Tag Archives: Kidney

Newcastle transplant youngster Eryn Howie is a real child of courage – Chronicle Live

Sep 17, 2014 19:12 By Craig Thompson

Transplant toddler Eryn Howie is firmly on the road to recovery after she received a life saving donation – from her own mum.

The three-year-old has now just started nursery as she fights back from the surgery which saved her life.

Eryn, of Fenham, Newcastle, was born without functioning kidneys and her desperate parents, Dawn and Mark, thought they would never see her grow up.

Both Dawn, 38, and Mark, 41, were tested to see if they could donate to a kidney to their little girl – and Dawn was found to be a match.

The mum and daughter had surgery at different hospitals last autumn while Mark faced an anxious wait.

But the operation was successful and Eryn is now recovering in leaps and bounds having just started Stocksfield Avenue Nursery in Fenham.

Dawn said: “She’s amazing. Every day I look at her and just can’t believe how far she’s come.”

Now Eryn has been nominated for a Chronicle Champions Award in the Child of Courage category.

Dawn Howie with daughter Eryn. Child of Courage nominee

Dawn, also mum to Niall, 15, Callum, 12, and nine-year-old Kian, said: “She is a massive inspiration to me and everyone she meets.

“We were told on four different occasions that she wouldn’t survive, but each time she has fought back and proved everyone wrong.

“Just a couple of weeks ago she did the mini Great North Run.”

At a 30-week scan when Dawn was pregnant, she and Mark, a retail manager, were told there was only a 50/50 chance that their baby would survive.

When Eryn was born in May 2011, Dawn hardly had time to cradle her newborn in her arms before worried doctors whisked her away.

Dawn was told Eryn had end-stage kidney failure and that an operation was needed to save her.

At just three days old, Eryn was taken into surgery as she was too small for regular dialysis and her mum and dad prepared for the worst.

The operation was a success, but the catheter they inserted became infected, so had to be taken out to let Eryn heal.

Again, Eryn battled back. Following her transplant on October 24, last year, Eryn was soon walking and talking, something Mark and Dawn feared they might never see.

Dawn added: “The progress she has made since then is incredible. She is loving nursery school and has settled in really well.

“We know that in the future she will need another transplant but Mark and the three boys have all said they are willing to be tested, so hopefully she won’t be short of donors.”

via Newcastle transplant youngster Eryn Howie is a real child of courage – Chronicle Live.

Many patients have concerns about pursuing kidney transplantation following kidney failure – Medical News Today

Last updated: 16 September 2014 at 12am PST

Concerns about pursuing kidney transplantation are highly prevalent among kidney failure patients, particularly older adults and women, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN). Reducing these concerns may help decrease disparities in access to transplantation.

There are thousands of patients with kidney failure who lack access to kidney transplantation, and disparities persist in terms of race, age, sex, and other patient characteristics. To improve access, it’s important to understand the sources of these disparities. For example, are clinicians not referring their patients for transplantation, or are patients’ concerns causing them to avoid transplantation despite appropriate referrals?

Dorry Segev, MD, PhD (Johns Hopkins University School of Public Health) and his colleagues conducted a study to understand the concerns and perceived barriers that dialysis patients have about pursuing transplantation, and what patient characteristics are associated with such concerns.

Among 348 adults who recently initiated dialysis and were recruited from 26 free-standing dialysis centers around Baltimore between 2009 and 2012, the most frequently cited concerns were that participants felt they were doing fine on dialysis (68.4%) and felt uncomfortable asking someone to donate a kidney (29.9%). Older age was independently associated with having high health-related or psychosocial concerns, as was being a woman, being less educated, and having more comorbid illnesses. Patients having such concerns had less than half the chance of getting listed for a transplant than those without them. Having never seen a kidney specialist before initiating dialysis was linked with high psychosocial concerns.

