Category Archives: Kidney

WFBMC researchers say intellectual disability should not prevent kidney transplants in children – myfox8.com

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myfox8.com

myfox8.com
Transplants for people with intellectual disabilities are a controversial issue. Many centers exclude such patients from consideration for transplants for a variety of reasons, including a decreased life expectancy, a belief that patients with  

Doctors use Facebook Live to broadcast Ontario kidney transplant – CTV News

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From election results to Chewbacca mom, Facebook Live has become a popular way to broadcast breaking events as they unfold.

On Wednesday, an Ontario hospital offered a live-streamed look inside an operating room as doctors transplanted a kidney from a wife to her ailing husband.

St. Joseph’s Healthcare Hamilton broadcast the surgery live on Facebook and its website and live-tweeted the event. Viewers were encouraged to ask questions about the procedure as it happened and were answered in real-time by doctors.

The event was intended to be a teachable moment on the science of organ transplants and the importance of kidneys. Local high school students watched in auditoriums, and several thousand Facebook viewers tuned in live.

And there was little left to the imagination. The camera offered an up-close view of the surgery, including the moment the successfully transplanted kidney swelled to a healthy pink and began producing urine.

“It’s peeing! Excellent,” said Dr. Anil Kapoor as he prodded a tube-shaped organ during the livestream.

The kidney recipient was 45-year-old Bhargav Turaga from Hamilton, Ont. His kidney function suddenly deteriorated two years ago, and he required a transplant soon or else face daily dialysis.

His wife, Nagamani Turaga, 44, volunteered her healthy kidney for the procedure.

The event was filled with fascinating factual tidbits. The average adult kidney is about the size of a fist. Doctors have a narrow window – about three minutes – to perfuse or clean the kidney once it’s removed, which preserves it. The kidney sits in a cooler filled with slushy ice while it waits to be transplanted to the recipient.

After all was said and done, Kapoor deemed the surgery a success.

“It was a 10 out of 10, there were no hiccups or complications,” he told the Facebook audience. “The kidney looked beautiful.”

Donor Nagamani will now rest for about four weeks as she recovers from the surgery. A healthy kidney can last about 15 to 20 years, and so it’s likely that Bhargav will require another surgery in the future, according to Dr. Darin Treleaven, medical director of the transplant program at St. Joe’s.

Kapoor said he enjoyed the experience and didn’t feel any extra pressure, despite the online audience.

“We teach residents and medical students and fellows all day long, so we always have an audience in the OR … so it’s really no stretch to do what we did today.”

Duffield first grader receiving transplant from father, support from community – WCYB

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WATCH: Duffield first grader…

In a class full of first graders, Caden Gilbert is hard at work.

However, the kind-hearted 7-year-old has a lot more to focus on than spelling tests and books. On June 8th, Caden will have a kidney transplant. His dad is the donor.

“I would give him both of them if that’s what it took,” Caden’s dad, Christopher Gilbert, said.

It was July 2015. The Gilbert family was coming home from Myrtle Beach only to find that Caden was extremely ill.

After countless tests, doctors told the family he had contacted E. Coli. Things only got worse and that E. Coli eventually turned into a rare disease, which caused kidney failure.

“We had a really hard time accepting it,” Gilbert said. “Going from one week at the beach and talking with your buddies, ‘oh he’s such a big boy I cant wait to be on the sidelines Friday night watching him play football,’ and then a week later we’re in the hospital with him clinging to life.”

Caden went through multiple surgeries and was put on dialysis to treat the syndrome, but nothing took. A transplant now seems like the best option.

“This is not a cure, this is just a treatment,” Caden’s mom, Candi Gilbert, said. “Typically kidney transplants only last 10-15 years from a living donor. I’ve heard cases where they do last a lot longer than that. We just have to wait and see how well we take care of it.”

His supporters want to help during the difficult time and started a fundraiser called “Coins for Caden.”

“Caden is a great kid, he’s a hero, his dad is a hero,” Caden’s principal, Greg Ervin, said.

“It just touches your heart,” Caden’s teacher, Shelly Miller, said. “His story touches your heart, his family touches your heart, and we are privileged to know him and his family. They’ve really touched us this year.”

Everything raised goes to Caden’s COTA (Children’s Organ Transplant Association) fund. It’s money he’ll be able to use for the rest of his life.

If you’d like to support Caden you can donate online by clicking here.

Donations can also be sent to the following address:

ATTN: Coins for Caden
Duffield Primary School
663 Duff-Patt Hwy
Duffield, VA 24244

So far around $3,000 has been raised.

