Discover and read the best of Twitter Threads about #transplant

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Bell Media Confirms 2022/23 Original Programming Slate of Nearly 100 Titles, Boasting 973 Hours of English and French-Language Content. Visit @thelede_ca for more info and assets. thelede.ca/LpUmiBtw #BellMediaUpfront
Coming to @CTV from #TheOffice’s @aqfarrell and @CounterfeitPics, #Shelved is an original single-camera work-place comedy centered around the employees and patrons at the Jameson Public Library in Parkdale. For more info visit @thelede_ca thelede.ca/LpUmiBtw #BellMediaUpfront
Recently announced @CTV Original drama, #SullivansCrossing begins production this summer, with @MorganKohan, @ChadMMurray, @ScottGPatterson set to star. For more info on Bell Media Original Programming, visit @thelede_ca thelede.ca/LpUmiBtw #BellMediaUpfront
Read 18 tweets
1/Hello everyone! Welcome to this month’s #ASPNFOAM group Tweetorial, featuring BK polyomavirus (BKV) & #BKNephropathy
🚨Spoiler alert: BK does not stand for Burger King🍔. But hopefully this 🧵 has been cooked up to your liking😉.
#Medtwitter #NephTwitter #PedNeph @ASPNeph
2.1/ So what’s “BK” & why can’t you have it with a side of🍟?
“BK” actually stands for B.K., the initials of the Sudanese🇸🇩 kidney transplant (KT) patient in whom the virus was 1st identified back in 1971! Not that long ago if you think about it 🤔
(PMID: 4104714, 33319201)
2.2/Also:
➤BKV is a non-enveloped double-strand DNA virus.
➤Primary infection occurs through respiratory secretions, mainly asymptomatic.
➤It infects urothelial and tubular cells in a non-replicative latent phase.
Read 35 tweets
#OutBreak of acute #hepatitis among #children
650 probable cases of acute hepatitis of unknown
aetiology in children have been reported to WHO from 33 countries in 5 WHO Regions between 5 April and 26 May 2022.
1/
who.int/emergencies/di… Image
- Three quarters (75.4%) of cases are 5 years of age.

- Of 156 cases with information on hospital admission, 22 (14.1%) were admitted to an intensive care unit.

Of the 117 cases for which this information was available, 14 (12%) have received a liver #transplant.
2/
- Overall, 181 cases were tested for #adenovirus by any specimen type, of which 110 (60.8%) tested positive. The positivity rate was the highest in whole blood specimens (69.5%).
3/

Table. Classification of reported probable cases per country Image
Read 7 tweets
🧵 Question Abt: Transplantation and Fetal Toxicity of Immunosuppressive Drugs in Pregnancy. 1/13 #Access #ProLife #prochoice #SCT #AbortionBan #healthcare
Q: What is the medical safety net for premenopausal women that are also transplant recipients who MUST take multiple immunosuppressive drugs? 2/13

#Access #ProLife #prochoice #SCT #AbortionBan #healthcare
She can’t depend on the #pill to prevent an unwanted #pregnancy because of daily antibiotics. 3/13

#Access #ProLife #prochoice #SCT #AbortionBan #healthcare
Read 14 tweets
🧵 In the US, until recently, your chances of receiving a donated #liver w/in 30 days would vary significantly depending on where you lived—as low as 1%, or as high as 60%. Remember Steve Jobs' speedy liver transplant? He got on multiple waitlists...🧵 columbiasurgery.org/news/end-liver…
For decades, experts and providers have been pressing for a more equitable system of organ allocation, one that would even the odds between, say, a patient in a dense urban center with a long waitlist and a patient in a more rural, statistically healthier area with a short one.
For almost 50 years, the system in place was an outgrowth of informal sharing networks between doctors and medical centers, resulting in a web of organ procurement organizations (OPOs) and donation service areas (DSAs) spread out across the country. #donatelife
@UNOSNews
Read 8 tweets
#pigtransplant #Transplant
PAKISTANI HEART SURGEONS DOCTOR’S ACHIEVEMENT!
Dr. Mohammed Mansoor Mohiuddin’s efforts finally paid off on January 7, when his team at the University of Maryland School of Medicine successfully transplanted the heart of a genetically modified pig into a man suffering from a severe heart ailment.
“It was my dream, which came true. It’s something I didn’t imagine doing in my lifetime,” Mohiuddin, who is the director of the Cardiac Xenotransplantation Programme at the university, tells TRT World.
Read 4 tweets
🩸🦠 Tainted Love 🦠🩸

