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8 Things To Know About Heart Transplants

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“A heart transplant may be the most dramatic surgery done in the operating room. Each step takes great precision, from the quick, careful journey to retrieve the heart to the preparation of the recipient, who may be gravely ill and bedridden. The best part is the outcome soon after the transplant, when the patient goes home and starts returning to his or her life—whether that means getting married, having babies, running in marathons, or simply breathing massive sighs of relief while strolling around the neighborhood without having to periodically stop to catch a breath.”

Read all 8 here.

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Common Gene Variant May Predict Peritoneal Dialysis Outcomes

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“A common genetic variant predicted poor outcomes from peritoneal dialysis, suggesting a potential factor for patient selection and treatment, researchers found.

Variants in AQP1, the gene that encodes for a key water transport channel across the peritoneal membrane, were associated with decreased ultrafiltration while on peritoneal dialysis and a 70% increased risk of death or failure of that form of dialysis as well.

The 10-16% of patients with the TT genotype of the rs2075574 variant could be good candidates for precision medicine in dialysis treatment, Johann Morelle, MD, PhD, of the Cliniques Universitaires Saint-Luc in Brussels, Belgium, and colleagues reported in the New England Journal of Medicine.”

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Donor Kidneys Further Out of Reach for Kids Regardless of Race

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“The revamped U.S. kidney prioritization system appeared to better even the field in pediatric kidney transplant wait times — by making organs similarly harder to get for children across races and ethnicities, according to a study.

Measuring time from dialysis to transplantation, Black, Hispanic, or other children of color had significantly longer wait times compared to white children before the Organ Procurement and Transplantation Network’s Kidney Allocation System (KAS) changes in 2014, but these differences were reduced afterward, Jill Krissberg, MD, MS, of Lurie’s Children Hospital of Chicago, and colleagues reported.”

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NKF Statement on Key Healthcare Policies to Help Kidney Patients

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“This week, the U.S. House of Representatives is reviewing several policy initiatives in the budget reconciliation process that, if passed, could positively impact patients with kidney disease. The National Kidney Foundation and our advocates nationwide have been working closely with Congress to keep kidney patients and their unique needs front and center and we strongly support the following initiatives:

Lowering the Cost of Prescription Drugs 

NKF is proud to have worked with the Partnership to Protect Coverage in advocating for lower cost prescription drugs for our patients. Among other things, this provision caps Medicare Part D out of pocket costs at $2000 per patient, per year. “

Learn more here.

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Three Drugs Better Than Two (or One) in Cystic Fibrosis

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“A three-drug combination for a certain form of cystic fibrosis (CF) not addressed with other therapies met its efficacy and safety endpoints in a phase III trial, researchers said.

Elexacaftor, tezacaftor, and ivacaftor (Trikafta) together improved forced expiratory volume in one second (FEV1) and lowered chloride levels in sweat in CF patients with Phe508del-gating or Phe508del-residual function genotypes, relative to a control regimen of ivacaftor either alone (Kalydeco) or with tezacaftor (Symdeko), reported Peter J. Barry, MD, of Manchester University NHS Foundation Trust in England, and colleagues in the New England Journal of Medicine.”

Read more, here.

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Heart Transplant: A Slightly More Level Playing Field Under New UNOS System

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“Recent changes to U.S. donor heart allocation were followed by a narrowing of racial disparities in listing and transplant, though much more work remains to eliminate inequality, researchers warned.

Black patients listed for cardiac transplantation in 2011-2020 were less likely than white peers to die while waiting (adjusted HR 0.88, 95% CI 0.78-0.98). However, they ultimately had lower odds of undergoing transplant (adjusted HR 0.87, 95% CI 0.84-0.90) and a higher risk of post-transplant death (adjusted HR 1.14, 95% CI 1.04-1.24), reported P. Elliott Miller, MD, of Yale School of Medicine in New Haven, Connecticut, and colleagues.”

Read more, here.

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For 2 Ga. Couples, a Transplant Created an Unbreakable Bond: ‘We’re the Kidney Warrior Family’

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“Tia Wimbush and Susan Ellis were coworkers for years at Children’s Healthcare of Atlanta, and while friendly to each other at work, they rarely interacted in the large IT department. But in March, the two became bonded for life when Tia donated her kidney to Susan’s husband Lance, and Susan donated her kidney to Tia’s husband Rodney.   

It all began with a chance encounter in the company restroom, and an introduction through another woman at work who knew that Tia’s husband Rodney had experienced sudden kidney failure in 2019 and that Susan’s husband Lance, who had long battled the disease, was in the same situation. Soon, they began to share what Ellis calls “a connection of sisterhood” after learning both their husbands had end-stage kidney disease and were on dialysis.”

Read full story, here.

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FDA OKs New Drug for CKD-Related Pruritus

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“The FDA approved difelikefalin (Korsuva) on Monday for treating pruritus in chronic kidney disease (CKD) patients, Cara Therapeutics and Vifor Pharma announced.

Difelikefalin is a first-in-class kappa opioid receptor (KOR) agonist that targets the peripheral nervous system, according to the two companies. Administered as an injection (0.5 μg/kg three times per week), the drug is indicated for moderate-to-severe pruritus in CKD patients on hemodialysis — the first therapy approved in this setting.”

Read more, here.

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Can Liver Donor Biomarker Predict Liver Transplant Rejection?

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“The biomarker, class I human leukocyte antigen (HLA) evolutionary divergence (HED), was tied to liver transplant rejection in adults and children, French researchers found.

In a retrospective study, adult-donor class I HED was associated with acute liver transplant rejection (HR 1.09, 95% CI 1.03-1.16) and chronic rejection (HR 1.20, 95% CI 1.10-1.31), in addition to 50% or greater ductopenia (HR 1.33, 95% CI 1.09-1.62), reported Cyrille Feray, MD, PhD, of the Hôpital Paul-Brousse in Villejuif, France, and colleagues.”

Learn more, here.

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The Science Supporting the U.S. Case for COVID Boosters

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“U.S. health officials laid out the scientific rationale for a third dose of the COVID-19 mRNA vaccines for all U.S. adults on Wednesday, relying on published and unpublished CDC data, as well as a preprint study.

Overall, they said that there is evidence that vaccine effectiveness against infection — both symptomatic and asymptomatic — has been decreasing over time, but that protection against severe disease, hospitalization, and death remains relatively high.

In anticipation of further waning of immunity amid the ongoing Delta variant-fueled surge — which is posing additional challenges — pulling the trigger on booster shots could help the U.S. stay ahead of the virus, they said.”

Read more, here.

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