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Morning Rounds Shraddha Chakradhar

New heart transplant method being tested for the first time in the U.S.

A new multicenter trial in the U.S. is testing a transplant procedure to allow more donor hearts to reach waiting patients. In “donation after cardiac death,” or DCD, transplants, physicians retrieve organs from those who died because their heart stopped. Massachusetts General Hospital and the University of Wisconsin in Madison just performed their first DCD heart transplant as part of the trial, following Duke University last month. The U.K. and Australia have been using the method for several years now. In the U.S. trial, a yet-to-be approved machine allows the heart to be perfused with warm blood after removal from the donor, and for physicians to assess the organ's function. U.S. transplant laws currently prohibit DCD hearts from being used for transplants, but if the FDA approves the machine for this procedure, it “will expand the donor pool by 30%,” says Dr. Jacob Schroder, who is part of Duke’s DCD heart transplant team. 

ACA helped reduce health access disparities among racial groups

The nonprofit Commonwealth Fund is out with a report showing that since the Affordable Care Act was enacted in 2010, it has reduced disparities in accessing health care among racial groups. Here’s more: 

  • Insurance coverage: Almost a quarter of Black adults and 40% of Hispanic adults were uninsured in 2013, but those rates dropped to around 14% and 25%, respectively, in 2018. This also narrowed the disparity compared to white adults. 

  • Financial barriers: 23% of Black adults avoided accessing health care in 2013 due to costs, but that dropped to 17% five years later. For Hispanic adults, the number fell from 28% to 21% over that time period. 

  • Medicaid expansion: Black adults living in states that opted to expand Medicaid through the ACA are now less likely to be uninsured than white adults in non-expansion states.

Harmful health effects of ageism seen in many countries

A new review of more than 400 studies finds that ageism is linked to worse health outcomes in adults. The studies included in the review looked at a host of effects tied to ageism, including how older adults are excluded from research, are denied work opportunities, and how ageism leads to worse physical and mental health. More than 95% of studies found that ageism led to worse health outcomes, as did nearly 75% of the associations between ageism and health. Although all 45 countries examined in the studies revealed this link, the review also found that the negative effects were more pronounced in less developed countries. Older people with less education were also more likely to experience the adverse health effects of ageism. 

Inside STAT: New Hampshire is trying to resurrect a vanquished ban on ‘price gouging’


Lawmakers in New Hampshire next month will consider legislation to ban "price gouging" in the generic drug market. (JULIO CORTEZ/AP PHOTO)

Next month, New Hampshire lawmakers are set to consider a bill banning “price gouging” of generic drugs. The bill would bar drug companies from hiking the price of generic drugs by more than 50% in a one-year period. As state legislatures look to bring in new reforms to the drug pricing landscape, the New Hampshire bill largely resurrects one that was left for dead when a similar Maryland law was struck down by courts two years ago. And if it passes and survives legal challenges, the proposal could pave the way for other states to take up comparable measures to keep rising drug prices in check. STAT Plus subscribers can read more from STAT's Lev Facher here

Mutations in stem cells of young donors can be passed to recipients

Stem cell donors may inadvertently be passing along disease-linked mutations to those who receive stem cell or bone marrow transplants to treat cancer and other blood disorders, according to a new study. It looked at data from 25 donors ages 20-58, and found that nearly 45% of the younger donors had mutations in transplanted stem cells that could increase recipients’ risk of certain conditions. Overall, nearly 85% of the mutations detected in all the donors were considered disease-causing and were missed by standard gene sequencing techniques. Although it was unclear if transplant recipients were actually experiencing related health issues, scientists say that the mutations are more likely to affect these patients — and not donors — because recipients’ immune systems are already weakened by disease and chemotherapy.  

Children in states with school snack regulations consume fewer calories

Children in states with school snack regulations consume, on average, fewer calories than kids in states where those aren’t in place, finds a small new study. Some states, including Florida and Illinois, follow the USDA’s 2013 “Smart Snacks” rule that calls for more nutritional snacks — low-fat and low-sugar items, for instance — to be available in schools over more calorie-rich foods. Students who lived in those states ate about 60 fewer calories from solid fats and sugar per day than those kids who lived in states that didn’t adopt the rule. Those in the former group also consumed fewer solid fats overall. However, the rule didn’t lead to students eating less snacks in general.

What to read around the web today

  • The kill-switch for CRISPR that could make gene-editing safer. Nature
  • Two sisters. Two different journeys through Australia’s health care system. Vox
  • Verily tangos at JPM with a health tech partner — and steps on a few toes. STAT Plus
  • When surgeons don't bother with checklists. The New York Times
  • Patient in Japan confirmed as having new virus from China. The Associated Press

Thanks for reading! More tomorrow,

Shraddha

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Thursday, January 16, 2020

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