For patients with acute alcoholic hepatitis (AAH), inflammation of the liver can result in a multitude of symptoms, including jaundice, fluid accumulation in the abdomen and hepatic encephalopathy — impaired brain function leading to irritability, tremors and confusion.

For some patients, it can lead to an irreversible coma and death.

“There is no standard treatment for patients suffering from end stage liver disease,” says Tiffany Kaiser, PharmD, research assistant professor of digestive diseases at UC. “Rather, the focus of medical therapy is to treat the associated impairments, for example, jaundice. Liver transplantation is the only cure. However, the demand for organs greatly outweighs the supply and patients with AAH are ineligible due to current and/or recent alcohol consumption.”

AAH patients can progress to liver failure or develop acute kidney failure from their liver disease. But a new device being studied at the University of Cincinnati (UC) could provide patients with a longer window of time in which to recover, complete an alcohol rehabilitation program and, for some, provide the potential for a liver transplant.

The ELAD bioartificial liver support system is being studied at UC and approximately 40 other centers in the United States, Middle East and Europe as part of a clinical trial sponsored by Vital Therapies, Inc., makers of the ELAD.

Maria Hernandez, MD, principal investigator and assistant professor of clinical medicine at UC, says the randomized trial is designed to evaluate the efficacy and safety of the ELAD, a system designed to serve as temporary liver support.

“The aim of this study is to evaluate ELAD’s ability to improve liver function and reverse the related impairments of AAH,” says Hernandez.

The ELAD is a bedside system, made up of chambered cartridges containing human liver cells populated from a cell line designed specifically for it. The cells function similar to a normal liver, processing toxins in the blood and synthesizing proteins and metabolites. The plasma is then remixed with the blood and returned to the patient.

Patients in the trial will be randomized—half receiving standard medical therapy plus treatment with the ELAD and half receiving standard medical therapy alone. The device is not kept on site and will be sent to researchers once a patient is enrolled in the trial.

Patients treated with the ELAD will stay on the machine continuously for three days before researchers re-evaluate their progress.

“We’re not using this for long-term therapy,” says Hernandez. “For recovery, patients with AAH must stop drinking alcohol. But we’re trying to see if the ELAD will help with survival rates for AAH patients, if it will give these patients a chance to get to transplantation.”

Amit Tevar, MD, director of the liver transplantation program at UC Health University Hospital, says that with liver transplantation suffering from an “ever-present” organ shortage, the ELAD trial represents “a very important modality in helping the right patients get the right organs, allowing patients to recover from their alcohol abuse and get a transplant in the future.”

Provided by University of Cincinnati (news : web)

Copyright ©2010. The associated Press. Produced by NewsOK.com All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.  

The moment his family had dreaded came with Jeff Kautz’s first wracking waves of pain.

His wife, Rolanda, rushed him to the hospital.

“They ran tests, and my kidneys had failed,” said Kautz, 41.

Doctors immediately surgically prepared the then-29-year-old Kautz for kidney dialysis to keep him alive until he could get his first kidney transplant.

The scene looked familiar to this Norman family — Kautz was suffering from the rare disease Alport Syndrome. during a touch football game decades before, his uncle got hit in the back and instantly went into kidney failure. The uncle, 59-year-old David Waggoner, of Yukon, has had two kidney transplants and undergone dialysis for the past 11 years as he waits for a third kidney and a liver transplant. Kautz’s grandmother’s kidney failure struck in the later years of life, in her late 60s.

Frequent bouts of high fever and blood in the urine when Kautz was about 5 years old quickly led to tests that showed he had the syndrome and his kidneys were deteriorating.

Early symptoms are bad news, said Dr. Brad Carter, nephrologist with Integris Baptist Medical Center.

“Usually if they have signs of it early in life, their kidneys will fail, usually at the age of 20 to 40 to 50. at that point, you have a couple of choices. It’s either a couple of different types of kidney dialysis or get a kidney transplant,” Carter said.

Alport Syndrome is an inherited disease that affects vision, hearing and kidney function, including chronic kidney disease. It’s so rare that it affects an estimated couple of dozen Oklahomans and 5,440 Americans. A disease is considered rare if it affects fewer than 200,000 people in the United States.

