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肝癌病危美女 丙肝移植后治癒

作者:change?  於 2019-10-29 23:48 發表於 最熱鬧的華人社交網路--貝殼村

通用分類:健康生活|已有1評論





(丹佛)—「我做了什麼?」小詹姆斯·伯頓博士不敢相信自己。

作為一名年輕的醫學院學生,他採取了希波克拉底誓言,並承諾「首先,不要傷害」。

但是在這裡,他故意感染了一名丙型肝炎患者。

那是3月13日,就在幾小時前,他的病人Betty Huart接受了肝移植以治癒她的肝癌。但是,原本可以挽救她生命的新捐贈肝臟被這種疾病污染了,這種嚴重但可治癒的感染會影響肝臟。

「那天晚上我睡不好覺,」伯頓告訴美國廣播公司新聞。

UCHealth的肝病學家,科羅拉多大學醫學院的醫學副教授Burton補充說:「但是我告訴自己……我知道我可以治癒。」

近年來,由於年輕人中阿片類藥物劑量的增加,大量可用的腎臟和肝臟大量湧入。儘管這些器官感染了丙型肝炎,但它們大部分都是健康且無疤痕的。

伯頓(Burton)知道研究人員在過去五年中在丙型肝炎治療方面取得了重大進展:現在,每天僅吃幾顆葯,幾乎所有接受該治療的感染者都可以在12周內治癒。

他回憶說,也許他可以將被感染的肝臟放入貝蒂體內,治癒疾病並最終挽救她的生命-根據UCHealth的說法,這是科羅拉多州的首次此類努力。

其他醫療中心也成功植入了患病器官。 2015年,約翰·霍普金斯醫院成功救治了一名等待肝臟治療三年的婦女。在向她解釋了抗病毒治療的過程后,她同意將其移植到感染了丙型肝炎的肝臟中。兩個月後,該病毒被發現,她的醫生說。 2017年,波士頓的百翰婦女醫院也成功地將感染了丙型肝炎的心臟和肺移植到了44名患者中,經過兩周的抗病毒藥物治療后,所有疾病的痕迹都無法發現。

根據美國肝臟基金會的數據,儘管美國每年進行6,000次肝移植,但仍有超過17,000人等待領取救生器官。

因此,在2018年秋天,伯頓讓Huart參加了一項新研究,該研究研究了醫院是否可以將丙型肝炎陽性器官移植到患者體內,然後治癒該患者。研究人員希望這項在科羅拉多大學和其他五個移植中心進行的研究能夠表明,通過使用這些受污染的器官,患者可以在移植名單上花費更少的時間,並有更多的時間生活。

休亞特本人已經在肝臟移植名單上待了幾個月。她在2000年代初被診斷出患有脂肪肝,後來演變為肝硬化,最後演變為肝癌。她已經用盡了所有其他路線,包括供者選擇。

「我不希望像那些人那樣生病。 …我只是知道那不是我想要做的,」 Huart說。她於1987年因肝病去世了父親。

她繼續說:「今年11月,我將66歲。那是我父親去世的年齡。」 「那麼你認為我在想什麼?我在想:我只有那麼多的滿月,也只有那麼多的流星。

丙型肝炎是通過靜脈吸毒,輸血或醫療設備傳播的病毒。目前,在美國估計有300萬人受到感染,該疾病也是肝臟移植的主要原因。

不過,Huart對丙型肝炎並不陌生。她的丈夫史蒂夫(Steve)在為海軍工作時已在80年代感染了這種病毒,並花了很多年與這種毀滅性疾病作鬥爭。包括打針以刺激免疫系統的舊療法僅在約40%的患者中有效,並伴有類似流感的副作用。

「這種葯使他消瘦了。使他消瘦了,看起來就像只是衣架上的西裝。」 Huart說。

新葯的發展使Huart和她的丈夫考慮了Burton的提議,但是他們的一些朋友並不那麼支持這個想法。

」有人說,『你是什麼,瘋子?史蒂夫經歷了什麼之後,你想經歷那件事嗎?'」史蒂夫說。

但是他們有什麼選擇呢?

