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Kidney Transplant Rejection: What You Need to Know

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Since the first kidney transplant more than 60 years ago,1 doctors have developed a deeper understanding of how to protect donated organs. With newer medications and improved management, it’s less likely transplanted kidneys will undergo rejection by the immune system.

That’s not to say doctors have completely eliminated the risk of kidney transplant rejection, though. Unfortunately, while many kidneys will last much longer, the median life of a kidney transplant is still only ten years. Understanding the risks and early warning signs of rejection gives you the best chance of a successful kidney transplant. Read the full story on CareDx.com.

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Kidney stones, CKD connection unclear, but clinicians collaborate on treatment

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It did not take long for nephrologist and kidney stone specialist David S. Goldfarb, MD, FASN, to realize that the buildup of pain radiating from the right side of his abdomen was from a kidney stone that had begun its downward migration.

And he came to the realization based on his experience with kidney stones – this was his second one – that the escalating pain meant he did not have the 30 minutes it would take by car to get to his favored hospital and employer, New York University’s Langone Health, for treatment. He told the driver – his wife – to divert to closer-by Columbia-Presbyterian Hospital. Read more in Healio.

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Anemia Following Pediatric Kidney Transplant

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Among recipients of pediatric kidney transplantation, the prevalence of posttransplant anemia (PTA) ranges from 22% to 85%. PTA is defined as early (within 6 months of following transplant) or late (>6 months following transplant). In Frontiers in Pediatrics, Anne Kouri, MD, MS, and colleagues in the department of pediatrics, University of Minnesota, Minneapolis, describe the etiologies and management of PTA [doi:10.3398/fped.2022.929504]. Read more in Nephrology Times.

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COVID-19 Mortality Risk Factors in Kidney Transplant Recipients Identified

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Investigators have identified risk factors for COVID-19-related mortality among kidney transplant recipients, including intubation and mechanical ventilation.

Among 218 kidney transplant recipients diagnosed with COVID-19 at a single center in India from April 2020 to July 2021, 30 died. Investigators matched and compared the 30 deceased patients with 188 survivors by age, sex, blood group, living or deceased donor transplant type, transplant duration, comorbidities, immunosuppression, hospitalization vs home care, and history of graft function, infections, acute kidney injury, and related therapies. Read more in Renal & Urology News.

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Nephrologists see some potential wins, losses in proposed Medicare rule for payment

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CMS has released a proposed rule for the 2023 Physician Fee Schedule with some mix results for nephrologists, according to the Renal Physician Association.

“ … As usual, the news is mixed to positive for nephrology,” Robert Blaser, director of public policy for the RPA, wrote in an analysis for the association. “While the fee schedule conversion factor is projected for an approximate (and expected) 4.4% reduction, valuation for virtually all dialysis services (inpatient and outpatient, adult and pediatric, home and in-center, monthly and daily) either held steady or ticked up slightly,” he wrote.
Read more in Healio.

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Nonprofit aims to help veterans requiring kidney transplants

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No veteran should die waiting for a kidney transplant. However, as of the July 4th weekend, there were 1,781veterans across the United States on a waiting list. Sharyn Kreitzer is on a mission to eradicate the wait.

Three years ago, Kreitzer founded the nonprofit Donor Outreach for Veterans, or DOVE. Her mission is to locate living kidney donors for higher risk patients.
Read the full story in MilitaryTimes.

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New kidney transplant approach could eliminate need for lifelong immune drugs

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“These kidneys are going to last forever,” one researcher said.

Three children who have undergone kidney transplants in California will likely be spared from ever having to take anti-rejection medication, because of an innovative technique that eliminates the need for lifelong immunosuppression, ground-breaking new research suggests.

Scientists at Stanford Medicine detailed the cases Wednesday in the New England Journal of Medicine. All three children have an extremely rare genetic disease called Schimke immuno-osseous dysplasia, or SIOD, that often destroys a person’s ability to fight off infection and leads to kidney failure. In each case, a parent donated stem cells taken from bone marrow, as well as a kidney. Read the full story from NBC News.

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Similar mortality for patients with COVID-19 on dialysis, kidney recipients with COVID-19

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Mortality among kidney transplant patients with COVID-19 and those on dialysis with COVID-19 was similar during the first and second waves of the pandemic in Europe.

“A number of studies compared mortality in the first and second waves among patients receiving kidney replacement therapy (KRT). These studies were hampered by the fact that they were single center by design and consequently had a small sample size,” Priya Vart, PhD, from the department internal medicine at the University Medical Center Groningen in The Netherlands, and colleagues wrote. “Furthermore, they lacked information on key patient and disease-related characteristics, including comorbidities, the reason for COVID-19 screening and disease symptoms.” Read more in Healio.

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