With his kidneys rapidly deteriorating, Kautz went on daily dialysis and began wearing a pager to let him know when a kidney was available for transplant.

Then in February 2001, the same week Rolanda discovered she was pregnant with their second child, the pager went off. Kautz called the hospital. though Rolanda already knew a kidney was available, she wanted to hear it from her husband.

“I got the call,” he said, simply.

“On that drive to the hospital, reality sets in that this is a gift from God; another life ended so he could live his,” Rolanda Kautz said.

Though doctors hope a transplanted kidney will last 10 or 15 years, Jeff Kautz’s new kidney lasted only a couple of years.

Carter said patients can get a third or even a fourth kidney, but it becomes harder to find a match. Kidneys are scarce, but most in demand. Almost 88,000 people are waiting for a kidney in the United States, including 336 people on the waiting list at Integris Baptist Medical Center. just more than 16,000 people nationwide are waiting for a liver transplant and more than 3,000 are waiting for a heart transplant.

“So I look at it as buying chunks of time with transplants and filling in the in-between times with dialysis,” Carter said. “He could live a normal life span but he’s only 40 and it’s going to be hard to buy enough time chunks to make him live until 80. but it’s still possible.”

Jeff Kautz has been on dialysis since the kidney failed in September 2003. The disease has left him wearing glasses and hearing aids, but he goes to work as an accountant every weekday. as soon as he gets home, he gets hooked up to the dialysis machine. with his condition deteriorating, his dialysis was recently bumped up from nine-hour treatments to 11 hours. He is near the top of the list for kidney donations.

Though Jeff Kautz is stoic about the effects of his disease, his wife admits that she cries as she worries about both the health and financial well-being of the family.

“I’m a feeler. I feel his pain,” she said.

While they’re all thankful 20-year-old son Zachary isn’t affected by the disease, she can’t help but struggle over the unknowns: what will happen to her husband and their 9-year-old daughter, Hannah?

Boys are affected more often than girls because about 80 percent of cases are caused by a mutation of the X chromosome and are transmitted from mother to son. The remaining 20 percent of cases affect boys and girls equally, according to the Alport Syndrome Foundation.

“We’ve gone down probably some of the darkest paths imaginable … but have come out with the strongest relationship,” said Rolanda Kautz, 39. “With the first transplant we had no insurance and we had to decide do we pay the electric bill or buy prescriptions? buy groceries or prescriptions?”

She credits God and said he’s worked through neighbors, friends, family and church friends who’ve helped them through, though they worry about the additional expenses ahead.

The Kautz family is trying to spread awareness of the disease to push for more research, as well as funding for families affected by the disease. at home, they’re piling their plates high with vegetables and pushing out processed foods to try to improve their health.

But blood has begun appearing in Hannah’s urine when she is ill.

Jeff Kautz and his wife hold on to hope that tests will show she doesn’t have the syndrome. Kautz said he expects to be cured.

“If not me, I know my daughter will,” he said.

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A transplant became his only chance for survival.

Chad hoped to wait for a cadaver transplant. but at any given time, close to 16,000 patients nationwide await a liver transplant, while only about 4,500 cadaver livers become available each year.

His best option, instead, was a living-donor transplant, a rare procedure in which a segment of the liver is taken from a healthy donor and transplanted into the ailing recipient. In just weeks, both the old liver and the transplanted liver regenerate and grow back to a normal size, providing long-term, regular function for both donor and patient.

In the more than 4,100 living-donor liver transplants conducted in the United States since 1989, just three donors had died from complications related to the surgery, according to the United Network for Organ Sharing, which manages the nation’s organ transplant system. at the University of Colorado Hospital, 141 such transplants had been performed with no fatalities.

Chad’s doctors said he’d need to find someone between 18 and 55 years old, a person in excellent medical and psychological health, whose blood type was compatible, though not necessarily an exact match.

When Chad relayed this to family members across the country, volunteers came flooding in. Cousins. In-laws. Friends. And all three of his siblings: Rod, 42; Janelle, 39; and Ryan, 34. Chad explained that the hospital wanted him to nominate one person, who would then take a blood test to see if he or she was a potential match. if so, another round of tests would follow.

