Recent journal articles focused on the use of laparoscopic nephrectomy in obese patients and on the use of clarithromycin following lung transplantation.
*Although laparoscopic nephrectomy is more difficult to perform when the donor is markedly obese, morbidity to the donor and renal outcome in the recipient are equivalent to when the procedure is performed in nonobese donors, Stephen C. Jacobs, Jr., and colleagues at the University of Maryland School of Medicine reported in December in Urology (2000;56:926-929). The researchers reached their conclusion after comparing 41 kidney donors with a body mass index greater than 35 with 41 controls with a body mass index of less than 30. The procedure "appears appropriate" for consideration in markedly obese donors despite a longer operative time, a need for more laparoscopic ports and increased port sizes, a higher conversion rate to open nephrectomy, and an increased estimated blood loss in the obese donors, the authors said.
*In a study by Mark T. Knower, MD, and colleagues at the Ochsner Multi-Organ Transplant Center in New Orleans, the use of clarithromycin following lung transplantation reduced the needed dose, and thus the cost, of cyclosporine. The baseline dose of cyclosporine, 9.9 mg/kg of body weight daily, was reduced to 5.8 mg/kg daily and 4.1 mg/kg daily one month and one year, respectively, after the nine patients in the study began taking clarithromycin. The estimated annual savings were $3,400 per patient, the authors reported in November in Southern Medical Journal (2000;93:1087-1092).
According to Dr. Robert T.V. Kung, Abiomed's chief scientific officer, the goals of initial trials in humans "will be to demonstrate improved life expectancy with a reasonable quality of life for selected patients who are in endstage heart failure and who are not candidates for heart transplantation or any other available therapy."
Abiomed's U.S. clinical centers are Brigham and Women's Hospital teamed with Massachusetts General Hospital, Boston; Hahnemann University Hospital, Philadelphia; Jewish Heart and Lung Hospital, Louisville, Kentucky; Texas Heart Institute, Houston; and UCLA Medical Center, Los Angeles.
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