Discover and read the best of Twitter Threads about #kidneytransplant

Most recents (6)

1/ Inspired by this exchange between @kidney_boy and @dreliotheher, here is my first ever #tweeetorial: the issues with the current #kidney allocation system in the U.S., based mainly on the work of @SumitMohanMD and Jesse Schold, and inspired by my jetlag #KidneyTransplant
@kidney_boy @dreliotheher @SumitMohanMD 2/ >100,000 patients on the kidney waiting list. Each year, >10K die or removed from the wait list without a transplant. Those who do not get a transplant have worse survival, quality of life, and cost to health care system. optn.transplant.hrsa.gov/data/view-data…
@kidney_boy @dreliotheher @SumitMohanMD 3/ Q: What % of kidneys procured FOR THE PURPOSE OF TRANSPLANTATION is not used for a transplant?
Read 19 tweets
1/ A continuation #tweetorial from my last one introducing human leukocyte antigen (#HLA) , the cell surface antigen...

Below, let's briefly review basics of #Luminex testing & "cross-matching."

What/who is Luminex?
2/ In this #tweetorial, we'll answer 3Qs that help us assess a #kidneytransplant recipient's immunological risk:

1. Does this recipient have #DSA* (against HLA-antigens) ?
2. Can the antibodies bind?
3. Can the antibodies activate complement?

*DSA: donor specific antibodies
3/ Q1: How do know if the recipient's serum contains DSA against HLA-antigens?

A1: #Luminex testing, a solid-phase (BEAD) based assay. To perform the test, take the recipient's serum and pipette it into multiple wells - each well has beads coated with #HLA antigens...
Read 12 tweets
1/ A short #tweetorial introducing human leukocyte antigen (HLA) and typing...an important and often confusing topic in #transplantation #kidneytransplant

#FOAMed @MedTweetorials

What is an "HLA"?
2/

HLAs = cell surface proteins encoded by highly polymorphic major histocompatibility complex (MHC) genes on Ch 6 🧬

In #transplantation, HLA proteins are #polymorphic antigens ➡️ alloreactive trigger for the immune response ➡️ can ultimately lead to organ #rejection ☠️
3/ The 2 primary classes of MHC molecules are 1⃣ and 2⃣.

Class 1⃣ MHC are found on the cell surface of ALL nucleated cells + platelets. Their role is to present intracelleular peptide fragments to CD8 #Tcells
Read 8 tweets
1/ Continuing the #immunosuppression #tweetorial series...@MedTweetorials

Today's player: #mTORi, mammalian/mechanistic target of rapamcyin inhibitors

Rapamcyin was @US_FDA approved for #kidneytransplant in 2003.

It was isolated from a soil sample from which island in 1975?
2/ Meet mTOR, a phosphatidylinositol 3-kinase (PI3)-related kinase (adds a phos). mTOR adds a phosphoryl group to serine/threonine residues.

It is a key component of the complexes mTORC1 and mTORC 2 - which regulate processes including cell growth, proliferation, and survival.
3/ mTOR inhibition blocks "Signal 3" of #TCell activation - reducing cytokine dependent cell proliferation and activation.

Take a look at all 3 signals below 👇🏽

nejm.org/doi/full/10.10…
Read 11 tweets
1/

A brief #tweetorial on the calcineurin inhibitors #CNI and their toxicities. Let's start with a quick poll.

Which of the following describes the main mechanism of action of #CNI?
2/

On to the mechanism of #CNI. Calcineurin inhibitors bind to the "immunophiliins" for which they are named. Cyclosporine (CsA) binds cyclophilin and tacrolimius(FK506) binds FK binding protein.

The CNI-immunophilin complex is the superhero which then inhibits calcineurin
3/
Meet calcineurin, whose superpower is a calcium-dependent PHOSPHATASE: enzyme that uses H2O to cleave phosphoric acid into a phosphate ion and an alcohol (read: removes phos)

Normally, calcineurin dephosphorylates NFAT - allowing it to freely swim into the nucleus.
Read 10 tweets
Today is #WorldKidneyDay, so here is a thread about living on #dialysis & #OrganDonation. My name is Belinda Otas. I’m #African. I’m #Nigerian. I'm #Benin. I’m #British & I’m #Black. Beyond the nationalities or passports with my name, I also believe in our shared humanity.
I was 16, when I was diagnosed with End Stage Renal Failure (ESRF.) I had no idea what was happening to me because at the time, it made no sense. However, I remember the pain of that period like noonday. I lived on dialysis until i was 22. #dialysis #OrganDonation #renalhealth
It took over my teenage years. I don’t remember having much of a life as a teenager because dialysis was 3x a week & every session was 4hrs. Add the time it takes to recover from being exhausted by the process, my day was pretty much over. #dialysis #OrganDonation #renalhealth
Read 70 tweets

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