But Ryan, the baby brother with the first-born instincts, didn’t want to wait. Back in Watertown, he scheduled his own blood test. And when he learned his blood type was, in fact, compatible, his message to Chad — to everyone — was clear. the transplant would happen. Chad would get better. And Ryan was going to be the donor, period. Even when Janelle checked her own medical records and learned she, too, had the right blood type, Ryan just waved her off.

“Nah,” he said. “We’re not going to need you.”

It was quintessential Ryan.

Leaning on family and faith “‘I think we can do this.’ Half the time Ryan said this he’d be buried in mud or snow or water up to his eyeballs in his Wrangler. the other times were real life issues that challenged him or a friend to their core. Either way, he always found a way through it. By the way, it was never an option to go ‘around.’ why do that and miss all the fun?”

— Chad’s journal entry called, “Axioms for An Idiot. (aka me)”

The memories sometimes come in a rush. Ryan and Chad as teenagers in Watertown driving to basketball practice at 6 in the morning. In wintertime the snow came down so thick and hard, Ryan would peer out the passenger’s window, while Chad stared out the driver’s side, just to find the stripe in the road. “Come my way,” Ryan would say.

The summers back home from college, spent together installing boat lifts on Lake Kampeska.

The guys’ fishing trip to Alaska, when a grizzly bear suddenly appeared and Ryan strung pieces of salmon on his line and then cast them out at the bear just for fun. “For once, can you just go easy?” Chad had chastised his little brother, as he, Rod and their father stared in wonder.

It was just so Ryan. Fearless.

Where Chad was the philosophical one who liked poetry, Ryan was analytical and saw things in black and white. he seemed to know from an early age the things he wanted out of life, and he went out and got them. Chad likes to say: “He lived life ahead.”

Ryan was the buddy friends called for a cup of coffee and a heavy talk. to his nieces and nephews — and his own three little boys, Graham, Owen and Oliver — he wasn’t just the guy who played superhero; he was Superman and Aquaman rolled into one. he loved all things fast and outdoors: snowmobiling, four-wheeling, pheasant hunting. but he especially loved the water. he lived on the shores of Lake Kampeska, and after work he’d often grab his kids and his gear and head to Janelle’s house in his boat to pick her kids up and take them all fishing.

He was a man of many passions, but Shannon, the high school sweetheart who became his wife, was his greatest. later, when all was said and done, she would write of her husband: “What has really been kind of a comfort to me isn’t in trying to see God’s hand in this, because I don’t yet. It’s not even in the memories yet. … It’s the absolute knowing that I know what love is. What it’s like to be adored. What it’s like to be completely cared for and protected … “

Ryan, the protector. That may be the most fitting description.

“It was very simple with Ryan,” says his brother, Rod. “It was about being there for people. if you were his friend, if you were his brother, it was all in for him.”

He was like this because of his unshakable faith, something that had long guided the Arnolds through good times and bad. as children, Rod, Janelle, Chad and Ryan saw their father suffer so much loss — the premature deaths of his father, his brother and a best friend. And still he never stopped believing that God would see him through.

Chad felt the same in the years after his diagnosis: “God’s going to get me through this.”

Faith gave them all the strength and conviction to face up to hard times.

And so, when his blood work came back, Ryan took it upon himself to call and schedule the next round of tests. In June, he flew to Colorado for a thorough mental and physical examination. Then it was just a matter of waiting for those results to see whether the transplant would go forward.

‘I don’t want you to do it’ Chad was quickly deteriorating. His liver was growing to try to survive. he was so fatigued he couldn’t get out of bed for more than a few hours each day. His jaundiced skin and eyes were stained a sickening shade of honey.

In July, despite his condition, Chad traveled home to South Dakota for an Arnold family tradition: a reunion at the family cabin in the Black Hills. In all, some 60 Arnolds descended on the forest, camping in tents and RVs. Chad spent most of the weekend in bed trying to rest. Then one afternoon, while everyone else was outside, he heard Ryan on the phone in the other room.

“OK,” his brother said. “Sounds like we’re on.”

When Ryan came to him, Chad knew. he tried, for what seemed like the hundredth time, to talk him out of it. he cried. he said he still wanted to wait for a cadaver liver.

