As the number of patients in need of heart or lung transplants continues to exceed the number of donor organs that are viable and available, many patients die while waiting for a transplant. Through the DONATE HCV Trial, a team at Brigham and Women’s Hospital is expanding the donor pool by enabling transplantation from hepatitis C-infected donors.
In a recent publication in the New England Journal of Medicine, a multidisciplinary team of experts from Brigham and Women’s Hospital reported a 100 percent success rate for transplant recipients who received lungs or a heart infected with hepatitis C (HCV).
Six months after transplantation, patients remained hepatitis C free and had functioning transplanted organs. The trial showed that a four-week antiviral treatment regimen started immediately following organ transplantation prevented HCV infection in all patients and led to excellent outcomes. Given the success of the trial, enrollment continues.
The DONATE HCV Trial is the largest clinical trial to date for HCV thoracic organ transplantation. “If even half the other centers in the United States were to adopt the Brigham protocol, we would, in fact, shorten the time to transplantation by nearly half,” says Mandeep Mehra, MD, medical director of the Heart & Vascular Center at Brigham and Women’s Hospital. The team has enrolled 69 participants to date.
In the above video, hear more from the investigators pioneering this trial, including:
- Hilary Goldberg, MD, MPH, Medical Director, Lung Transplant
- Mandeep R. Mehra, MD, Medical Director, Heart & Vascular Center
- Lindsey R. Baden, MD, MSc, Infectious Disease
- Ann E. Woolley, MD, MPH, Infectious Disease
- Hari R. Mallidi, MD, Surgical Director, Heart and Lung Transplant
As a primary care physician at Brigham and Women’s Hospital, Laura N. Frain, MD, MPH, saw firsthand the challenges of caring for older adults, particularly those living with frailty, cognitive impairment/dementia and multiple geriatric syndromes within the primary care system. Now, as a geriatrician in the Brigham’s Division of Aging, she leads collaborations with primary care to develop and implement new models for co-managing outpatient geriatric patients.
In 2017, nearly 700,000 robotic-assisted procedures were performed in the United States. Robotic surgery is fast becoming the preferred method for procedures in gynecological, thoracic, urologic, colon and rectal surgery. Today, a wide range of colorectal problems can be treated with robotic surgery.
Absent of a cure for inflammatory bowel disease (IBD), physicians at Brigham and Women’s Hospital have pioneered a broader approach to improving the health of patients with ulcerative colitis and Crohn’s by focusing on lifestyle, health education and psychosocial aspects of disease.
Over the past two decades, the Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC) has become a national leader in the care of patients with hereditary gastrointestinal cancers, from Lynch syndrome to polyposis syndromes.
Complications and high readmission rates are a persistent challenge following radical cystectomy for the treatment of bladder cancer. The complex, intrabdominal operation, which includes replacement of the bladder or creation of a stoma, and often includes removal of reproductive organs as well, is associated with a high rate of morbidity. Patients undergoing the procedure often have additional risk factors for venous thromboembolism (VTE), such as pre-operative chemotherapy, older age and a history of smoking, and VTE is estimated to occur in 5.5 to 8.5 percent of patients and cost more than $10,000 per event. In a comprehensive effort to reduce risk of VTE, reduce length of stay and improve other measures of quality of care, Brigham and Women’s Hospital urologists have implemented a perioperative VTE prophylaxis program and analyzed its results, reporting key quality of care improvements. In addition, in collaboration with nurses, anesthesiologists, pharmacists and other members of patients’ care teams, clinicians in the Division of Urology are exploring innovative initiatives to continue to make strides in improving patient care.
Urologists and oncologists at Dana-Farber/Brigham and Women’s Cancer Center have laid the groundwork for what would be the first Phase III international, randomized trial of a new treatment for patients with high-risk prostate cancer in more than a decade. The treatment involves using novel, potent neoadjuvant hormone therapy for six months prior to prostatectomy surgery, an approach that has been shown to improve both tumor pathology and long-term remission.
For decades, the medical and scientific community has looked for ways to repair damaged vocal cords through injectable agents. Current best practices involve the use of carboxymethylcellulose, hyaluronic acid or calcium hydroxylapatite (CaHA). However, these injectable agents do not provide permanent effects and typically carry the additional burden of requiring two people to perform the medialization procedure, thus adding to their cost.
Face transplants are still infrequent enough that every one of them is considered a remarkable feat of medical collaboration and expertise. However, they no longer garner the news headlines that the first transplant did when it was performed in France in 2005.
Five years ago, Vivek Shah, MD, a hip and knee replacement surgeon, replaced the right hip of an 85-year-old woman. After the routine surgery, she stayed in the hospital for three days. A few years later, she visited Dr. Shah when she needed her left hip replaced.