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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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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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How Common is Cancer in Organ Transplant Recipients?

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As an organ transplant recipient, you already “know” several things:

  • You know what the anxiety and stress of end-stage organ disease feels like
  • You know that your life has been improved after receiving your transplant
  • You know that by taking care of your transplant, you can reduce the risk of rejection of the organ

Did you also know that the important immunosuppressants (anti-rejection medications) you take to prevent your body from rejecting your transplanted kidney, heart, lung, or liver may increase your risk of developing certain types of
cancer?1

While the risk of dying from cancer is low, you need to be proactive and get screened for various types of cancer—most notably skin cancer.

Read the full article, here.

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SCD Kidney Transplantation vs Dialysis Ups Survival in Older Patients

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“Patients aged 65 years or older on a waiting list for a kidney transplant may be better off waiting for a kidney from a standard criteria donor (SCD) than accepting one from an expanded criteria donor (ECD), according to recent study.

“The acceptance of an ECD transplant should be carefully balanced against the risks of continued dialysis while waiting for a better donor offer,” investigators Rachel Hellemans, MD, of Antwerp University Hospital in Edegem, Belgium, and colleagues wrote in Nephrology Dialysis Transplantation.

The study included 3808 adult Belgian patients, of whom 3382 received a kidney transplant and 426 were waitlisted and remained on dialysis. The investigators divided patients into 3 age groups: 22 to 44 (1006 patients), 45 to 64 (2213 patients), and 65 years or older (589 patients). The median waiting time on the active waiting list for transplantation while on dialysis was longest for patients aged 22 to 44 years (22.4 months, followed by 18 months for those aged 45 to 64 years, and 11.7 months for those aged 65 years or older.”

Read the full article, here.

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‘Amazing’ recovery of donations, transplant rate seen during pandemic

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Organ donation and kidney transplants have made an “amazing” recovery from the worst days of the pandemic, a speaker said here, with more than 33,000 kidney transplants performed in 2020.

“There were some parts of the Northeast where there were zero living donor transplants done for weeks,” Matthew Cooper, MD, director of Kidney and Pancreas Transplantation at Medstar Georgetown Transplant Institute and professor of surgery at Georgetown University School of Medicine, said during a presentation at the virtual National Kidney Foundation Spring Clinical Meetings. “It was amazing how the country regained … the key was getting organs to areas where transplants could happen.”

Read the full article, here.

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