Thursday, April 26, 2012


Add kidneys to list of things that can be recycled


 (AP) — It turns out you can recycle just about anything these days — even kidneys and other organs donated for transplants.
Recently in Chicago, in what is believed to be the first documented case of its kind in the U.S., a transplanted kidney that was failing was removed from a patient while he was still alive and given to somebody else.
There have been other cases since the 1980s of transplant organsbeing used more than once, but they were rare and involved instances in which the first recipient died.
Typically when transplanted organs fail in living patients, doctors throw them away. But with more than 73,000 people awaiting transplants nationwide, some specialists say doctors should consider trying to reuse more organs to ease the severe shortage.
"The need for kidney transplantation doesn't match our capacity," said Dr. Lorenzo Gallon, a Northwestern University transplant specialist who oversaw the kidney recycling operation in Chicago. "People die on dialysis" while awaiting kidneys.
That was the possible fate awaiting two strangers. A research letter describing the unusual case was published in Thursday's New England Journal of Medicine.
The donated kidney lasted just two weeks in the first patient, a 27-year-old Illinois man. The same disease that ruined his kidneys started to damage the new kidney, given to him by his sister. He was getting sicker, and doctors needed to act fast if they were going to save the organ. With permission from the man and his sister, they removed it last July and retransplanted it into a 67-year-old Indiana man.
The Illinois man is back on dialysis and will probably get another transplant eventually.
Still, reusing a transplanted organ can be tricky — and riskier — because surgeons have to deal with scar tissue that typically forms around an organ as the body heals from the operation.


The re-emergence of short daily haemodialysis


DT Plus(suppl 3): iii29-iii31. doi: 10.1093/ndtplus/sfr122

Brigitte Schiller-Satellite Healthcare, Medical Affairs, San Jose, CA, USA

Abstract

Thrice weekly in-center hemodialysis is the standard of care for dialysis patients with end-stage renal disease (ESRD). However, there is ongoing debate as to whether more frequent hemodialysis, with its readier management of both toxin and fluid removal, benefits patients. New evidence from recent studies, both in center dialysis and in home haemodialysis patients, adds further confirmation of improved cardiovascular outcome and quality of life in patients undergoing short daily hemodialysis. A paradigm shift in ESRD care delivery may be facilitated due to new technology enabling daily therapy at home.

Wednesday, April 18, 2012


Discovery could help develop new treatment options for organ rejection

Nephrology News and Issues 17/4/2012
http://www.nephrologynews.com/kidney-transplant/article/discovery-could-help-develop-new-treatment-options-for-organ-rejection

Loyola researchers have reported findings about a molecule that helps ramp up the immune system in some cases and suppress it in others.
Researchers studied mouse cells grown ex vivo in laboratory dishes and focused on a molecule called transforming growth factor beta (TGF-β). TGF-β is known to be a powerful regulator of the immune response -- generally suppressing the strength of the response. In this study, however, the researchers demonstrated that TGF-β can amplify the immune response and result in a more effective targeted response under specific conditions.
 "Understanding the dual role of TGF-β could help in the development of drugs to either activate or suppress the immune system, as needed," said senior author Makio Iwashima, PhD, an associate professor in the Department of Microbiology & Immunology of Loyola University Chicago Stritch School of Medicine.
The study is published online ahead of print in the Journal of Immunology.

Thursday, April 12, 2012

To our Tamils, Skihs & Malayalees
Brothers and Sisters

Wishing you 
A Blessed and Joyous

Puthandu, Vaisakhi & Vishu

Best Wishes and Warmest Regards
Malaysian KidneySPA

Wednesday, April 11, 2012


File-Flag_of_the_Supreme_Head_of_Malaysia.svg.png

Daulat Tuanku! 
Daulat Tuanku! 
Daulat Tuanku!

Friday, April 6, 2012

Woman receives kidney from husband's mistress


Malaysian Chronicle
http://www.malaysia-chronicle.com/index.php?option=com_k2&view=item&id=31496:woman-receives-kidney-from-husbands-mistress&Itemid=4
c1904877f5c24ad4a715c49bc6f9b1f5_XL.jpg A 34-year-old Turkish woman discovered that she would die without a kidney transplant, her unlikely saviour came in the form of her husband's mistress.
Meliha Avcı's kidneys had both failed her 12 years ago, resulting in the need for dialysis three times a week, four hours per session.
During this time, her husband of 16 years, Mehmet Avcı, met another woman while accompanying his wife on a hospital trip.
After getting to know 34-year-old Ayse Imdat, Mehmet asked her to move to his mother's home, under a pretence that she was the new babysitter for the couple's son.
After his wife found out about the affair, she pleaded with her husband to marry Imdat after she died.
As Meliha's condition continued to deteriorate, Imdat made the suggestion that Meliha be saved with one of her kidneys, as the two women shared the same blood type.
Upon Imdat's insistence that she take her kidney, Meliha agreed.
"We shared a husband, and now we shared a kisney," she reportedly said.
She added that she has her husband and Imdat to thank for completely changing her life. Imdat on her part has promised to continue taking care of Meliha after the surgery.
-YourHealth, AsiaOne

