Immunologists Develop Method

To Decrease Rejections

Of Kidney Transplants

A nephrologist has found that a specialized type of anti-rejection therapy using intravenous immunoglobulin can make kidney transplants possible for patients with high ‘anti-donor’ antibodies. 25 to 30 percent of patients on the kidney transplant list could benefit from this therapy. Tissue compatibility issues exist with any organ transplant, but the risk is greatly increased for those with high exposure to antigens received through blood transfusions, previous transplantation, or even pregnancy.

Seventy-thousand Americans are waiting for a kidney transplant. A third of them are parked on dialysis because their antibody levels are too high for a transplant. But that’s no longer a barrier for some people.

“I used to just sit around and throw up,” says former dialysis patient Soraya Kohanzadeh.

Dialysis is something Kohanzadeh would rather forget, but if telling her story saves lives, it’s worth it.

Kohanzadeh — like many kidney failure patients — developed high levels of “anti-donor” antibodies through blood transfusions. Her highly sensitized immune system would likely reject any donated kidney.

“Essentially, she would have a very short, sick life on dialysis,” says Joan Lando, Kohanzadeh’s mother.

But Kohanzadeh is no longer here, thanks to intravenous immunoglobulin therapy or IVIG. Here’s how it works: during dialysis, patients are given blood containing a mix of immunoglobulins, which “turn-off” the anti-donor antibodies’ attack response without suppressing the patient’s immune system.

“A significant other comes forward, donates an organ, and there’s an incompatibility there. We can treat the patient and remove those antibodies. Then the transplant can be done,” Stanley Jordan, M.D., director of nephrology at Cedars-Sinai Medical Center in Los Angeles.

More than a year after surgery, Lando’s kidney keeps her daughter alive.

“It was sort of shocking to think I wasn’t going to have to be sick forever,” Kohanzadeh says.

Through their website, this mother-daughter team works to spread the word of a little known therapy that could save thousands in need of a kidney. IVIG is covered by Medicare and can be used in both living and cadaver-donor transplants. Nearly 30 percent of patients on the kidney transplant list might benefit from this therapy.

To learn more go to www.sevenluckystars.com

BACKGROUND: About one-third of kidney patients are often told they cannot have a transplant even if they have a donor with an otherwise perfectly matched tissue and blood type. Their anti-donor antibody levels are so high that any transplanted organ would be rejected by their highly sensitized immune system. Now there is a specialized type of anti-rejection therapy using intravenous immunoglobin (IVIG), which injects antibodies from healthy people into the blood supply, to modulate the immune system without suppressing it. This makes kidney transplant possible for as much as 25-30% of this group of patients, who would otherwise not be eligible for a transplant because of their high antibody levels.

DEALING WITH REJECTION: Tissue compatibility is an issue for all patients receiving organ transplants, but rejection risks are much higher for those with high exposure to human leukocyte antigens (HLAs) that are not produced by their own bodies. Exposure may be the result of blood transfusions, previous transplantation, or even pregnancy if the mother is exposed to the father’s antigens, which are then expressed in the cells of the developing fetus. The immune system is then ’sensitized’ to those antigens — primed with antibodies that attack any foreign tissue, even if the antigens arrive in the form of a life-saving donated organ.

ABOUT IVIG: IVIG modulates the immune system without suppressing it. In fact, the therapy actually boosts the immune system because the antibodies found in IVIG help fend off infections — a common post-surgery complication. For the most highly sensitized patients, IVIG is combined with a new drug, Rituxan, which reduces treatment time from four months to one before transplantation. The therapy can be used in both living-donor and cadaver-donor transplants. In the late 1980s. Dr. Stanley C. Jordan pioneered the use of IVIG as a way to reduce organ rejection among highly sensitized patients. It is now a fully accepted, Medicare-approved therapy as of 2004, when it was found to be effective in a multi-center study partly funded by the National Institutes of Health.

WHAT IS DIALYSIS? Hemodialysis is a treatment for end stage renal disease (ESRD), or kidney failure, in which blood is removed from the body, filtered through an artificial kidney and then the cleaned blood is returned to the body. In the US, hemodialysis is the most common treatment for people who have kidney failure. However, dialysis is also a painful, expensive procedure, and while it cleans the blood well enough to maintain existence, it does little to improve a patient’s overall quality of life. Also, data shows that if patients get a transplant before they get to the point of dialysis, they do better in the longer term.

Sourced and published by Henry Sapiecha 12th June 2010

The Rolling Stones changed lives. So do kidney stones. Both can make you keel over like a rugby player who’s been kneed in the groin (for different reasons). Traditionally, keeping stones at bay (kidney stones, not the Rolling Stones) meant treating your body like an empty swimming pool and flooding it with water to flush it out.

That’s still a good idea. But now, there’s also evidence that a little addition and subtraction can dramatically reduce your risk for the stones that create intense pain (and we mean intense) in your lower back and side when you urinate:

What to add: Vegetables, nuts, legumes, nonfat dairy products and 100 percent whole grains. Pile ‘em on.

What to subtract: Sodium, sweetened beverages, and red and processed meats.

What it gets you: People who ate this way had a gigantic 40 percent to 45 percent reduction in kidney-stone risk (men saw the higher drop in risk).

Even niftier about this whole equation (even if you don’t like math) is that the diet the stone-free people were eating was similar to the DASH diet.

That simple diet has been shown to lower blood pressure — a major health boost, since high blood pressure will be responsible for more than 60,000 deaths this year in the U.S. alone.

The diet is also rich in nutrients the rest of your body loves for other reasons, and low in the stuff that treats your body the way pigeons do a statue. So add a little, subtract a little and reap the rewards.

