Hi all,

Finally I can summerize Dr. Harlan Wright, MD's lecture at the Milk Bank Conf
I was at last March.  Some netters have asked about breastmilk and adult
uses.  Dr. Harlan spoke on "Mothers' Milk for IgA Deficiencey in Liver
Transplantation".  Approximately 40,000 liver transplants are needed each
year.  Organ shortages reduce the number of actual transplants to about 4,000
per year.  Survival in normal liver transplant patients is only about 85%,
with 5% of the deaths occurring in the first 4 months post-transplant.
 However, if IgA dificiency is present in a transplant patient, the mortality
rate is 42% with most of the mortality caused by sepsis from enteric
organisms.  With so few livers available this becomes a waste of organs.
The only good sources of IgA is in human milk.  IgA levels in colostrum can
be as high as 7 gms/dl with levles decreasing as milk production increases.
 IgA can be absorbed through the gut.  Two patients who received an
empirically chosen dose of 300 cc of donor milk for 10 days after surgery
were identified as initially having serum levels of IgA less than 7mg/dl.
 Levels rose to 10mg/dl in one patient and 30 mg/dl in the other.  One
patient died 7 monts after surgery from massive sepsis.  The second developed
pneumonia after three months and is being treated with donor milk on an
ongoing basis, 4 ozs, three times/day.  He has remained infection-free for
over a year.  Dr. Wright feels that all transplant patients should have IgA
levels drawn prior to surgery. The cost for treating one case of sepsis in
the ICU is more costly than 4 years worth of human milk used as a preventive
measure.  One cirrhotic's chronic care costs $300-400,00 while a transplant
costs about $150-200.00.  Insurers will cover cost of transplant because it
is so much cheaper.  The justification for donor milk therapy is that it
reduces costs significantly.
Small bowel transplants are going to be the next big issue for donor milk
therapy due to high infection risk.
All is so very interesting.  We all know how valuable human milk is for
infants, but now the discovery of all the other potential uses opens all new
doors.  Have a good memorial weekend everyone.

Pat Bull, RN, IBCLC
The Breastfeeding Connection/Medela
Naperville, IL