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EHR ‘Nudge’ Linked to Fewer C. Diff Tests for Organ Transplant Recipients

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An antibiotic stewardship program led to fewer Clostridioides difficile (C. diff) tests ordered for solid organ transplant recipients without impacting the negative test rate, a retrospective study found.

Compared with a pre-intervention period, C. diff toxin test orders dropped 47% after a diagnostic stewardship program was enacted (median 18 vs 8.5 processed orders per quarter, respectively, P=0.038), reported Michael Kueht, MD, of the University of Texas Medical Branch in Galveston, and colleagues, writing in Transplantation Proceedings.
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Baby gets heart transplant with a twist to fight rejection

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Duke University doctors say a baby is thriving after a first-of-its-kind heart transplant — one that came with a bonus technique to try to help prevent rejection of the new organ.

The thymus plays a critical role in building the immune system. Doctors have wondered if implanting some thymus tissue that matched a donated organ might help it survive without the recipient needing toxic anti-rejection medicines. Read more.

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DRE bacteremia associated with high mortality following liver transplant

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Liver transplant recipients with daptomycin-resistant Enterococcus bacteremia were more than twice as likely to die within a year compared with those who had vancomycin-resistant Enterococcus bacteremia, a study found.

“In our institution, we noted a significant increase in Enterococcus isolates resistant to daptomycin, leaving few options for treatment,” Rachael A. Lee, MD, MSPH, associate professor of infectious diseases at the University of Alabama at Birmingham, told Healio. 
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How a Low-Protein Diet Can Delay Dialysis in Patients With Chronic Kidney Disease

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At any given time, an estimated 15% of the US adult population has chronic kidney disease (CKD). It manifests as reduced kidney function to below 60% of its normal range (estimated glomerular filtration rate < 60 mL/min/1.73 m2) or by spillage of protein into the urine. The many causes of CKD include diabetes, hypertension, glomerulonephritis, and cystic kidney diseases. CKD is an irreversible malady with no known cure, and it invariably worsens over time. CKD is associated with higher mortality risks as it advances. If the patient does not die of cardiovascular or infectious events, end-stage renal disease ensues and the patient requires maintenance dialysis therapy or kidney transplantation to survive.
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Adherence promotion strategies cost-effective, improve graft rejection rates

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Adherence promotion strategies, such as the Medication Adherence Promotion System, proved to be cost-effective and improved rejection rates among adolescent kidney transplant recipients, according to a published study.

“To date, there are several randomized controlled trials that show systems to improve medication adherence can improve adherence in transplant patients, but they have not demonstrated a decrease in rejection rates — which is the primary purpose to improve medication adherence in transplant patients,” Charles D. Varnell Jr., MD, MS, assistant medical director of kidney transplantation from the division of nephrology and hypertension at Cincinnati Children’s Hospital Medical Center in Ohio, told Healio.
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They say their children are being denied transplants because of their disabilities. A new federal law may help change that.

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A patient with disabilities can be denied life-saving organ transplants because of those disabilities, and parents often fear the worst. Families have won protections in many states — including 14 in the last year. 

But more than three decades after the Americans with Disabilities Act — which prohibits discrimination based on a person’s disability — became federal law, advocates say inequities persist in health care. Read more.

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