Sourced and published by Henry Sapiecha 8th Sept 2009

One million Americans suffer heart attacks every year. Quickly getting their arteries propped open with stents saves lives, studies have found. But millions more develop heart symptoms gradually. Usually it comes in the form of angina, a squeezing pain in the chest or arms caused by clogged arteries that starve the heart muscle of oxygen. The pain comes with exercise or stress, and then goes away.

People often assume they need a stent to get that artery opened up right away–or else. But new results from two big trials are unambiguous: The high-tech procedures don’t save lives or prevent heart attacks for most patients with stable symptoms. “It doesn’t do anything to lower risk of subsequent death or heart attack,” says William Boden, a cardiologist at the State University of New York at Buffalo who led one of the trials. Drug treatment alone is just as effective.

The reason for this counterintuitive result is that most heart attacks don’t occur at the locations that appear most clogged on an angiogram. Instead, heart attacks happen when lesser narrowings become inflamed and suddenly rupture, spewing a clot into the bloodstream. The blockage that bursts isn’t necessarily the one that causes symptoms. People think heart disease “is just a plumbing issue, that clogged pipes mean an impending heart attack,” says James Stein of the University of Wisconsin at Madison. “A stent is just a local therapy for a systemic problem.”

Stents are installed during angioplasty, in which a balloon is used to unclog an artery. They are necessary if drugs cannot produce enough pain relief, say cardiologists. One of the two trials found that 66 out of 100 patients who received a stent were angina free after a year versus 58 out of 100 who received only drugs; that difference faded after five years.

Another study published in June comparing stents to drugs in diabetic heart patients found no difference in the risk of death or heart attacks, and only a little over 40% of those assigned drugs later got a stent. A more clogged-up group received either drugs or cardiac bypass surgery, in which veins are used to bypass blocked arteries. The bypass patients didn’t live longer but did have fewer nonfatal heart attacks. “I think physicians will be more likely to consider bypass for their diabetic patients and steer away from angioplasty,” says study author Sheryl Kelsey of the University of Pittsburgh.

One diabetic patient who did well without a stent is Earl Anderson of Old Bridge, N.J. The 62-year-old retired FBI agent first felt chest pains while rushing to catch a plane in 2002. An angiogram revealed a narrowing in one artery, and doctors gave him drugs. His angina soon went away and hasn’t come back. Now his cholesterol and blood sugar are down; he plays tennis weekly with his 14-year-old son

• A User’s Guide to Your Heart

• The Mystery of Sudden Cardiac Arrest

• Fighting Heart Failure

• Soothing Angina

• Your Heart: An Interactive Graphic

• Heart Disorder Afflicts Millions

• Thousands Of Children Suffer Cardiac Death

Cardiologists who install stents say that these relieve pain better than drugs and that most patients have more symptoms than Anderson. “Patients with a lot of symptoms don’t do well with drug therapy,” says Gregg Stone of New York-Presbyterian Hospital.

One reason so many stents are implanted is money. “Hospitals are paid handsomely if the patient has bypass surgery or has a stent. But they are not paid [so much] if a patient has drugs,” says cardiologist David Hillis of the UT Health Science Center in San Antonio. While generally safe, stent procedures can cause heart attacks, bleeding or even death.

Another misconception is that getting a procedure will obviate the need for drugs. “People have this impression that ‘If I get a stent, then I am not going to have to take medicine,’ and that is wrong,” says Mayo Clinic cardiologist Raymond Gibbons. “Everybody is going to get medicines. The real question: Is stenting or surgery going to bring enough benefit in addition?” Patients who get drug-coated stents often must take more drugs; they need to stay on the blood thinner Plavix for at least a year to prevent rare cases of clots forming in the stent.

One key test that is often skipped: stress tests to determine if your heart is getting enough oxygen during exercise. The problem, says Scripps Research Institute cardiologist Eric Topol: Without stress tests, doctors don’t know whether narrowings seen on an angiogram are causing problems.

Heart patients with stable symptoms have choices–and time to consider their decisions. For many of them drug therapy alone, drug therapy and stents, or drug therapy with angioplasty are all reasonable options. If you are not sure which you want, you can ask the doctor doing your angiogram to hold off on the stent if nothing alarming is found. This will give you time to discuss the result with your primary care doctor or referring cardiologist.

Prevention
Eat a healthy diet and exercise to prevent the buildup of artery plaque.

Take statins and blood pressure drugs if your doctor dictates.

Treatment
For most patients, drug therapy can reduce the risk of heart attack and treat chest pain.

A stent/angioplasty procedure can reduce chest pain but has no proved impact on survival in those with stable symptoms.

Sourced and published by Henry Sapiecha 28th June 2009

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Sourced and published by Henry Sapiecha 25th June 2009

New Research Uncovers Amazing Brain Saver!

Clogged arteries prevent blood supply to the brain. Oxygen-deprived brain cells become damaged or even die.

But when scientists induced strokes in laboratory rats and treated them with an amazingly simple nutrient—a remarkable discovery was made. Here’s what happened…

In one experiment, strokes were induced in laboratory rats by blocking the carotid artery for 30 minutes. Once blood flow and oxygen were restored, there was a burst in the production of free radicals. This overwhelmed the brain’s antioxidant defenses and killed 80% of the rats within 24 hours.

In a follow-up experiment, everything was the same, except this time, researchers injected a powerful antioxidant into the rats before blood and oxygen was restored. After a 24 hour period—only 25% of the rats died. The remaining 75% made a full recovery. Further study concluded the brain of the antioxidant-treated rats showed no signs of a stroke at all!

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Sourced and published by Henry Sapiecha 25th June 2009

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