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Test to Predict Kidney Transplant Rejection Works for Children

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Cedars-Sinai Patient Pioneers Successful Pediatric Use of Test Developed for Adults

“In many ways 19-year-old, Brenna Kahlen is a typical teenager. She is living at home in Newport Beach, working and going to college. But unlike most of her peers, Brenna is a now a medical first.

Brenna was born with a disease known as tuberous sclerosis, which affected her kidneys. At age 11, she had both kidneys surgically removed and was placed on dialysis until she could receive a donated kidney.

The transplant happened in 2013 and Brenna “has done extremely well,” said Dechu Puliyanda, MD  Cedars-Sinai’s director of Pediatric Nephrology and Transplant Immunology, who oversees Brenna’s care”

Read the full story, here.

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A Patient Pioneer: Minimally Invasive Lung Transplantation

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Frank Coburn Is the First Patient in Southern California—and Possibly First in the U.S.—to Undergo the Lifesaving Surgery

“To anyone else, it’s just a walk around the block. But for Frank Coburn, 57, and his wife, it’s a miracle.

A miracle that resulted from Coburn becoming the first Southern Californian—and possibly first in the U.S.—to receive a minimally invasive double lung transplant. The procedure was performed at the Smidt Heart Institute.

“After getting the call that a pair of lungs became available and I needed to be at the hospital immediately, I remember being wheeled into the operating room, finally feeling calm and ready to trust the process,” recalled Coburn, a Huntington Beach resident and longtime boat mechanic. “Once I woke up, my care team shared I had undergone a minimally invasive procedure instead of the traditional, more invasive approach. I was so fortunate and felt so proud to be the first. Truly lucky.”

During a routine lung transplant, surgeons usually create a “clamshell” or sternotomy incision, which involves breaking the breastbone in two pieces and requires many patients to rely on a heart-lung machine.”

Read the full story, here.

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Mayo Clinic Q And A: How lung restoration improves organ availability

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“DEAR MAYO CLINIC: I was reading about lung restoration and innovation in the field of lung transplantation. Can you share more about this?

ANSWER: Over the past several years, devices outside the body have been used to evaluate human lungs donated for organ transplant before the lungs are transplanted. In the future, lung restoration may increasingly be used to treat donated lungs to make them healthier, so they could be viable for a transplant. The Food and Drug Administration has approved the use of a device known as the Xvivo Perfusion System with Steen Solution Perfusate, which is being used at Mayo Clinic in Florida, in a model constructed to make organs available regionally. Other systems are being investigated.

A lung transplant can be a lifesaving procedure for people with serious lung diseases, such as pulmonary hypertension, emphysema, pulmonary fibrosis, bronchiectasis or cystic fibrosis. But the number of lungs available for transplant consistently falls far short of the number of people waiting for a lung transplant.”

Read the full Q&A, here.

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New Drug, Positive Results. How Will it Benefit People with Diabetic Kidney Disease?

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“There is promising news for patients with chronic kidney disease (CKD) and type 2 diabetes—a serious medical condition that is also known as diabetic kidney disease.

Clinical trials have shown finerenone, a pill taken once per day, may prevent diabetic kidney disease from getting worse. Worsening diabetic kidney disease can cause heart problems and kidney failure.

Diabetes and kidney disease

Diabetes damages small blood vessels throughout the body, affecting the kidneys as well as other organs and tissues including skin, nerves, muscles, intestines, and the heart. More than 1 out of 4 adults with diabetes will eventually develop kidney disease, and in the US alone, millions of people already have diabetic kidney disease.

People with type 2 diabetes and kidney disease are three times more likely to die of heart-related causes than those with type 2 diabetes alone. Diabetes is also the leading cause of kidney failure, accounting for 44% of new cases.”

Read the full post, here.

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Advancements in Lung Transplants with the Cleveland Clinic Team

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“A trio of experts from the Cleveland Clinic join Dr. Rizzo for a talk on lung transplant trends and challenges in the US.