“The study is an important reminder that major disparities still exist in access to kidney transplantation, and it sheds some light on the mechanism of these disparities,” said Dr. Segev. “Knowing that older patients, women, and less educated individuals have more concerns about transplantation, and as a result are less likely to seek transplantation, should inspire the development of educational programs to address these concerns and help patients make the most informed treatment decisions possible.”

via Many patients have concerns about pursuing kidney transplantation following kidney failure – Medical News Today.

Fareham kidney transplant boy lives the dream and takes gold at games – Portsmouth News

Published on the
10 September 2014 10:59

A SCHOOLBOY’S dream to take part in a sporting event came true after years of waiting for a new kidney.

Matthew Nolan, was born with chronic renal failure and has had a lifetime of watching sports from the sidelines while he waited for transplant surgery.

After 18 months on the donor list, the 10-year-old underwent a kidney transplant last September at Southampton General Hospital.

And finally he got to live out his dream of becoming a sports star as he took part in the Westfield Health British Transplant Games, in Bolton.

Matthew, of Fareham, joined the Southampton children’s group that is made up of eight children aged between five and 14.

He said: ‘Our team was called the Organators.

‘We were given a uniform with our names on the back and all had different areas to compete in.

‘I did swimming, athletics, tug of war and the triathlon and won two gold medals. Most of the people who went were from my clinic so some of them I already knew and was quite good friends with.

‘One of the best parts was the opening ceremony where we all walked through Bolton high street in our team uniforms with people cheering and at the end we had a photo with a giant minion from the film Despicable Me.’

His mum Sonja Nolan and 12-year-old sister Becky attended to games, which took place at the Macron Stadium, home of Bolton Wanderers football team.

Sonja said: ‘It was a wonderful weekend and great seeing all the kids have fun.

‘Matthew didn’t have very much energy before the operation. He was so happy to take part and we’ve already registered for next year in Newcastle.

‘I’d definitely recommend the games to other people who go through transplants.’

The games welcome 60 teams of all ages who come together to compete from all over the country.

via Fareham kidney transplant boy lives the dream and takes gold at games – Portsmouth News.

The Yeshiva World Gaza Child Undergoes a Transplant in Rambam Medical Center « » Frum Jewish News

(Tuesday, September 9th, 2014)

16Once again, a Gazan resident benefits from Israeli medical technology. For years, M, a 14 year-old-boy from Gaza suffered from kidney failure. Recently, the youth’s doctor informed his family that without a transplant, the boy’s life would be at great risk. Exacerbating his condition, M’s blood also coagulated too easily, reducing the chance of a successful transplant. Against all odds, with the donation of a kidney from his sister, doctors at Haifa’s Rambam Medical Center saved the boy’s life.

M urgently needed a kidney transplant, but his blood condition had obstructed all blood vessels in his groin except the one vein through which he received dialysis. This significantly lowered chances for a successful transplantation.

Doctors explained to M’s family that it was only a matter of time before the final vein would also clog up, preventing dialysis and greatly threatening the boy’s life. To save him, his sister decided to donate a kidney.

Eight years ago, the boy had received a kidney donation from his brother, but the transplant, performed in Egypt, failed immediately. In light of this situation, Rambam doctors made it clear to the family that M’s chances for success were especially low. Despite this, his sister insisted upon the donation.

Considering the state of M’s blood vessels, the doctors were faced with a great challenge. In a regular transplant, doctors remove the donor’s kidney and then connect it to the recipient’s blood vessels. In M’s case, the doctors feared they wouldn’t find healthy blood vessels that could feed the transplanted kidney.

As a result, the doctors worked ‘in reverse’: first, they operated on M and checked for useable blood vessels. Finding a few, they then removed one of his sister’s kidneys and transplanted it in within M.

To compensate for all the blocked veins, M’s body had developed a system of bypass veins. Shortly after surgery, it became apparent that this collateral network could not stand up to the demands of the transplant.

Two hours after leaving the operating room, the youth was returned there. Examinations revealed that all vascular connections performed by Rambam doctors were working, but M’s own blood vessels were not sustaining the transplanted kidney.