Covid convalescent and those vaxxed for Covid may continue to have the spike protein or the S1 subunit circulating in their blood for some time after recovery or
after💉,research studies show>
Some of those people will have a "delayed onset" reaction of Long Covid or delayed Adverse Event related to the coagulation cascade, immune response and inflammation caused by the spike protein. This may not occur for weeks or a year after 💉or after recovery from illness.>
Read 15 tweets
My sincerest & humblest apologies all! For the first time in my life, ever, 9pm, Christmas Eve & i actually just realised what day it was! 😱⚠️
No, i have no idea either but i guess that's what 2 years of near isolation can do to you (throw in painkillers, CF, fibro & depression)
Never assume that because you don't hear from someone everything is ok (the old, "no news is good news" {as all must be ok!}, they're just busy! Especially when it's such a landmark day & ppl are invariably wrapped up with their families. That's not always the case!
Why am i isolating at Christmas? 2 reasons:
🔵 many NHS staff appear to be falling ill despite being triple jabbed &
🔵 Studies seem to be showing effectiveness behind to wane a bit after 10 weeks.

So do you go meet your elderly mum, who's allowing my nephew to shuttle between..
Read 10 tweets
🧵1/5 #UKchildren 💔I’ve lost track the number of times this kind of “but…”argument is used where (all ages) covid death figures are concerned- but they were old, but they had serious health problems, but they were obese… it feeds down the flow chart of u can ignore covid b’cos
..2/ at the results end of the flow chart we have personal choice trumps severe health risks, eugenics, getting told to f-off on SM when raising issues for CEV community, valid concerns dismissed as hysteria or anxiety, stay indoors & keep the hazmat suit on etc etc….
3/ the longer covid drags on thanks to these ignorant, hurtful,discriminatory takes, the gloomier the outlook gets, yet doom & gloom is what those wanting to suppress covid were accused of. Having #asthma, #chemotherapy #transplant pt, etc your risks are waaayyy higher
Read 5 tweets
1/
👻 AKI in patients with a kidney transplant can sometimes be “SCARI”

🧵Let’s talk about an approach I recently learned to some common causes of late (>3 months) allograft dysfunction to overcome the fear together #Tweetorial #NephTwitter
2/
🎃 Allograft dysfunction is defined by a rise in serum Cr of approximately 25%

🎃 It is often asymptomatic, identified on routine blood work

🎃 It can also present with nonspecific symptoms such as nausea, vomiting or diarrhea.
3/
Let's start with a not-so-SCARI case!

👨🏽 50 y/o M with ESKD due to DM2 s/p deceased donor kidney transplant 5 yrs ago

🧪 Cr 2.0 (176 umol/L) baseline Cr 1.3 (115 umol/L). No change in urinary frequency, amount or color. No recent illness

What kidney imaging do you suggest?
Read 21 tweets
BREAKING via ⁦@washingtonpost

👉”Pfizer-BioNTech coronavirus vaccine wins full FDA approval, potentially persuading the hesitant to get a shot”

I pray this motivates others to keep my #transplant-recipient mom safe by getting vaccinated 🙏🏻🙏🏻
apple.news/APBJR6utzRUiqO…
Let the vaccine-mandate dominoes begin their cascade! nytimes.com/2021/08/23/nyr…
And another 🎖 msn.com/en-us/news/us/…
Read 3 tweets
Thread: Thoughts on #valuebased & #patientcenteredcare

Within #healthcare & #advocacy there seems to be a great deal of discussion on both #valuebased care & #PCC. #Healthcare costs have skyrocketed’ & thus a need to #reduce. I am not an #economist but as a #caregiver I 1/
definitely have seen ‘waste’. From my POV costs will continue to skyrocket even if #valuebased care is implemented. One reason (again not an economist) is the vulture ‘istic’ aspect of industries profiting from our system. The other reason is that our system is not centered 2/
around the #patient or patients needs. Thus, if the value based metric is reduced hospital admissions, this, on the face seems straight forth, however if the patients needs are not taken into account but only focused on established metric, costs could (& I will argue often r) 3/
Read 14 tweets
1/ Serious End-of-Life 🧵

…He told her, “Never give up on me because I’ll keep fighting to live.” What does it mean when a person valiantly asks this of a spouse & then illness leads to #transplant, #infection, and eventually #life support that doesn’t help?
 
