2016's Biggest Medical Science Revolutions

Pennsylvania: In the grand scheme of things, it can seem like progress in science and medicine moves pretty slow. For example, we still aren’t sure what causes premature birth, or why racial disparities exist in certain conditions. And, for all intents and purposes, Alzheimer’s is still a big black box. But in reality, when you put science and medicine under the microscope, you find that a single year can bring big, meaningful gains and exciting advances. So, as we welcome a brand new year, let’s pause to reflect on some of Penn Medicine’s biggest newsmakers from the last 12 months.

Low-potassium diet increases risk of losing donor kidney

Groningen: Patients who eat a low-potassium diet after a kidney transplantation have a higher risk of losing function of the donated kidney and dying prematurely. These are the conclusions of researchers from the department of Nephrology/Internal Medicine at the UMCG. The results of their research are today published in The American Journal of Clinical Nutrition.

Will head transplants create an entirely new person?

TheConversation: The world’s first full head transplant could take place as soon as 2017 if the controversial plans by Italian neuroscientist Dr Sergio Canavero come to pass. Wheelchair-bound Valery Spiridonov, who has the muscle-wasting Werdnig Hoffman disease, has volunteered to have his head transplanted onto a healthy body in a day-long operation.

Researchers discover molecule that accelerates tissue regeneration after bone marrow transplants

Dallas: A joint investigation including UT Southwestern Medical Center has found a molecule that may play a significant role in accelerating cell recovery following bone marrow transplants, liver disease, and colon disease. The collaborative effort by UT Southwestern, Case Western Reserve University, and the University of Kentucky identified an enzyme named 15-PGDH that regulates tissue regeneration in multiple organs. By blocking 15–PGDH in mice with the newly discovered molecule, SW033291, the researchers found that they can rescue damaged bone marrow, liver tissue, and colon tissue. Tissue regeneration is important to recovery from injury, disease, and certain medical treatments.

Tissue ‘scaffold’ technology could help rebuild large organs

Bristol: Scientists have developed a new tissue ‘scaffold’ technology that could one day enable the engineering of large organs. Research led by the Universities of Bristol and Liverpool has shown that it is possible to combine cells with a special scaffold to produce living tissue in the laboratory. It is hoped this can then be implanted into patients as a way of replacing diseased parts of the body. Until now, the approach has generally been limited to growing small pieces of tissue, as larger dimensions reduce the oxygen supply to the cells in the centre.

Teams from Houston Methodist Hospital and The University of Texas perform first multi-organ transplant that includes skull and scalp

Houston: Surgical teams from Houston Methodist Hospital and The University of Texas MD Anderson Cancer Center successfully transplanted, for the first time, a scalp and skull while performing kidney and pancreas transplants. James Boysen, a 55-year-old software developer from Austin, Texas, is the first patient to receive the simultaneous craniofacial tissue transplant together with solid organ transplants. "This has been a long journey, and I am so grateful to all the doctors who performed my transplants," Boysen said. "I’m amazed at how great I feel and am forever grateful that I have another chance to get back to doing the things I love and be with the people I love."

Sixth kidney transplantation for a woman in France with help of a new drug

A woman received a sixth kidney transplant, a "surgical prowess" and a first in France, conducted at the Necker Children's Hospital, said the Paris Hospital Group AP-HP. This new procedure, which lasted five hours, was made possible by the arrival of a new drug that neutralizes the rare disease afflicting the patient, preventing the destruction of the transplanted organ. Followed since the age of five, the age of five, the patient alternated throughout his life periods of dialysis and kidney transplants, some lost very rapidly because of a recurrence of his illness.

Building replacement kidneys in the lab

Wake Forest: Researchers at Wake Forest Baptist Medical Center report progress in their quest to build replacement kidneys in the lab. The teams’ goal is to make use of the more than 2,600 kidneys that are donated each year, but must be discarded due to abnormalities and other factors. The scientists aim to “recycle” these organs to engineer tailor-made replacement kidneys for patients.

Don’t blame families for low organ donation rates, fix the system

TheConversation: Despite more than A$250 million of investment into organ donation programs since 2008, transplant rates have not increased as quickly as the government had hoped. A private consulting firm will now review the nation’s organ donation and transplantation program to investigate what else can be done. One issue at play is the claim that 37% of families override their loved ones' wishes in more than one-third of cases, which is much higher than international rates.