史蒂夫解釋說:「整個移植過程,簡直令人難以置信。」

他繼續說道:「您正在等待電話。」 「每一天就像'這將是這一天嗎?',如果沒有打來電話,您就上床睡覺,'哦,好一天。'[但是]我要去那兒嗎?明天?還是我要完全做到?」

對於貝蒂來說,決定很明確。

「就像在懸崖的邊緣。有兩個孩子的母親Huart解釋說,要麼您要跳過懸崖,要麼要乘坐正對著您的貨運列車。

她補充說:「我以為我會越過懸崖。」

2019年3月12日下午,Huart在塔吉特跑腿時接了電話。是醫院打來的,告訴她要進行手術報告。他們發現了肝臟(儘管患有丙型肝炎)。

休亞特(Huart)試圖不讓她的希望變得渺茫-他們之前曾兩次參加過醫院比賽,但被告知手術不會由於一個或另一個原因而繼續進行。

同時,丹佛的氣溫迅速下降,狂風猛烈。

瓦特(Huart)和她的丈夫在晚上8:30左右到達醫院。不過到了午夜,外科醫生還沒有把她帶回手術室。這對夫妻開始變得緊張起來。休亞特的肝臟在哪裡?冬季暴風雨肆虐在外面,它還在路上嗎?

「但是後來他們進來說,『肝臟在裡面!我們知道了!'」 Huart回憶道。

在Huart接受手術的同時,Burton醫生在醫院等候區與Steve緊張地坐著。幾個小時后,貝蒂帶著新的肝臟和新的生命從手術室出來。

但是三天後,驗血證實了預期:Huart感染了丙型肝炎。

一周之內,伯頓和他的醫學專家團隊就開始使用Huart進行新的口服藥治療,幾天之內就無法發現這種疾病。

十二周后,Huart被正式治癒。

「每天都越來越好,」 Huart告訴ABC新聞。

她繼續說:「我騎自行車已經很多年了,在過去的12年中,我一直不想騎自行車。」 「我太受過嘗試了。」但是在手術四個月後,Huart發現自己踩了一條泥濘的小路。

「(當我騎著自行車時)我臉上的微笑並沒有表現出我內心的微笑。我實際上又騎著自行車騎了,」 Huart咧嘴一笑。

伯頓承認,他仍然很難纏住事實,因為曾經傷害過史蒂夫的事情實際上幫助治癒了史蒂夫的妻子。

伯頓說:「如此有效,將不再進行研究,也不會進行丙型肝炎的研究,」他希望其他需要腎臟或肝臟移植的患者會考慮丙型肝炎感染的器官。

「研究已經完成。沒有更多的治療方法了。他說:「很難有效地改善一些東西。」

版權所有©2019,ABC廣播。



原文:A woman was dying of liver cancer, until a hepatitis C-infected organ saved her life

(DENVER) — 「What have I done?」 Dr. James R. Burton Jr. thought to himself in disbelief.

As a young medical student, he had taken the Hippocratic Oath and pledged 「first, do no harm.」

But here he was, purposefully infecting one of his patients with hepatitis C.

It was March 13, and just hours before, his patient, Betty Huart, had undergone a liver transplant to cure her liver cancer. But the new, donated liver that was supposed to save her life was tainted with the disease — a serious but curable infection that affects the liver.

「I did not sleep well that night,」 Burton told ABC News.

「But I told myself … I know I can cure this,」 added Burton, a hepatologist at UCHealth and an Associate Professor of Medicine at the Colorado University School of Medicine.

There had been an influx of available kidneys and livers in America in recent years due to the rise of opioid overdoses in young people. And while these organs were infected with hepatitis C, they were, for the most part, healthy and unscarred.

Burton knew that researchers had made significant ground in hepatitis C treatments in the last five years: Now, with just a few pills a day, nearly all people infected who took the treatment were cured in a matter of 12 weeks.

Perhaps he could put an infected liver inside Betty, cure the disease and ultimately save her life, he recalled thinking — the first such effort in Colorado, according to UCHealth.

Other medical centers had successfully implanted a diseased organ too. In 2015, Johns Hopkins hospital successfully saved a woman who has been waiting for a liver for three years. After the process of antiviral recovery was explained to her, she agreed to be transplanted with a liver infected with hepatitis C. Two months later, the virus was undetectable, her doctors said. In 2017, Brigham and Women』s Hospital in Boston also successfully transplanted hepatitis C-infected hearts and lungs into 44 patients, and all traces of the disease were undetectable after two weeks of antiviral drug treatment.

While there are 6,000 liver transplants performed every year in America, there are still more than 17,000 people waiting to receive the life-saving organ, according to the American Liver Foundation.

