Tuesday, January 25, 2011

The Transplant Web

The most recent issue of AJT, under AJT report discusses the Transplant web and what is on the web for transplantation. It discusses many issues that pertain social media and transplantation. It brings home key points that patients are using the internet for their information and physicians are to be aware of that.  Social media can be a very good and powerful tool to discuss and teach physicians, students and patients. Many centers around the country are using it.  Mayo Clinic has a social media center.  What our role is to make sure patients are looking at association driven or university based websites that have peer reviewed material and accurate information. There is a lot out there -- perhaps that instills a "blogger's bias".

Check it out

Friday, January 21, 2011

Fibrosis with Inflammation at One Year Predicts Transplant Functional Decline

At the ASN 2010, there was an abstract regarding the role of fibrosis and inflammation at one year to predict transplant survival. Kidney transplants with both interstitial fibrosis and subclinical inflammation but not fibrosis alone after 1 year have reduced survival. This study tested whether fibrosis with inflammation at 1 year associates with decline of renal function in a low-risk cohort and characterized the nature of the inflammation.
A group of patients with their biopsies were studied. Over-expression of toll-like receptor signaling, antigen presentation/dendritic cell maturation, interferon production and cytotoxic T lymphocyte-associated and acute rejection-associated genes were noted more in the ones with increased fibrosis. Therefore, the combination of fibrosis and inflammation in 1-year protocol biopsies associates with reduced graft function and survival as well as a rejection-like gene expression signature, even among recipients with no clinical risk factors for poor outcomes.
The abstract can be found at Nephrology Now as well

NSLIJ - Innate B Cell in Humans that Protects Against Infections

NSLIJ - Innate B Cell in Humans that Protects Against Infections

Tuesday, January 11, 2011

Quiz 9 Answers

Which of these statements is TRUE regarding living donor related transplantation in Fabry's Disease?

Renal Transplantation from a heterozygote female relative into a patient with Fabry is risky as globotriaosylceramide accumulation might be present in this donor, without clinical symptoms ( is a true statement)
The measurement of Alpha galactosidase A activity in a potential female living related donor for a patient with Fabry's is not sufficient as a normal value cannot exclude a random X chromosome inactivation( is a true statement as well)
Living related transplantation is possible in donors who do not have the mutation.( this is true)
One has to be careful with male donors as late onset Fabry's disease exists in males and they 
develop proteinuria and renal failure after age of 25 years.( this is true)
Demonstration that the recipient's gene mutation is absent in the potential female relative donor is required before living related transplantation is performed in a patient with Fabry's ( also true)
Hence the answer is all of the above

Check out the Nature Review Nephrology Dec 2010 edition for Kidney Transplantation evals in Hereditary Nephropathies

Wednesday, January 5, 2011

Can Alcohol Consumption be protective post transplant?

One study presented at the recent ASN 2010 at Denver found that alcohol consumption in moderation was indicative of lesser incidence of post transplant diabetes (NODAT). The investigators argue that the belief of interactions with medications might be false and without evidence. Not only did they show that it was a decreased NODAT risk but also decreased risk of death post transplant.  So kind of similar to the general population.  
Check out Renal and Urology news's website for a video on the presenter at ASN 2010