Health Matters: Dialysis vs Kidney Transplant – NBC2 News

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Last year more than 33,000 patients received transplants. Many of those were kidney transplants. Before getting a kidney transplant, many patients live on dialysis for years.

Dr. Gautham Mogilishetty, a kidney transplant surgeon with Lee Health, says dialysis can prolong life expectancy. “Dialysis is an artificial means of providing kidney function. The closest amount of kidney function that you can provide with dialysis is about 15 to 20 percent.”

The average life expectancy on dialysis is five years. If patients get a kidney transplant their life expectancy triples. “Transplantation is not only a cure for kidney disease but it gives back some of your life expectancy,” said Dr. Mogilishetty.

While dialysis is not a cure, doctors say it’s a bridge that buys the patient time until they can have a kidney transplant. For patients who can’t receive a transplant, it’s the only way to provide them more time. “You will die if you don’t get dialysis. But the amount of kidney function you get back is surprisingly very, very low compared to transplantation or your natural kidney,” said Dr. Mogilishetty.

If patients can have a kidney transplant doctors say timing is everything. “The goal is to transplant them early enough but not too early. The recommendation for kidney transplantation is when your kidney function has dropped to less than 20 percent, or if you’re on dialysis. If you’re on dialysis your kidney function is usually less than 15 percent or less than 10 percent,” said Dr. Mogilishetty.

Patients who are born with kidney disease or who develop it early in life may need multiple kidney transplants. “It’s the quality of life alone when you get a kidney transplantation, it’s the quantity of life,” said Dr. Mogilishetty.

Both treatments can give patients a chance to live a longer, healthier life.

https://vimeo.com/215562288

Kidney transplant funds to rise 50% – Royal Gazette

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Published May 9, 2017 at 8:00 am (Updated May 9, 2017 at 7:01 am)

  • Welcoming move: Bill Carter RN, Irena Ashton RN, Marianne Herbert RN

    Welcoming move: Bill Carter RN, Irena Ashton RN, Marianne Herbert RN

Island favours deceased donors

Bermuda has reverted to receiving mainly deceased donor organs for kidney transplant patients despite a rise in living donors between 2003 and 2009.

According to transplant co-ordinator Marianne Herbert, this could potentially be attributed to the high rate of contraindicated diseases in the local population.

“Living donors are selected very carefully and have to meet strict psychological and physiological criteria before being accepted as donors,” Ms Herbert, of Bermuda Home Dialysis Services, said.

“For a healthy individual, donating a kidney is safe and recovery is rapid.

“Having one kidney should not affect the donor’s health in any adverse way and the physical examination and testing involved in the preoperative work up will probably be the most comprehensive health evaluation that the person has ever undergone.”

But she said it was not always possible for transplant recipients to have a living donor “because of the very high incidence of contraindicated diseases such as diabetes and hypertension in the community”.

“Obesity, as we know, is a huge contributing cause of many diseases and this automatically rules out many potential donors.”

According to Ms Herbert, 106 people have received kidney transplants through programmes in Bermuda since 1972 and 32 of these were from living donors.

“Although recently we have had mainly cadaver donors for our clients, there was a period between 2003 and 2009 when we had as many living donors as cadaver donors.”

She said this mirrored a worldwide trend at the time, which could partly be attributed to the advent of laparoscopic or keyhole surgery to remove the donated kidney.

“It is a far less invasive surgery than the old traditional surgery where a rib was removed and the donor was exposed to major, painful, open surgery, which required a lengthy hospital stay and recovery period.”

She added that living donations were also opened up to friends and spouses, having at one time been reserved for blood relatives alone.

Other strategies to increase living transplants include “paired exchange programmes, ‘relay’ kidney transplantation programmes and other beneficial strategies such as moving a potential recipient to the top of the list if a donor who is unable to donate to that person is able to donate to someone else”, she added.

“Good Samaritan” donor programmes have even been set up for anonymous donations, she said, with one Bermudian the recipient of such a donated kidney and one altruistic donation by a Bermudian.

Kidney transplant funding for HIP and FutureCare patients is to increase by 50 per cent to up to $150,000 under new legislation.

A health Bill has been tabled to expand coverage from June 1 so that more patients can come off dialysis, a government spokeswoman said.

According to Irena Ashton, owner of Bermuda Home Dialysis Services, this is a move in the right direction but travel expenses, which can be significant, remain to be addressed.

She also stressed that more focus should be placed on living donors because this can lead to better patient outcomes, shorter wait times and therefore less time spent on dialysis.