So in the fall of 2018, Burton enrolled Huart in a new study that looked at whether hospitals could transplant a hepatitis C-positive organ into a patient and then cure the patient of the disease. Researchers hoped that the study, which took place at the University of Colorado and five other transplant centers, would show that by using these tainted organs, patients would spend less time on transplant lists, and more time living their lives.

Huart herself had been on the liver transplant list for several months. She was diagnosed with fatty liver disease in the early 2000s, which later evolved into cirrhosis, and finally turned into liver cancer. She had exhausted all other routes, including a living donor option.

「I did not want to get as sick as some people [on those lists]. … I just knew that that』s not what I wanted to do,」 said Huart, who lost her father to liver disease in 1987.

「This November, I will be the age of 66. And that was the age [my father] died,」 she continued. 「So what do you think I』m thinking? I』m thinking: I』ve got only so many more full moons, only so many more shooting stars to see.」

Hepatitis C is a virus that is transmitted through intravenous drug use, blood transfusions or medical equipment. An estimated 3 million people in America are currently infected and the disease is also the leading cause for liver transplants.

Huart was no stranger to hepatitis C, though. Her husband Steve has contracted the virus back in the 』80s while working for the Navy, and spent years battling the devastating disease. The old treatment, which involved giving shots to stimulate the immune system, only worked in about 40% of patients and was associated with flu-like side effects.

「The medicine just emaciated him. Emaciated him to where he looked like he was just a suit on a hanger,」 said Huart.

New drug advancements made Huart and her husband consider Burton』s offer, but a few of their friends weren』t so supportive of the idea.

「Some said, 『What are you, nuts? After what Steve went through, you want to go through with that?'」 said Steve.

But what choice did they have?

「The whole transplant process, it』s just mind boggling,」 explained Steve.

「You live waiting for a phone call,」 he continued. 「Every day is like 『Is this going to be the day?』 And if the phone call doesn』t come, you go to bed going, 『Oh, well another day.』 [But] am I going to make it to the next day? Or am I going to make it at all?」

For Betty, the decision was clear.

「It was like being at the edge of a cliff. Either you』re going to jump over the cliff, or you』re going to take that freight train that』s running right at you,」 explained Huart, a mother of two.

「I thought I』d jump over the cliff,」 she added.

On the afternoon on March 12, 2019, Huart answered her phone while running errands in Target. It was the hospital calling, telling her to report for surgery. They had found a liver (albeit with hepatitis C).

Huart tried not to get her hopes up – they had already raced to the hospital twice before, only to be told that the surgery wouldn』t go forward for one reason or another.

Meanwhile, Denver』s temperature was dropping rapidly and an intense storm raged.

Huart and her husband arrived at the hospital around 8:30 p.m. By midnight, though, the surgeon still hadn』t taken her back to the operating room. The couple started to get nervous. Where was Huart』s liver? Was it still en route, with the winter storm raging outside?

「But then they came in and said, 『The liver』s in! We got it!'」 recalled Huart.

While Huart was transferred to surgery, Dr Burton sat nervously with Steve in the hospital waiting area. Several hours later, Betty emerged from the operating room with a new liver and a new lease on life.

But three days later, blood tests confirmed the expected: Huart had contracted hepatitis C.

Within a week, Burton and his team of medical professionals started Huart on her new oral pill treatment and within a few days, the disease was undetectable.

Twelve weeks later, and Huart was officially cured.

「Every day just gets better and better,」 Huart told ABC News.

「I rode a bike for many years, and for the last 12 years, I have not wanted to ride a bicycle,」 she continued. 「I was just too tried.」 But four months after surgery, Huart found herself pedaling down a dirt-covered trail.

「The smile on my face [when I rode that bike] doesn』t do the smile that was going on in my mind. That I was actually on a bike again and riding,」 said Huart, breaking into a grin.

Burton admitted he still found it difficult to wrap his head around the fact that something that once hurt Steve actually helped cure Steve』s wife.

「It』s so effective that there will be no more studies, no more research with hepatitis C,」 said Burton, who hopes other patients in need of kidney or liver transplants will consider a hepatitis C-infected organ.

「The research is done. There』s no more treatments coming. It』s hard to improve on something that is [so] effective,」 he added.

Copyright © 2019, ABC Radio. All rights reserved.


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回復 fanlaifuqu 2019-10-30 03:07
丙肝和肝癌之間的聯繫很微妙!

facelist doodle 塗鴉板

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