There are approximately just 2000 lung transplants conducted annually in the US—a rate which pales significantly to counts of yearly kidney and liver transplants, and is similar to the rate of heart transplants.

The count is in spite of numerous opportunities borne by the growing rate of possibly lethal chronic lung disease in the country, as well as by the fact that lung transplant has become a refined practice since first attempted a half-century ago.”

Listen to the podcast, here.

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Managing Acute Complications with Outpatient Interventions: A Scoping Review

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“Rates of use of emergency departments (ED) and hospital admission are high among patients with chronic kidney disease (CKD), particularly among patients with CKD requiring dialysis. Patients receiving maintenance dialysis have, on average, three visits to the ED per year, a rate that is three to eight times higher than among the general population. Of those ED visits, a significant proportion result in hospital admission. Further, ED and in-patient care are drivers of medical costs for patients with CKD, and are associated with significant emotional burden for patients and their caregivers.”

Read more, here.

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First COVID-19 Vaccine Dose Elicits Weak Antibody Response in Most KTRs

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“Most adult kidney transplant recipients (KTRs) exhibit a weak antibody response to the first injection of the Moderna mRNA COVID-19 vaccine, according to the findings of a prospective study published in Kidney International.1

“We already know that kidney transplant recipients tend to respond less well to vaccines because of the immunosuppression, but data concerning the anti-SARS-CoV-2 antibody response after COVID-19 vaccine in this population were lacking,” said first author Ilies Benotmane, MD, of Strasbourg University Hospital and the Fédération de Médecine Translationnelle (FMTS) in Strasbourg, France.

COVID-19 vaccine distribution programs worldwide have given priority to immunocompromised patients, including KTRs. Vaccination was recommended, however, for this patient population even though KTRs were not included in the vaccine clinical trials. Dr Benotmane and colleagues conducted a preliminary study investigating the efficacy and safety of the Moderna mRNA-1273 vaccine in KTRs by looking at the anti SARS CoV-2 antibody response after the first injection.”

Read more, here.

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Removing Race from Estimates of Kidney Function: What Happens Next?

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“The American Society of Nephrology (ASN) and the National Kidney Foundation (NKF) announce the concurrent publication of “Special Article: Reassessing the Inclusion of Race in Diagnosing Kidney Diseases: An Interim Report from the NKF-ASN Task Force” in the Journal of the American Society of Nephrology(JASN) and the American Journal of Kidney Diseases (AJKD).

The publication in JASN and AJKD provides an essential review of the many challenges relative to identifying and implementing alternative methods to diagnosing kidney diseases. Last month, ASN and NKF asserted that race modifiers should not be included in equations used to estimate kidney function. ASN and NKF also stated that current race-based equations should be replaced by a substitute that is accurate, representative, unbiased, and provides a standardized approach to diagnosing kidney diseases.”

Read the full article, here.

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Preguntas Frecuentes Acerca del COVID-19

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“La División de Trasplantes (DoT, siglas en inglés) de la Administración de Recursos y Servicios de Salud (HRSA, siglas en inglés) está controlando el impacto de la emergencia de salud pública por coronavirus (COVID-19) sobre la procuración y el trasplante de órganos.

¿Debería inscribirme como donante de órganos durante el brote de COVID-19?

Si no es donante de órganos registrado, le sugerimos que se inscriba en línea a través de su registro estatal de donantes. Inscribirse significa que, algún día, podría salvar vidas.”

Mas informacion aqui.

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Japanese Doctors Perform World’s First Living Donor Lung Transplant on COVID-19 Patient

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“A COVID-19 patient in Japan has received the world’s first lung transplant from living donors.

Receiving transplant lung tissue from her son and husband, the patient underwent an 11-hour operation at Kyoto University Hospital to receive her transplant last Wednesday.

The woman who underwent the operation contracted COVID-19 late last year. According to Kyoto University Hospital, she spent months on a life support machine acting as an artificial lung, because hers had become no longer functional. It’s expected that she’ll recover from last week’s operation within months.”

Read the full story, here.

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