#medtwitter
2/ First I just listened to her heartache and saw their immense love. “I made a #promise, Doctor.” My personal commitment became to help this couple uphold that promise, yet medical options had long since run out & failed him. I asked her to come into the hall.
 
#nursetwitter
3/ Always go out outside a pt’s room to discuss anything you don’t want the patient to hear, even when he is in a dense coma. Assume dying pts hear everything said & respect their dignity as your number one goal in all interactions. Here is what I said…
 
#PalliativeCare
Read 10 tweets
As we learn more about #COVIDvaccine #immune response in people w/ #immunedisorders, remember that not all #immunodeficiencies are created equal. You might see in the news claims about #vaccines not working in the #immunocompromised, but that's not always true. A 🧵
One of the earliest articles showed 15% of #transplant patients were Ab positive after dose 1. This increased to 54% after dose 2, but varied by medications being taken. bit.ly/3x00nyA and bit.ly/3cmfria
In #cancer patients, Ab response varied by type of cancer. Two studies showed 92-95% w/ solid tumors were Ab pos after the 2nd dose. One showed only 60% w/ hematological cancers were positive. bit.ly/34LseXc (both) bit.ly/3chrU6s (solid tumor only)
Read 7 tweets
1/A horrific patient scene today. A #kidney #transplant patient doing well since 2015. Had fall and fracture of foot. Underwent surgery,improving. Asked for physio sessions to continue at home. Asks around,finds #ayurvedic traditional healer. He does external works.
2/ patient feels better. #Ayurveda healer gets his trust. Says post transplant infections and diabetes worsen (patient was already diabetic kidney disease for which transplant was done). Says #natural is safest way. Patient falls for healers confidence. Starts #herbal drugs.
3/ Drugs and potions prepared at home from locally sourced plants. Small fee Healer also advise nutritional changes. More like starvation. No proteins. Remember patient is post kidney transplant. #weightloss in 1 mo. Loss of appetite in 2 months. Then came something unexpected.
Read 9 tweets
Delighted to share a new study from our lab on the role of gut commensal fungi mycobiota in shaping the human protective IgG antibody repertoire @CellCellPress cell.com/cell/fulltext/…
During immunosuppression ( organ #Transplant #chemotherapy ) or in diseases such as #IBD #crohnsdisease, gut #mycobiota can turn into a “reservoir” of pathogens, BUT most people live peacefully with their fungi. Do they benefit from them? Do fungi benefit form us? Neutral rl.?
Fungi are considered a minor component of the gut #microbiome ( less than 0.1% of genetic material in feces), but we found that fungal biomass in the healthy human gut makes considerably more: up to 2%.
Read 13 tweets
#ToughTxCase I am going to start an educational series for #transplant professionals/trainees on complex cases I have the privilege to see @UWHealth Patients have provided informed consent for us to discuss their condition in order to help other similar cases @uw_nephrology
#ToughTxCase #1 is the story of Tom, a 73 year old man, who received a living unrelated #kidney tx for #ESRD due to an unknown etiology. Low immunological risk, VXM (-), #CMV D+/R-, basiliximab induction, standard TAC/MPA/P maintenance Rx on Valgan prophylaxis x 6M @TxPharmD
At his 3M visit, Tom complains of #diarrhea, weight loss (4 lbs in 1 month) and poor energy. His kidney fxn is at baseline Scr 1.3 mg/dL. What is the most likely diagnosis? Please feel free to discuss! @uw_IMresidency @askrenal @Nephro_Sparks
Read 35 tweets
My attempt on "Decoding the HLA" with tweetorial & some slides/VisualArts @kidney_boy @NSMCInternship @Nephro_Sparks @hswapnil @rheault_m @RenalFellowNtwk @ssfarouk #Transplant
1/
💥MHC complex
⚡️cluster of genes--> encodes HLA molecules
⚡️located on chromosome 6p21
⚡️over 200 genes; of which 40% involved in immune response
2/
💥HLA Genes:
⚡️main function is immune regulation
⚡️major barrier to transplant
⚡️gene products are histocompatibility molecules
⚡️highly polymorphic
⚡️significant linkage disequilibrium 👇
3/
Read 18 tweets
#crazy Useless #patient