Anatomic configuration affects the flow rate and diameter of porcine arteriovenous fistulae

Mahesh K Krishnamoorthy1,2, Rupak K Banerjee1,3,6, Yang Wang2, Ann K Choe4, David Rigger5 and Prabir Roy-Chaudhury2,6

  1. 1Department of Mechanical Engineering, University of Cincinnati, Cincinnati, Ohio, USA
  2. 2Division of Nephrology, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio, USA
  3. 3Department of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio, USA
  4. 4Department of Radiology, University of Cincinnati, Cincinnati, Ohio, USA
  5. 5Vascular Laboratory, University of Cincinnati, Cincinnati, Ohio, USA
Kidney International (2012) 81, 745–750; doi:10.1038/ki.2011.468; published online 22 February 2012

Abstract

Although arteriovenous fistulae are currently the preferred form of vascular access, early failure is a significant problem. Since wall shear stress is thought to play an important role in the pathogenesis of early failure, and this stress varies markedly in different fistula configurations, we assessed the influence of configuration (curved or straight) on longitudinal changes of flow rate and lumen diameter in a porcine fistula model. 

Fistulae were created in eight pigs between the femoral artery and vein, with each animal having a curved and a straight configuration on opposite sides. Velocity measurements were obtained by ultrasound at the time of surgery and at intermediate time points up to 28 days. 

Quantification of both the configuration and the internal diameter of the fistulae was determined by CT scans. The overall rate of increased flow during each time interval (0 to 2 days, 2 to 7 days, and 7 to 28 days) was more pronounced with the curved fistulae. Moreover, the luminal diameter of curved fistulae had dilated more from the time of surgery to 28 days as compared to the straight fistulae. 

Thus, anatomical configuration of fistulae plays a major role in flow-mediated dilatation. Identifying the optimal configuration may result in increased diameter and consequently blood flow, and perhaps reduce the incidence of early failure.

Tuesday, April 3, 2012

Prevalence of sleep apnea and excessive day time sleepiness in patients with end-stage renal disease on dialysis

Department of Medicine, Sleep Disorders Centre, King Saud University for Health Science, King Abdulaziz Medical City, Riyadh, Saudi Arabia

Saudi J Kidney Dis Transpl [serial online] 2012 [cited 2012 Apr 3];23:251-61

Abstract

Sleep apnea (SA) and excessive daytime sleepiness (EDS) are common sleep disorders among patients with end-stage renal disease (ESRD). This cross-sectional study, carried out in two dialysis centers in Saudi Arabia, assessed the prevalence of sleep apnea and sleepiness in Saudi patients with ESRD who are on maintenance dialysis with either peritoneal or hemodialysis. 

We used questionnaires to assess the prevalence of SA and EDS. The association between sleep apnea, EDS, and other sleep disorders, the underlying causes of renal failure, and other demo graphic data were also examined. Among 227 enrolled patients, the mean patient age was 55.7 years ΁ 17.2 years; 53.7% were male, and 46.3% were female. The overall prevalence of SA as defined by the Berlin questionnaire (BQ) was 37% in males and 34% in females, which was not a statistically significant difference (P = 0.459). Sleep apnea was significantly associated with age, neck size, afternoon and evening hemodialysis shift, obesity, diabetes, and hypertension (P-values, 0.001, 0.029, < 0.0001, < 0.0001, < 0.008, 0.002, and < 0.001, respectively). 

Sleep apnea was also significantly associated with other sleep disorders such as restless leg syndrome, insomnia, habitual snoring, and EDS (P-values, < 0.001, < 0.001, < 0.001, and < 0.001, respectively). The prevalence of EDS was 44%, and EDS was significantly more prevalent in patients undergoing peritoneal dialysis (P < 0.001); it was also associated with older age, diabetes mellitus, and other sleep disorders. SA and EDS are common in dialysis patients and are significantly associated with other sleep disorders.