“Money is everything when it comes to transplants,” the dialysis nurse told The Royal Gazette. “I would like things to be moving a little faster but this is a good start.

“HIP is really trying, they are moving it forward in a much faster way. Now we just have to wait and see — hopefully it is going to get passed.”

While Ms Ashton pointed out that “HIP actually covers a lot of things”, she added that “travel is sort of an outstanding thing”.

She said patients often had to spend up to six weeks abroad and also had to travel back to the transplant centre for follow-up appointments.

Extra help is available for those receiving financial assistance and others can apply to the Lady Cubitt Compassionate Association for loans, but she said travel costs can still make transplants “prohibitive”.

“Most dialysis patients in Bermuda, I’d say 60 per cent, have HIP — they cannot afford it,” Ms Ashton said, adding that they “are forced to remain on the much more expensive dialysis treatment”.

She added that performing the procedure locally, if this were a possibility, could be a positive development [see separate story].

Ms Ashton also stressed that more focus on living donors, which she said are not currently financially reimbursed for HIP and FutureCare patients, would be a “big step”.

“If there is another progression, it would really be to explore living donors,” she said, adding that this would “speed things up more”.

There are about 170 people in Bermuda who are on dialysis and Ms Ashton also emphasised the need for patients to start the transplant process sooner, ideally before starting dialysis.

“A lot of them are walking around with chronic kidney disease and don’t even know it. Ideally we would like to get these folks to get the proper education and part of that education is transplants.”

She added that “they don’t get transplanted overnight,” noting that patients on dialysis have to wait between three and seven years — depending on their blood type — for a suitable match.

According to the health ministry spokeswoman, the Mutual Reinsurance Fund covers $30,000 towards a kidney transplant, with HIP and FutureCare providing an additional $70,000.

“The ministry has tabled legislation seeking to increase the MRF coverage to $100,000 from June 1, 2017,” she said.

“HIP and FutureCare benefits are also being updated accordingly to cover up to $150,000 altogether, including the MRF portion, in order to ensure their policyholders can have access to transplants.

“The intent of the change is precisely to pay for transplants so that more persons can come off dialysis, which will be more cost-effective in the long run.”

The spokeswoman added that coverage of pre-transplant costs was dependent on the case rates at the different facilities, which vary in what they include.

“Pre-surgical evaluations can extend from several years to immediately before the surgery. HIP is currently in negotiations to improve the coverage.”

She also said that some overseas facilities had offered case rates that cover some of the costs of the live donor.

“When costs are not covered in the case rates for the transplant recipient, the facilities charge the live donors’ insurance separately.”

The legislation was tabled on March 20 as part of the Health (Miscellaneous) Amendment Act 2017.

Ask the Expert: What is a kidney transplant chain? – The Daily Progress

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Q. What is a kidney transplant chain? How do they benefit people in need of a transplant?
A. Transplantation by a live kidney donor offers several advantages to the potential transplant recipient, including better life expectancy, less time on dialysis and better kidney quality.
A substantial number of live kidney donors are incompatible with their intended recipients — such as a family member or friend — either because of blood type differences or the presence of preformed antibodies in the recipient’s body that would be directed against proteins from the donated kidney and cause his or her body to reject the kidney.
Kidney-paired donation (KPD), which can exist in a number of different scenarios, often offers the best option for such incompatible donor-and-recipient pairs. A chain is initiated when a donor from an incompatible pair donates a kidney to the recipient of another incompatible pair. The chain continues when the donor from the second incompatible pair donates a kidney to the recipient of a third incompatible pair and could continue indefinitely.
A chain also can be initiated by an altruistic donor who is not seeking to donate his or her kidney to a particular person. In this case, the chain culminates with what we call a bridge donor, who then can initiate another chain of donations.
KPD via a chain can allow recipients to receive better-matched kidneys, and its greatest benefit is the potential to help multiple people at once by facilitating many transplants. A well-known example of a chain was published in the New England Journal of Medicine in 2009. Ten patients, many of whom would have been very difficult to find matches for because of high antibody levels, were transplanted in less than one year through a chain initiated by an altruistic donor from Michigan.
Dr. Karen M. Warburton is a nephrologist specializing in kidney and pancreas transplantation, including living-donor kidney transplant, for the Charles O. Strickler Transplant Center at University of Virginia Health System. For more information about kidney transplants, visit uvahealth.com/services/transplant-services/kidney-transplant.