The Rambam medical staff had never been confronted with such a situation before. “It was a nightmare scenario,” said Dr. Ran Steinberg, head of Pediatric Surgery. To solve the problem, the doctors implanted a synthetic connector between the vein exiting the kidney and the one that exits the liver.

This innovation worked and M’s body was able to function with the new kidney. After an eight-month stay in Rambam, the boy recently went home to Gaza, and will return for periodic check-ups.

“There are no words to describe the excitement of triumphing in an impossible situation. Not everyone believed we would succeed,” said Dr. Steinberg. “As soon as M started to recover, our doctors’ smiles returned. M is a great kid and he will be able to enjoy the regular life of any child his age.”

(YWN – Israel Desk, Jerusalem / Photo: Rambam Medical Center)

via The Yeshiva World Gaza Child Undergoes a Transplant in Rambam Medical Center « » Frum Jewish News.

European Commission : CORDIS : News and Events : New drug tackles transplant complications

To reduce the number of discards and thus make more kidneys available, researchers and medical scientists from the European consortium MABSOT have created a new drug called OPN-305 to reduce inflammation of the donor organ after transplantation.

Every year nearly 50.000 dialysis patients worldwide receive a kidney transplant, but depending on the type of donor between 20 to 60% of the implanted kidneys are not working. The reason: a complication called “Delayed graft function” (DGF) which can even lead to acute rejection and organ failure.

Now researchers from the MABSOT (Monoclonal Antibody Solid Organ Transplantation consortium) are putting their forces together to minimize the incidences of DGF. Opsona Theurapeutics in Dublin, Ireland, developed a new drug called OPN-305. The humanized protein is directly active against the TLR-receptor 2, which is involved in the inflammatory response triggering DGF during transplantation.

The first clinical trial, with 139 patients from Europe and the USA, seem promising. If the results are successful, in the future the new therapy could not only be used in renal transplantation, but also in heart, lung or other solid organ transplantation.

Watch video: http://www.youris.com/Health/HEALTHTV/New-Drug-Tackles-Transplant-Complications.kl#ixzz3CAWzSd00

via European Commission : CORDIS : News and Events : New drug tackles transplant complications.

Discordance between patient and provider in discussions about kidney transplantation – Medical News Today

Last updated: 1 September 2014 at 12am PST

In a study of dialysis patients, those who reported that they had discussed the option of transplantation with clinicians were more likely to be put on the transplant waiting list; however, clinician-reported discussions of transplantation did not increase patients’ likelihood of being waitlisted. The findings, which appear in an upcoming issue of the Journal of the American Society of Nephrology (JASN), indicate that better ways of informing patients about kidney transplantation may be needed.

One of the key principles of informed consent is describing alternative treatments. So when starting someone on hemodialysis, it is imperative to discuss the alternatives to hemodialysis, for example peritoneal dialysis and kidney transplantation. The Centers for Medicare & Medicaid Services (CMS) believe the discussion of kidney transplantation is so important that they mandate it. Unfortunately, though, there is no guidance as to what kind of discussion is required.

Dorry Segev, MD, PhD (Johns Hopkins University School of Public Health) and his colleagues asked 388 patients if providers (kidney specialists or dialysis staff) had discussed transplantation with them, and then they looked to see whether the providers reported to CMS that they had discussed transplantation with those patients.

The investigators discovered that in almost one-third of cases, providers reported to CMS that they had discussed transplantation with a particular patient, but the patient said that nobody had discussed it with them. Such discussions were reported by both patient and provider for 56.2% of participants, by provider only for 27.8%, by patient only for 8.3%, and by neither for 7.7%.

The researchers also discovered that patient-reported discussions about transplantation were associated with a nearly 3-fold increased likelihood that patients would be listed for transplantation, but provider-reported discussions did not increase a patient’s likelihood of being listed. In other words, it didn’t matter if the provider reported discussing transplantation with the patient; it was only if the patient reported receiving this information that led to him or her to being referred for and listed for a transplant.