Study Suggests Acute Injured Kidneys can be considered for Transplant

Mayo Clinic: The shortage of kidneys needed for organ transplantation in the U.S. can be alleviated in part by using select kidneys with Acute Kidney Injury (AKI), resulting in safe and positive outcomes, according to research conducted at Mayo Clinic in Arizona. Results of the single-site study, led by Raymond Heilman, M.D., Chair of the Division of Nephrology, suggest that acutely injured kidneys from deceased donors can be considered for transplantation — reconsidering previous thinking that such kidneys should be discarded.
Kidneys can result in acute injury when the organ ceases to function, generally caused by heavy blood loss, severe infection, extreme dehydration and some medications.  At the same time, according to Dr. Heilman, “The kidney has a remarkable ability to regenerate parts of the organ that weren’t working.”

Purging a virus from organ transplants

Lausanne: Scientists have discovered the switch that can awake a dormant cytomegalovirus, a dreadful pathogen in immuno-compromised patients. The switch can be controlled with common drugs, opening a new strategy for purging the virus from organ transplants. Human cytomegalovirus (HCMV) is an extremely common herpes-family virus that infects people for life. It infects 60% of the population in industrialized countries, and almost everybody in poorer regions. Its symptoms are easily fought off by a healthy immune system, but can be devastating to individuals with defective immunity, e.g. newborn babies, people with AIDS, or those taking immunosuppressive drugs after receiving organ transplants. After infection, HCMV hides ("lies dormant") in blood-making stem cells, occasionally reactivating as these cells mature.

Cell transplant therapy can help people with diabetes

Edinburgh: People with Type 1 diabetes are being helped by a transplant therapy that uses cells from the pancreas, a study shows. Patients who have received the cells from donor organs have shown an improved quality of life, University researchers say.

The technique aims to combat hypoglycaemia - a drop in blood sugar triggered in patients on insulin treatment, which can prove fatal.

New hope for kidney disease

Monash: Researchers have made a discovery that could see patients with kidney disease no longer having to resort to dialysis or kidney transplants.

Even injured kidneys can be used for transplants

Yale: Kidneys from deceased donors that have acute injuries are frequently discarded instead of being used for transplant. However, a Yale-led study finds that such kidneys may be more viable than previously thought, and should be considered to meet the growing demand for organ transplants.

Immunological successes drive transplants forward

Karolinska: Recent years have seen many breakthroughs within immunology and the effects of these are now being seen in clinics. At a conference at the Swedish medical university Karolinska Institutet we will hear about how this new knowledge is being used to understand diabetes and treat cancer. New possibilities are also opening up for  sorts of transplants – not just of internal organs but also of arms.

Baylor-led study examines lung transplantation outcomes since implementation of need-based organ allocation system

Baylor: A study led by researchers at Baylor College of Medicine has revealed that since the implementation in 2005 of a medical need-based allocation system for donor lungs, double-lung transplantation has been associated with better graft survival than single-lung transplantation in patients with idiopathic pulmonary fibrosis (IPF). However, there has been no survival difference between double- and single-lung transplant recipients in patients with chronic obstructive pulmonary disease, or COPD.

Gentler treatment effective for many with graft-vs.-host disease

Hutchinson Center. US: A new study finds halving standard steroid dose treats most acute Graft Versus Host Disease just as well; could limit dangerous side effects.

Transplant patients have high rate of cancer death

University od Adelaide. Australia: Researchers at the University of Adelaide are working to better understand how patients who receive life-saving organ transplants can be spared from dying of cancer many years later. Transplant patients are 3-5 times more likely to develop cancer than the general population.  For example, one third of Australian kidney transplant patients will eventually die of cancer many years after their surgery – and a third of these deaths are due to skin cancer.

Growing number of donor hearts rejected while need for transplants rises, study finds

Stanford University. US: A new study has found that improving scientific guidelines to determine whether a donor heart is acceptable for transplant will help save the lives of patients with deadly heart disease.

Growing number of donor hearts rejected while need for transplants rises, study finds

Stanford University. US: A new study has found that improving scientific guidelines to determine whether a donor heart is acceptable for transplant will help save the lives of patients with deadly heart disease.