Kidney patients may be eligible for transplant – Bismarck Tribune

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People unable to live without dialysis or a new kidney are candidates for transplant. These patients — who are in end-stage kidney disease — may receive a kidney from a living or deceased donor. In the United States, the most common causes of end-stage kidney are diabetes and high blood pressure, though there are many more. About 100,000 people are waiting for kidney transplants in the U.S.
How do deceased adults become donors?
After being pronounced dead, adults who have identified themselves as donors have their kidneys harvested for transplant. Most transplanted kidneys come from this process known as deceased donor transplant. The family of a deceased person can also agree to organ donation.
How are living adults able to be donors?
Family members may be able to donate one of their kidneys through living transplant. The same is true of unrelated people who are a good match. Potential donors are extensively screened physically and psychologically. These living donors have unchanged life expectancy and quality of life.
What’s the process involved in finding a new kidney?
Placement on the transplant list involves extensive evaluation — diagnostic and psychosocial. Initial blood tests help determine urgency of kidney need and to establish blood chemistries essential in matching to a potential donor. Further blood evaluations are designed to lessen the chances of eventual organ rejection. A potential recipient will undergo a further battery of tests to gauge overall health. Though many are determined based on the individual, these diagnostic tests can include:
• Renal ultrasound — non-invasive test utilizing sound waves to produce a picture of the kidney to determine its size, shape and check for masses and cysts
• Kidney biopsy — removal of tissue samples to identify the presence of cancerous or other abnormal cells
• Intravenous pyelogram — series of X-rays of the kidney, ureters and bladder looking for tumors, abnormalities or obstructions
A team determines candidates for transplant based on the evaluations outlined above. People accepted are listed on the United Network for Organ Sharing registry.
What must a recipient do after transplant?
Some combination of medication will need to be taken for the life of the transplanted kidney. These medicines reduce the strength of the immune system, essentially tricking it into not attacking the transplanted organ. The patient’s health care team can manage side effects that may develop from the anti-rejection drugs.
What’s the earliest age a person can become a recipient?
A child older than 2 years can generally receive an adult kidney.
What can I do to become a donor?
April marks Donate Life Month, an ideal time to register as a donor. To learn more, visit donatelifemidwest.org.

Father, daughter celebrate 50th anniversary of kidney transplant – 6abc.com

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A father and daughter are celebrating a milestone, a kidney transplant 50 years ago that changed the course of medicine.Ted Lombard gave his then-13-year-old daughter Denice a kidney to save her life.

Denice and twin sister Diane were born with a genetic defect which causes kidney failure.After Diane died at age 7, doctors wouldn’t put Denice on dialysis, saying it was too new and risky.

Her mother convinced UCLA Medical Center to do a living-donor transplant. It was experimental at the time.

“I lost one daughter and I just didn’t want to lose another,” said Ted.

Now, transplants – including those from living donors – are being done every day.

But the Lombards want everyone to consider becoming a living donor.

There are 100,000 people on the waiting list now and a new name is added every 14 minutes.The Lombards are believed to be the oldest living donor pair in the United States.

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Donor-recipient weight and sex mismatch may contribute to kidney transplant failure – EurekAlert (press release)

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Highlights

  • Among deceased donor kidney transplant recipients, those who were >30 kg (66 pounds) heavier than the donor had a 28% higher risk of transplant failure compared with equally weighted donors and recipients.
  • If the kidney was from a smaller donor of the opposite sex, the relative risk of transplant failure was further elevated to 35% for a male receiving a kidney from a female donor and 50% for a female receiving a kidney from a male donor.
  • More than 100,000 people are on the kidney transplant waiting list in the United States.

Washington, DC (March 30, 2017) — A new study indicates that the success of a kidney transplant may rely in part on a kidney donor’s weight and sex, factors that are not typically considered when choosing a recipient for a deceased donor kidney. The findings, which appear in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN), suggest that changes may be needed to current immunology-based protocols that match donors and recipients.

Previous research has shown that there may be a higher risk of kidney transplant failure if a kidney donor is smaller than the recipient, perhaps due to increased strain on the relatively smaller transplanted kidney. Very few studies have investigated outcomes associated with donor and recipient weight mismatch, however. There is also a suggestion that sex mismatch between kidney donor and recipient may lead to worse outcomes post-transplant, but studies have generated conflicting results.

