Faculty Bibliography

On Dec. 6, 1967, three days after Dr. [Christiaan N. Barnard] gave Louis Washkansky a new heart, Dr. Adrian Kantrowitz, who had relied on Dr. Shumway's technique while experimenting on dogs, performed a heart transplant on an infant at Maimonides Medical Center in Brooklyn. The infant died six and a half hours later, and Dr. Kantrowitz declared the operation a failure. On Jan. 2, 1968, Dr. Barnard carried out his second heart transplant on Dr. Philip Blaiberg, who lived 19 months. Mr. Washkansky survived 18 days. In the late 1960's, Dr. John Hauser, the coroner of Santa Clara County, Calif., which included Stanford, sought criminal charges against Dr. Shumway for transplanting organs without an autopsy on the donor, an act that would have made transplantation impossible. The two men shouted at each other over the issue in Dr. Shumway's office, recalled Dr. Eugene Dong, then a transplant surgeon at Stanford and now a lawyer. Dr. Shumway's group began to test the drug independently after a member of the Cambridge team gave a lecture about its findings at Stanford and achieved good long-term results in dogs. ''The animal experiments kept us going while everyone else, who did not have that experimental background, dropped out,'' Dr. Shumway said

The turnaround owes largely to what Shumway called his 'radical perseverance.' He rescued heart transplants with a new immunosuppressant drug, cyclosporin, that helped keep the body from rejecting its new organ, and with a heart biopsy technique to detect and treat rejection before it became lethal. Shumway reshaped the way chest surgeons learn their craft, and he trained many who now perform heart transplants. The transplant revolution he helped set in motion extended far beyond medicine, upsetting the traditional definition of death as the moment the heart stops beating. Instead, an organ donor can now be considered dead as soon as electrical activity of the brain has ceased, allowing transplantation of a living heart or other organ. For a decade starting in 1958, and supported by federal grants from the National Institutes of Health, Shumway experimented on dogs to create what is now the standard technique to remove a patient's heart and replace it with a stranger's. By the time Shumway performed his first human heart transplant on Jan. 6, 1968, it was the world's fourth. But those early transplants seldom achieved long-term success. It was easy enough to transplant a heart, as Shumway once said, 'but it's what happens later with regard to the containment of rejection that makes the real difference.'

The World Health Organization declared two more nations free of indigenous polio, leaving only four -- an all-time low -- where a reservoir of the paralytic disease remains

After three years, 93 percent of the older kidneys that scored favorably functioned well, a rate comparable to kidneys from younger donors. Among older transplanted kidneys that were not biopsied, the rate was 72 percent. In the United States, of the estimated 60,000 patients who await kidney transplants each year, 16,000 receive a kidney. In 2003, 12 percent of kidneys from donor bodies were discarded, chiefly because of the donor's age and the quality and size of the kidneys. Dr. [Edward Cole], who has been a research partner with Dr. [Giuseppe Remuzzi] of Italy, said that one possible problem is that while the lists for older kidneys have been short, ''the more we publicize their potential benefits, the more people will sign up for them, the longer the lists will be'' and ''if you do more double kidneys,'' there will be fewer recipients

Two days after the operation Ms. [Dinoire] was transferred to the Edouard Herriot Hospital in Lyon where Dr. [Jean-Michel Dubernard] and a team of immunologists could monitor her course. Dr. Dubernard led the team that performed the first hand-arm transplant in Lyon

Heparin, a short-acting anticoagulant, is given to prevent a recurrent stroke, not to dissolve the offending clot. But giving it can be dicey in the early stages of a stroke because it can help turn a mild ischemic stroke into a devastating bleeding one. Ischemic strokes account for a vast majority of strokes. They occur because the brain is starved of oxygen and other vital nutrients from a clot that forms in a brain artery or that breaks off from a larger artery elsewhere in the body and travels to lodge in a brain artery. Also, a long-term buildup of fats in the walls of brain arteries can narrow the vessels and reduce flow to critically low levels, causing an ischemic stroke. The two categories make it imperative to use CT and M.R.I. imaging scans in the initial care. The distinction between ischemic and hemorrhagic strokes is critical because drugs like T.P.A. and urokinase can rapidly reverse the damage from an ischemic stroke, but giving them for a hemorrhagic stroke is like pouring gas on a fire

The new findings concern only the strain of influenza causing regular seasonal influenza, and not avian influenza or pandemic influenza, said the centers' director, Dr. Julie L. Gerberding. She said 91 percent of the human influenza A (H3N2) virus samples isolated in her agency's laboratories this flu season were resistant to both amantadine and rimantadine. A (H3N2) is this season's dominant strain. The agency's influenza surveillance program studies samples from state health departments. Influenza viruses constantly mutate. One theory is that the A (H3N2) influenza strain suddenly developed a mutation against amantadine and rimantadine. Another theory is that the resistance developed from inappropriate use of the two drugs, which are widely available over the counter in many countries. In the United States, all marketed antiviral drugs effective against influenza require a prescription

Over the last few days, the Israeli news media, along with a number of Israeli doctors, have raised questions about the treatment Mr. [Ariel Sharon] received after he had a mild stroke on Dec. 18, before he had a major one on Jan. 4. The condition, which is relatively common in elderly people, is marked by weakened blood vessels in the brain, and blood-thinning medicine can increase the risk of cerebral hemorrhage, according to doctors. Mr. Sharon suffered a hemorrhagic stroke on Jan. 4. If Mr. Sharon had not received such medicine, he could have suffered another clot in the brain instead of bleeding in the brain, Dr. Jose Cohen, one of his neurosurgeons, told Israeli television this week

[Rodier] said that transmission seemed to be occurring in families with children in an epidemiologic picture that closely resembled the one seen in East Asia. The recent cases identified in Turkey are the first outside of East Asia. The sudden appearance of a number of cases of avian influenza in different parts of Turkey is worrisome, Rodier said, but is probably linked to the complexities of bird migration

In the process, which could last several days, the brain will 'show us what it has got' after the stroke and three operations, [Lee Schwamm] said. The operations were performed to reduce the pressure on [Ariel Sharon]'s brain and to remove blood clots and dead brain tissue. A possible failure to respond to commands on the first day would not necessarily be a bad sign, Schwamm said, 'in part because it may take a few days for Sharon's body to fully wash out the anesthetics.' Some stroke patients who have little response on the first day after a coma is lifted can often follow commands readily on the third day. Another concern is the heart. In Sharon's case, the stress of the stroke and three operations led to the release of high amounts of adrenaline and other hormones that could bring on a heart attack. Sharon also may have needed blood transfusions because of the amount of bleeding into his brain