“This is a critical lesson for quality improvement in the care of patients with end-stage kidney disease: it’s not enough to ask physicians if they provided information to the patient, but rather we need to be asking the patient, because there is major discordance between patient and provider reports, and only the patient report was associated with the expected clinical behavior,” said Dr. Segev.

In an accompanying editorial, Mark Unruh, MD (University of New Mexico School of Medicine) and Mary Amanda Dew, PhD (University of Pittsburgh School of Medicine and Medical Center) noted that that “even the best educational efforts will be for naught if the patient does not take in the information or understand it.” They cautioned, however, that the form submitted to CMS has been recognized as providing an important but inexact snapshot of patients with kidney failure and other conditions. They also stressed that providing kidney transplant information likely requires repeated discussions when patients are open and able to receive it.

via Discordance between patient and provider in discussions about kidney transplantation – Medical News Today.

Tocilizumab Research Could Lead to Personalized Treatments for Kidney Transplant Patients

Eileen Oldfield, Associate Editor

Published Online: Saturday, August 9, 2014

A multicenter study will examine whether a drug used to treat rheumatoid arthritis can improve kidney transplant patients’ health.

Researchers from several medical centers will use rheumatoid arthritis drug tocilizumab in a study to determine whether the drug improves kidney transplant patients’ long-term survival. The study will include 2 clinical trials.

The research focuses on regulatory T cells (Tregs), lymphocytes that suppress activity in other immune cells, a press release from the University of California, San Francisco, stated. Normally, Tregs maintain the immune system’s normal homeostasis and safeguard against autoimmune diseases. Researchers hope to induce long-term donor-specific tolerance without impeding immune response to pathogens and tumors in transplant patients.

Preclinical studies show that the cells can be used to control responses in graft-versus-host disease; however, additional research on Treg reactivity, dosing, adjunct immunosuppression, and infusion timing is needed.

The goal is to control inflammation in kidney transplant recipients by increasing the number or activity of Tregs by either infusing the cells into the body or by using tocilizumab to block the inflammatory effects of interleukin 6, the press release stated.

The results of small patient studies suggest a significant, sustained increase in Tregs following tocilizumab treatment, leading to the theory that the drug will increase Treg population in patients who received kidney transplants.

The National Institutes of Health will fund this 7-year, $17-million study investigating the therapy. In addition to the University of California, San Francisco, the University of Alabama at Birmingham, Emory University, and Cedars-Sinai Medical Center will participate in the research.

Although transplantation advances have reduced early acute rejection rates and improved 1-year graft survival, long-term graft success rates remain unchanged. The reasons for the flat long-term success rates include interstitial fibrosis progression and tubular atrophy in the kidney.

According to principal investigator Flavio Vincenti, MD, UCSF professor of medicine, the research holds the promise of personalized treatments for transplant patients.

“This grant allows us to work toward achieving 2 important advances in the transplant field,” Dr. Vincenti said. “We can introduce personalized medicine by treating patients based on molecular profiling of their kidney. We also can allow control of the response to the transplant by the patient’s own immune systems by regulatory T cells, either through infusions or pharmacologically.”

via Tocilizumab Research Could Lead to Personalized Treatments for Kidney Transplant Patients.

Horlick’s former female football player recovering after transplant

August 08, 2014 5:47 pm  •  PETE WICKLUND pete.wicklund@journaltimes.com(1) Comments

Family Encourages People to Become Donors

As 18-year-old Abbi Strack recovers from a kidney transplant, she and her family are asking people to consider registering as potential organ donors.

Her father, John, said that commitment could be as simple as filling out the organ donor registry for your driver’s license, or by getting more information from the National Kidney Foundation, www.kidney.org, or contacting Shelley Chapman, the kidney transplant coordinator at Children’s Hospital of Wisconsin, at schapman@chw.org.

WAUWATOSA — Abbi Strack has faced hurdles before in her young life, including breaking the gender barrier as a four-year player with Horlick High School’s football program.

