 percent to 15 percent—albeit with a poor quality of life." 

Not only was Charlie not interested in the new procedure, but he closed his practiced and "never set foot in a hospital again." Charlie spent the rest of his life spending time with family. He never received chemotherapy, radiation, or surgical treatment. 

Doctors spend a lot of time saving lives, but they can die like the rest of us. As experts, doctors are well aware of what is going to happen to them, and of course they do not want to die. 

It is their knowledge of modern medicine and its limits that keep them from receiving treatment for terminal illnesses. Many medical professionals would rather go gently than to live through the pain and side effects that are often a part of treatment and "heroic measures." 

Thus, many doctors would rather suffer naturally and not exacerbate this suffering with treatments and surgeries. 

See Ken Murray, M.D., How Doctors Die, The Saturday Evening Post: Caregiving, March 6, 2013. 

Special thanks to Lewis Saret (Attorney, Washington, D.C.) for bringing this article to my attention.  

EXERCISE MAY HELP SLOW COGNITIVE DECLINE IN SOME PEOPLE WITH PARKINSON’S DISEASE

Parkinson's disease can and often does affect thinking and memory skills. Actually, these problems are "among the most common nonmotor symptoms of the disease." "A new study shows that exercise may help slow cognitive decline for some people with the disease." 

Research has also indicated that those with Parkinson's disease who have the gene variant apolipoprotein E e4 or APOE e4, may experience cognitive decline at an earlier, and quicker rate than those without the variant. Also, APOE e4 is known as a "genetic risk factor for Alzheimer's disease." 

The mew study focused on whether exercise could slow down the cognitive decline for people that have the APOE e4 variant. 

According to Jin-Sun Jun, M.D., of Hallym University in Seoul, Korea stated, “[p]roblems with thinking skills and memory can have a negative impact on people’s quality of life and ability to function, so it’s exciting that increasing physical activity could have the potential to delay or prevent cognitive decline.”

Jun also stated that there will need to be more research done in order to confirm the findings, but the results of the research suggests that "interventions that target physical activity" play a role in delaying cognitive decline in people with early Parkinson's who have the APOE e4 gene variant. 

See EXERCISE MAY HELP SLOW COGNITIVE DECLINE IN SOME PEOPLE WITH PARKINSON’S DISEASE, American Academy of Neurology, March 31, 2021. 

Special thanks to Lewis Saret (Attorney, Washington, D.C.) for bringing this article to my attention.  

NHS saves children’s lives with world-first ‘dead’ heart transplants

Anna Hadley, a 16-year-old from Worcester, waited for nearly two years for a new heart. Now, almost two years later, Anna is healthy and playing hockey again. Anna has British surgeons to thank, as they "carried out the world's first transplants in children using dead hearts that were brought back to life." 

The surgeons used a pioneering machine to reanimate hearts from donors whose hearts stopped. So far, use of the machine has saved the lives of six British children ranging in age form 12 to 16. Also, each of the transplants occurred during the pandemic. 

Anna was the first to have her life saved by the pioneering machine. She received the call at 2:30am after she had waited almost two years after being diagnosed with restrictive cardiomyopathy. 

Within 24 hours of the operation, Anna was sitting up in bed. Within weeks, Anna was playing hockey again. Anna said, "I just feel normal again. There's nothing I cannot do now."

See Andrew Gregory, NHS saves children’s lives with world-first ‘dead’ heart transplants, The Sunday Times (U.K.), February 20, 2021. 

Special thanks to Lewis Saret (Attorney, Washington, D.C.) for bringing this article to my attention.  

Apple Watch can help track Parkinson’s disease symptoms, research shows

Apple watches have become increasingly popular as the amount of features they have continues to increase with new models and updates. Recent health research has lead to the possibility of an even greater feature. 

The new feature would monitor symptoms of Parkinson's disease. "Researchers at Apple, working with specialists who treat Parkinson’s, designed a system that uses the Apple Watch to detect the motor symptoms that are a hallmark of the neurological disease." 

The researchers monitored resting tremors and other involuntary movements to "identify the characteristic 'on' and 'off' patterns of medication's effects." If the research is successful and implemented, the feature could be used as a "round-the-clock" monitoring system. As of now, Parkinson's specialists typically rely on clinical visits and self-reporting to monitor the disease and the effects of the medications that patients are taking. 

This would not be the first time that a device could provide this type of monitoring, but given the popularity and comfortability surrounding the Apple Watch, there would be many advantages to this feature. 

Michael Okun, executive director at the Fixel Institute for Neurological Diseases, “Having the ability to take a commonly available device that’s already out there like an Apple Watch … and be able to do this type of monitoring is really nice because you’ll be able to give the clinicians who are caring for these people in their home a much clearer idea of what’s going on throughout the cycle of the day.”

See Mario Aguilar, Apple Watch can help track Parkinson’s disease symptoms, research shows, February 3, 2021. 