1/n
Middle-aged man, loves his #family, #farming, drives a cab, #happy. Son & wife at #home. Father-son relationship strong as rock. One #morning, son finds father mumbling to self. Mother says he hardly slept
Mumbling becomes angry ramblings. #Clinical LAENNEC WAS TAUGHT THE IMPO...
2/n
Has very little #breakfast. Walks excessively. Goes and lies down, only to get up and walk again. Family interactions little. Sleeps well for 2 hours from 12 to 2PM. Lunchtime. Groggy #father gets on the lunch table and defecates near plates and food. Son and mother aghast.
3/n
Father has gone mad. Calls the friendly neighbor, brings his car, rushes to #Medical specialty #clinic nearby. Father disoriented. Son gets the Fword from his own father multiple times, he is shocked! Then comes hurling of abuses after which they restrain him in the car.
Read 15 tweets
Meet Kevin Hendrawan, the PhD Student from the @SVH_BSCCR lab at St Vincent's Centre for Applied Medical Research @UNSW, the researcher helping us understand how people with #multiplesclerosis may benefit from stem cell transplantation

A thread 👇

#stemcells #transplant #Tregs Image
While our immune system is important for eliminating harmful foreign molecules and/or pathogens (like the virus causing COVID-19), it is equally important that it does not attack our own cells and organs (which is what occurs in autoimmune diseases).
This delicate balance is, in part, maintained by immune-suppressive cells known as T regulatory cells (Tregs).

(📸: blog.quartzy.com/iq_biosciences…) Image
Read 12 tweets
(1/3) Amazing case study in the American Journal of #Transplantation:

A kidney #transplant patient was being treated for metastatic cancer using a checkpoint inhibitor, which caused the patient's immune system to reject the kidney (...)

onlinelibrary.wiley.com/doi/abs/10.111…
(2/3) After experiencing a complete response, the patient was re-transplanted with a second kidney. This second graft was monitored for rejection using a novel #liquid #biopsy.

This is the first time, to my knowledge, a patient beat cancer and active organ rejection.
(3/3) We think liquid biopsies will fundamentally change the transplant space, allowing doctors to precisely dial #immunosuppressive medication, anticipate organ rejection, and monitor organ health, using a non-invasive approach.
Read 3 tweets
Did my fellows' curriculum lecture today, "Images in #Nephrology"
Thought of sharing the slides as a tweetorial. Goal is to present some 'classic' images that aid in kidney-related diagnoses. Not exhaustive; plan to make 2nd part as well.
#MedEd #FOAMed Not much POCUS involved!
1st question. Classic image but rarely encountered. Note the super high blood urea nitrogen and serum creatinine.
Here is the answer.....
Read 61 tweets
Clinical Pearl of the day:
#transplant #pearl

Drug-induced HTN is VERY common in txp-pts 2/2 Calcineurin inhibitors & corticosteroids. 💊

Dihydropyridine CCB (amlodipine/nifedipine) are tx of choice given they can ⤵️CNI induced renal vasoconstriction&↗️ graft function 👍
Although they do not cause nephrotoxicity, be aware of the compounded ADRs with CNIs & steroids with CCBs

🛑CsA+CCB⤴️gingival hyperplasia👄
🚷Steroids + CCB ⤴️ pedal edema

🛑 DO NOT USE NON-dihydropyridine CCBs (verapamil/diltiazem) ➡️⬆️⬆️CNI LEVELS ‼️

#cardiology #cards
Shout out to @stormigale for the amazing review on therapeutic drug classes for HTN in transplant patients last week in the @accpcardprn webinar!
Read 3 tweets
1/ I note with deep sorrow the passing of .@MarkARKleiman, an early mentor and longtime friend of mine. Mark set the bar high for intellectual honesty and creative thinking about hard problems, especially in the #criminal #justice and #drug #policy areas...
@MarkARKleiman 2/ @.MarkARKleiman hired me for my first substantive job as his research assistant at .@Harvard's Kennedy School of #Government and as part of his then-nascent consulting firm, BOTEC Analysis, in 1984. He was unrelenting about putting data first...
@MarkARKleiman @Harvard 3/ ...fearlessly following facts wherever they may lead. He hosted a blog called The Reality-Based Community, samefacts.com, the tagline of which is "Everyone is entitled to his opinion, but not his own facts."
Read 10 tweets

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