On Friday, she was enduring pain — but doing well — in the aftermath of a kidney transplant at Children’s Hospital of Wisconsin, her father John, a principal at Horlick, said.

Events leading up to the surgery unfolded quickly, John Strack said, with Abbi, 18, being put on the recipient list for a transplant on June 17 and the family being notified Thursday night to report to the hospital to prepare for the operation early Friday.

John Strack said his daughter was born with one of her kidneys being about one-third of the size of the other, leaving the dominant kidney handling the bulk of the work for Abbi’s system. In the third grade, Abbi underwent surgery to move the ducts that move urine between the kidneys and bladder. In the seventh grade, she was again hospitalized due to heart problems brought on by high blood pressure related to her condition.

Between that health crisis and Friday’s surgery, there was nothing major, John Strack said. Abbi kept up an active teenage life. In addition to her football participation, she played softball for most of her high school career, was an honor student and participated in choir. Outside of school, she was active in Job’s Daughters, the youth wing of the Freemasons for girls, and was named a chapter sweetheart of the Racine chapter of DeMolay, the boys organization for the Freemasons.

But shortly after winter holiday season, Abbi’s health began to decline, John Strack said. She tried to keep her schedule going, even continuing with softball, but had to quit the team after three games because her stamina was gone. In June, Abbi was outfitted with the apparatus needed for dialysis and was just days away from undergoing her first dialysis treatment when the call for the transplant came, John Strack said.

Along with her dad, with Abbi at the hospital on Friday was her mom, Jan, a nurse; and brothers John Jr., 23, and Branden, 19, who are both in the Army. A third brother, Taylor, 22, who is also in the Army, was expected to arrive before today at the hospital.

John Strack Sr. gave thanks and praise to the Army and especially the Red Cross in arranging emergency leaves for his sons.

Also at Abbi’s side was her boyfriend, Jason Hilderbrand, 24, of Burlington. John Strack said Abbi and Hilderbrand met through mutual friends.

The next days will be crucial for Abbi, John Strack said, as medical staff watch for signs of rejection of the new kidney. She will be in the intensive care unit for at least four days and then will continue on in a regular hospital room for a few days before a month of in-home rest. John Strack said that visits to Abbi are restricted and well-wishers are asked not to send flowers or items containing latex to the hospital.

John Strack said that social workers at the hospital are working with officials at the University of Wisconsin-Milwaukee, where Abbi plans to start nursing studies this fall, to try to keep Abbi’s studies on schedule. For updates on Abbi’s condition, visit www.facebook.com/Abbischallenge.

via Horlick’s former female football player recovering after transplant.

Reunion after 38 years for transplant pioneers – Yorkshire Post

A TRANSPLANT patient who underwent a pioneering operation in Leeds has been reunited with her surgeon – 38 years on.

Ruth Moorhead was a teenager when she was the first child to undergo a kidney transplant at St James’s Hospital in January 1976.

In a double first, she received the organ from her father Mervyn – the hospital’s first operation using a live kidney donor.

Ruth – now Ruth Wright – and her parents travelled from their homes in Plymouth to Leeds to meet surgeon Dr Stanley Rosen.

He flew in from California for a special event for former kidney transplant patients and said it was an “immense pleasure” to meet Ruth and fellow transplantees.

Mrs Wright lived in York at the time of her operation, and she and her father, now 87, and mother Beryl brought scrapbooks of press cuttings, letters and mementoes to Leeds.

The family were also reunited with Fred Gungaram, a former nurse who cared for her during her treatment.

Meanwhile another former transplant patient, Charlotte Tate, has marked the anniversary of her lifesaving surgery.

Mrs Tate, previously Charlotte Rogerson, had a heart transplant 20 years ago while she lived in Leeds, but now lives in Northumberland.

via Reunion after 38 years for transplant pioneers – Yorkshire Post.