To investigate these issues, a team led by Amanda Miller, MD and Karthik Tennankore, MD (Dalhousie University and the Nova Scotia Health Authority, in Canada) examined whether receiving a kidney transplant from a smaller donor of the opposite sex would impact a recipient’s transplant outcomes. The researchers analyzed information on a cohort of US deceased donor recipients between 2000 and 2014 who were listed in the Scientific Registry of Transplants Recipients. Over a median follow-up of 3.8 years, 21,261 of 115,124 kidney transplant recipients developed transplant failure.

After accounting for other transplant variables, the researchers demonstrated that if a kidney transplant recipient was >30 kg (66 pounds) heavier than the donor, there was a 28% higher risk of transplant failure compared with equally weighted donors and recipients. If the kidney was from a smaller donor of the opposite sex, the relative risk of transplant failure was further elevated to 35% for a male receiving a kidney from a female donor and 50% for a female receiving a kidney from a male donor. This risk is similar to that observed when a recipient receives a kidney transplant from a donor who has diabetes, a known risk factor for kidney failure.

“This study is extremely important because we have shown that when all else is considered, something as simple as the combination of a kidney donor’s weight and sex is associated with a marked increase in kidney transplant failure,” said Dr. Miller. “While more research is required before including these variables in a recipient matching strategy, this study highlights the importance of donor and recipient matching above and beyond current immunology-based protocols.”

In an accompanying editorial, Bethany Foster, MD, MSCE and Indra Gupta, MD (McGill University) noted that while matching for sex and body size in organ allocation algorithms deserves consideration, this idea must be approached with a great deal of caution. It would require complex matching, and special care would have to be taken to avoid disadvantaging larger recipients. “Restricting transplant options by prioritizing sex matching may also lead to longer waiting times,” they wrote. “Females with a large body size would be particularly disadvantaged by an approach that favoured allocation of sex- and body-size matched kidneys.”

###

Study co-authors include Bryce Kiberd, MD, Ian Alwayn, MD, and Ayo Odutayo, MD.

Disclosures: The authors reported no financial disclosures.

The article, entitled “Donor-Recipient Absolute Weight and Sex Mismatch and the Risk of Graft Loss in Renal Transplantation,” will appear online at http://cjasn. asnjournals. org/ on March 30, 2017, doi: 10.2215/CJN.07660716.

The editorial, entitled “Donor Quality in the Eye of the Beholder: Interactions Between Non-immunologic Recipient and Donor Factors as Determinants of Graft Survival,” will appear online at http://cjasn. asnjournals. org/ on March 30, 2017.

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Since 1966, ASN has been leading the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients. ASN has nearly 17,000 members representing 112 countries. For more information, please visit http://www. asn-online. org or contact the society at 202-640-4660.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

100 percent success rate for baby kidney transplants at U of M – KMSP-TV

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– Three-year-old London Hall has no problems keeping up with her brothers now, but as an infant it quickly became clear her twin brother was reaching milestones she wasn’t.

“[She was] three months old or so when we first started noticing that maybe when they were laying the floor she wasn’t moving her legs and arm quite as much,” said Gloria Hall, London’s mom.

Later when London struggled to eat and keep food down, her parents learned they were both carriers of a rare gene mutation, which was now preventing London’s kidney from processing proteins properly and she needed a transplant. At 17 months old, London received her mother’s kidney.

“I remember someone saying that you gave life to her twice: birth and then donating a kidney,” said Branden Hall, London’s dad.

London’s story is similar to the many success stories Dr. Srinath Chinnakotla from the University of Minnesota’s Amplatz Children’s Hospital recently researched. He studied pediatric kidney transplants at the U of M going back to the 1960’s and discovered most recently those performed on children under two years old have a 100 percent success rate after one year and five years. That’s better than any other age group.

“When a child has kidney failure and you put them on dialysis, the dialysis only purifies about 10 percent of the blood, so those children don’t develop well,” said Dr. Chinnakotla. “They have growth failure and they have problems in achieving milestones as well. The studies we’ve done at our institution show once you do the kidney transplant, boy, they quickly grow like a weed.”

Dr. Chinnakotla points out the U of M is a longtime pioneer of living donor transplants. He says transplant teams nationwide typically wait until a child is at least two years old. The Halls agree with Dr. Chinnakotla’s philosophy – some kids can’t afford to wait.

“I do feel like there is a little bit of a different connection there, you really would do anything for your kid,” said Gloria.

March 9 happens to be World Kidney Day. According to the National Kidney Foundation, there are an estimated 400,000 people living with kidney disease in Minnesota alone and nearly 9,000 are on either dialysis or the transplant wait list. Doctor Chinnakotla says roughly 10 percent of patients on that wait list are children.