“I don’t want you to do it,” he told his brother, to which Ryan responded: “You’d do it for me, wouldn’t you?”

The next night, the family all gathered around a campfire to hear the good news: Ryan was a match, and the surgeons wanted to do the transplant within weeks. as scared as Chad was for his brother, he was excited, too, to finally be healthy again. the family prayed and shared communion. There were tears, but mostly there was so much joy and hope. Ryan exuded such optimism that he gave the others confidence. His utter lack of fear instilled peace in them.

“The one thing you can know about Ryan is he is determined,” says Chad. “He did things, and he didn’t worry about the consequences. he just did it, because he knew that was the right thing. so, I kind of had to swallow hard — and accept the gift.”

The gift. how strange it is, still, to call it that. but at that moment especially, back home in South Dakota, surrounded by prayers and peace and family and Ryan, it was only a beautiful gift.

“You see that hope that you’ve been seeing in your mind. And you’re getting there. You’re excited and the family’s excited,” Chad says.

“And then … code blue in the middle of the night, and everything changes.”

“I miss him so much. Sometimes I can’t sleep because my heart feels like it’s physically going to rupture inside my chest. And because he risked it all to help save my life, I know I have to deal with things at the very core of me that no one else will ever understand. no one.”

— Journal entry called, “Scarred.”

Read part II: Transplant recipient struggles amid brother’s loss

Copyright 2010 the Associated Press. all rights reserved. this material may not be published, broadcast, rewritten or redistributed.

August 24, 2010 – Central Hockey League (CHL) Bossier-Shreveport Mudbugs BOSSIER CITY, LA – Join the Bossier-Shreveport Mudbugs tomorrow at Buffalo Wild Wings as we support “We believe in Abilea”, a fundraising effort to help the family of 3-year-old Abilea Bounds as she undergoes medical treatments for a rare genetic disorder.

Abilea (pronounced Abby-Lee) suffers from a disorder known as PFIC(Progressive Familial Intrahepatic Cholestasis), which primarily affects liver function. the condition causes inhibited growth, nutritional deficiencies and extreme itching throughout her body. in order to be free of these symptoms and other health risks, Abi needs a liver transplant that cannot currently be performed anywhere in the state of Louisiana.

Her parents have thus been forced to look outside the state to continue her treatment at a pediatric transplant facility, but will not be covered by her Louisiana health insurance. the Bounds’ will likely be forced to pay for these extremely expensive medical procedures and travel costs themselves.

That’s why the Mudbugs are teaming up with Buffalo Wild Wings for tomorrow’s fundraiser, which will take place at both Bossier-Shreveport area locations. stop by either the Shreveport store at 7441 Youree Drive or the Bossier City store on the Louisiana Boardwalk for lunch or dinner and pick up a flyer for the fundraiser. When you present the coupon at the bottom of the flyer to your server, 20% of your purchases will go to support “We believe for Abilea”.

Mudbugs Head Coach Scott Muscutt, current and/or former players, mascot Clawed and team staff members will be on hand with Abilea and her family for the event. the ‘Bugs will first visit the Shreveport location from 11:00 am to 1:00 pm and then the Bossier City location from 5:00 to 7:00 pm.

So come out to either local BWW Grill & Bar tomorrow to enjoy a great meal for a great cause!

Mudbugs 2010-2011 season tickets and mini-plans are on sale now, so call 752-BUGS or stop by the team office inside the CenturyTel Center to get yours today! For all the latest Mudbugs offseason news, log on tomudbugshockey.com .

Season and group tickets are on sale by calling 318-752-BUGS (2847) or by visiting our website at mudbugshockey.com.

• Discuss this story on the Central Hockey League message board… • Digg this story • Add to Del.icio.us • Blue Liner Hartwick Bound for Quad Cities; Byrd, Axtell Sign Tryout Agreements – Quad City Mallards • Bucks Sign High Scoring Robinson – Laredo Bucks • Join the Mudbugs and “Believe for Abilea” Tomorrow at BWW – Bossier-Shreveport Mudbugs • Dunn, Ofukany Re-Sign with Jackalopes – Odessa Jackalopes

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