Special thanks to Lewis Saret (Attorney, Washington, D.C.) for bringing this article to my attention.  

Alzheimer’s Prediction May Be Found in Writing Tests

It could be possible to predict who will develop Alzheimer's by looking at writing patterns. "IBM researchers trained artificial intelligence to pick up hints of changes in language ahead of the onset of neurological diseases. 

The IBM researchers, along with other, say that this research is just the beginning. "People with a wide variety of neurological illnesses have distinctive language patterns that, investigators suspect, may serve as early warning signs of their diseases." 

The Alzheimer's study focused on 80 men and women, all in their 80s. Half of them had Alzheimer's and the other half did not. 

As part of the study, the group took a writing test before any of them had developed the disease. The test asks the participants to describe "a drawing of a boy standing on an unsteady stool and reaching for a cookie jar on a high shelf while a woman, her back to him, is oblivious to an overflowing sink." 

The researchers used the subjects' responses to analyze their word usage with an artificial intelligence program that looked for "subtle differences in language." 

The A.I program predicted who would get Alzheimer's with 75% accuracy. 

See Gina Kolata, Alzheimer’s Prediction May Be Found in Writing Tests, N.Y. Times, February 1, 2021. 

Special thanks to Lewis Saret (Attorney, Washington, D.C.) for bringing this article to my attention.  

The Case of the Serial Sperm Donor

In 2015, Vanessa van Ewijk decided to use a sperm donor to have a child, given the high cost of going through a fertility clinic. Van Ewijk decided to use a website called Desire for a Child which is an online sperm market that matches candidate donors and potential recipients. 

Van Ewijk was particularly interested in Jonathan Jacob Meijer, a Dutch musician in his 30s. Van Ewijk said that he appeared very genuine stating, “I spoke to him on the phone and he seemed gentle and kind and well-behaved,” she said. “He liked music, and he talked about his thoughts on life. He didn’t come on strong in any sense. He seemed like the boy next door.”

Van Ewijk and Mr. Meijer eventually met and Mr. Meijer provided Van Ewijk with his sperm in exchange for 65 euros (about $200). Van Ewijk eventually gave birth to a daughter, which was Mr. Meijer's eighth child. 

In 2017, van Ewijk reached out to Mr. Meijer again and made another purchase of a sperm. This time, van Ewijk had a baby boy. Before reaching out to Mr. Meijer the second time, van Ewijk had learned that Mr. Meijer had fathered at least 102 children in the Netherlands. 

Although van Ewijk was alarmed, she wanted her children to be full siblings, so she reached out to Meijer nonetheless. 

The want for children to be full siblings is especially popular in Netherlands because as a small country, there is a higher chance of half siblings meeting each other—completely unaware of their relation—and have kids of their owns. These children would have a heightened risk of carrying hereditary defects. 

Van Ewijk decided to confront Meijer and he admitted to her that he had fathered at least 175 children, even admitting there could be more. 

See Jacqueline Mroz, The Case of the Serial Sperm Donor, February 1, 2021.

Special thanks to Lewis Saret (Attorney, Washington, D.C.) for bringing this article to my attention.  

 

 

 

In Life, She Defied Alzheimer’s. In Death, Her Brain May Show How

"A woman in Colombia with a rare genetic mutation recently made the ultimate dontation to science." 

Aliria Rosa Piedrahita de Villegas had a rare genetic mutation that made it almost certain that she would develop Alzheimer's disease in her 40s. However, she did not begin experiencing symptoms until the age of 72. On November 10, she died from cancer, but the good news is that her dementia was not significantly advanced at the time, 

Neuorology investigators from the University of Antioquia in Medellin. have been closely studying Villega's and her family members in attempts to learn more about early-onset Alzheimer's disease. They found that there were several people whose disease did not develop until their 50s or 60s, which is a later development than expected. 

Although there were several outliers, they say none were as "medically remarkable" as Villegas, whom they knew as doña Aliria. 

Aliria had traveled to Boston where investigators conducted nuclear imaging studies of her brain "as part of an ongoing study of this Colombian family, the largest in the world with genetic early-onset Alzheimer's." 

The investigation revealed that Aliria had exceptionally large quantities of amyloid beta, which is a protein normally found in Alzheimer's patients. The researchers found that "something had interrupted the usual degenerative process, leaving her day-to-day functioning relatively preserved." 

Researchers at Harvard Medical School stated that although Aliria "carried a well-known mutation, unique to Colombia, that causes early Alzheimer's, she also carried two copies of another rare mutation that appear to have thwarted the activity of the first one." 

If researchers can unlock the secret to why Aliria's brain was able to fight off Alzheimer's for so long, it would be a very important discovery and a huge step forward against Alzheimer's. 

See Jennie Erin Smith, In Life, She Defied Alzheimer’s. In Death, Her Brain May Show How, N.Y. Times, December 11, 2020. 

Special thanks to Lewis Saret (Attorney, Washington, D.C.) for bringing this article to my attention.