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Influence of organ quality on the observed association between deceased donor kidney procurement biopsy findings and graft survival

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Deceased donor kidney procurement biopsies findings are the most common reason for kidney discard. Retrospective studies have found inconsistent associations with post-transplant outcomes but may have been limited by selection bias because kidneys with advanced nephrosclerosis from high-risk donors are typically discarded.
Read the full abstract from Wiley Online Library.

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Father’s Life is Saved after Receiving Heart, Kidney and Liver Transplant

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Triple organ transplant is first in the nation to use three organs from a donor after circulatory death using innovative approach for organ recovery

Anthony Donatelli, age 40, has served in the U.S. Navy for 22 years. On February 14, 2022, he was wheeled into the operating room at UC San Diego Health; his body facing a different kind of combat. His kidney, heart and liver were failing, and he was about to receive three new organs.

“I didn’t have the option of dying. I had two children at home, a six and three-year-old,” said Donatelli. Read the full story from UC San Diego Health.

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Is Metformin Now in Our Armamentarium for Autosomal Dominant Polycystic Kidney Disease (ADPKD)?

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Treatment options for autosomal dominant polycystic kidney disease (ADPKD) are sparse despite the detrimental course of the disease. Tolvaptan, a vasopressin V2 receptor (V2R) antagonist, is the only FDA approved treatment so far to decelerate decline in glomerular filtration rate (GFR) in ADPKD. There has been a pressing need for additional therapeutic strategies that can prevent kidney enlargement and progression to end-stage kidney disease (ESKD), which occurs in almost half of the patients with ADPKD. In that regard, metformin has been investigated in preclinical and clinical studies with a proposed mechanism of AMP-activated protein kinase (AMPK) activation.

For the past 20 years, researchers have used rodent models of ADPKD to investigate efficacious therapies for ADPKD. Read the full article in the American Journal of Kidney Diseases blog.

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Robotic kidney cancer surgery shows desirable outcomes in study

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Robotic surgery compared favorably with standard surgery in a review and analysis of data from 1,375 patients who underwent surgery to remove cancer from the kidney and inferior vena cava. The inferior vena cava (IVC), the body’s biggest vein, carries blood out of the kidneys back to the heart. Cancer can infiltrate this vein and advance to the liver and heart. Robotic IVC thrombectomy resulted in fewer blood transfusions and fewer complications overall in patients compared to standard, open IVC thrombectomy. The findings should compel further studies of the benefits of robotic IVC thrombectomy. Read the full study from the University of Texas Health Science Center at San Antonio in ScienceDaily.

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The psychosocial needs of adolescent and young adult kidney transplant recipients, and associated interventions: a scoping review

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Renal transplantation is considered the gold standard treatment for end-stage kidney disease. Adolescent and young adult kidney transplant recipients have the highest rate of graft loss amongst transplanted patients. It is largely accepted this is due to psychosocial and behavioural difficulties, which impact adherence to prescribed therapies. This phenomenon is not isolated to a particular healthcare system having been observed in multiple countries across different continents. It is a global issue of concern. We sought to review the psychosocial needs of these patients, and the interventions designed to meet these needs. Read more from BMC Psychology.

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Kidney transplant recipients may have immune-insufficiency during acute COVID-19

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Kidney transplant recipients experience immune-insufficiency during acute COVID-19, which may explain the low rates of acute rejection among these patients even with reduced immunosuppression, according to a recently published study.

“Immunosuppressed kidney transplant recipients (KTRs) are largely reported to have poor outcomes compared to non-transplant patients. Since immunosuppression could inhibit the development of protective anti-COVID-19 immunity, most centers have empirically reduced anti-rejection immunosuppression in KTRs with COVID-19 from the onset of the pandemic,” Zeguo Sun, from the department of medicine at the Icahn School of Medicine at Mount Sinai, and colleagues wrote. Read the full story in Healio.

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Robotic kidney cancer surgery shows desirable outcomes in study

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Robotic surgery compared favorably with standard surgery in a review and analysis of data from 1,375 patients who underwent surgery to remove cancer from the kidney and inferior vena cava. The inferior vena cava (IVC), the body’s biggest vein, carries blood out of the kidneys back to the heart. Cancer can infiltrate this vein and advance to the liver and heart. Robotic IVC thrombectomy resulted in fewer blood transfusions and fewer complications overall in patients compared to standard, open IVC thrombectomy. The findings should compel further studies of the benefits of robotic IVC thrombectomy. Read the study in Science Daily.

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Study provides insights into how the immune system of kidney transplant recipients responds to COVID-19

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Kidney transplant recipients (KTRs) have experienced severe symptoms and poor outcomes with COVID-19. Because the long-term antirejection immunosuppressive drugs that KTRs take could inhibit the development of protective anti-COVID-19 immunity, most hospitals have reduced the drugs’ doses in KTRs with COVID-19. Surprisingly, reported rates of acute rejection have been low despite reduced immunosuppression in these patients. A new study in JASN provides a potential explanation.

To study KTRs’ immune responses in the face of COVID-19, a team lead by Madhav C. Menon, MBBS, MD (Yale University School of Medicine and Icahn School of Medicine at Mount Sinai) analyzed the blood of 64 KTRs with COVID-19, including 31 acute cases (< 4 weeks from diagnosis) and 33 post-acute cases (>4 weeks). Patients were enrolled form Mount Sinai and Montefiore hospital (Albert Einstein College of Medicine)—two hospitals at the forefront of the pandemic in its early months. Read the full story in Medical Xpress.

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Pediatric Kidney Transplant Rate Lower at For-Profit Dialysis Facilities

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Children receiving maintenance dialysis have lower rates of pediatric transplant waitlisting and kidney transplantation at facilities that are for-profit rather than nonprofit, according to an analysis of data from the US Renal Data System.

Among 13,333 pediatric patients with end-stage kidney disease (ESKD) who initiated dialysis during 2000-2018, 3618 (27%) attended for-profit facilities, 7907 (59%) attended nonprofit facilities, and 1748 (13%) switched profit status. Read more in Renal & Urology News.

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