UAB – UAB News – $17 million multi-institutional grant to maximize kidney transplant survival

by Tyler Greer

August 04, 2014 Print Email

The University of Alabama at Birmingham is participating in a new seven-year, $17 million multicenter study funded by the National Institutes of Health to determine whether certain immune system cells and/or a drug used for treating rheumatoid arthritis can improve and maintain the long-term health of kidney transplant recipients.

The goal of the study is to reduce or eliminate inflammation in kidney transplants and prevent the associated decline in graft function, thereby maximizing long-term organ survival. It will involve two clinical trials in parallel by researchers at four sites around the country.

Roslyn Mannon, M.D., professor in the School Medicine in the Division of Nephrology and professor of surgery in the Division of Transplantation, is the principal investigator for the grant at UAB. University of California, San Francisco is the lead institution for the study.

Mannon, director of research for the Comprehensive Transplant Institute and immediate past president of the American Society of Transplantation, says the newly funded series of trials to take place at UAB will involve the use of regulatory T cells, or Tregs, and the use of an anti-IL6 receptor antibody. The programs are expected to begin this fall.

“We have been a site for NIH and Clinical Trials in Organ Transplantation studies since 2009,” said Mannon, also a member of the NIH steering committee for the CTOT and a member of the mechanistic studies committee. “In the current funded projects, we collaborate with other institutions on three clinical trials devoted to kidney transplant patients. We have 27 UAB patients enrolled to study a novel combination of immunosuppression with a total of 65 enrolled in all three sites. Additionally, one study is specifically for kidney and pancreas transplant recipients, and is one of the first studies in this patient population to be performed in the past 15 years. To be a part of this new multicenter study is great news. We will continue to participate in these cutting-edge national research efforts.”

Despite advances in transplantation — reducing early acute rejection rates to less than 15 percent and improving one-year graft survival to more than 90 percent — long-term graft success rates have remained unchanged at 4 percent loss annually. A major contributor is the progression of interstitial fibrosis and tubular atrophy in the kidney.

The Comprehensive Transplant Institute provides a means to expand patient options, including incompatible transplantation and kidney-paired donation and new access to transplants for patients with HIV or hepatitis C infection. Every gift will help expand UAB’s expertise in transplant immunology, transplant pathology, and outcomes research, which will have a direct impact on patient care. The cells that the researchers are focused on are Tregs, a small population of lymphocytes that suppress the activity of other immune cells. They maintain normal immune system homeostasis and safeguard against autoimmune diseases, and their immunosuppressive properties also can be harnessed to control transplant rejection.

Tregs have the potential to induce long-term donor-specific tolerance without impeding desired immune responses to pathogens and tumors in transplant patients.

The principal investigator of the study is Flavio Vincenti, M.D., UCSF professor of medicine and a kidney and pancreas transplant specialist at UCSF Medical Center. Other participating institutions are Emory University and Cedars-Sinai Medical Center.

“This grant allows us to work toward achieving two important advances in the transplant field,” said Vincenti. “We can introduce personalized medicine by treating patients based on molecular profiling of their kidney. We also can allow control of the response to the transplant by the patients’ own immune systems by regulatory T cells, either through infusions or pharmacologically.”

Researchers believe inflammation can be controlled in kidney transplant recipients by increasing the number or activity of Tregs, either by infusing them into the body or by blocking interleukin 6 (IL6) with the drug tocilizumab.

To do so, they will conduct two clinical trials — Treg Adaptive therapy in Subclinical inflammation in Kidney transplantation, or TASK, and Therapy to Reduce Allograft Inflammation with IL6 inhibition, called TRAIL.

The trials will involve expert clinical investigators, translational Treg biologists and mechanistic core researchers. The four selected transplant centers are noted for high-quality patient care, high patient volume and the necessary translational infrastructure to ensure successful recruitment. In fact, there already are pre-existing, productive working relationships among the transplant centers and investigators.

Learn more on UAB’s research efforts to help transplanted patients keep their organ permanently and listen to Mannon’s podcast on kidney research at UAB’s The Mix.

via UAB – UAB News – $17 million multi-institutional grant to maximize kidney transplant survival.