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Mayo Clinic’s Week at #WSCS13 in San Diego

Posted on December 16th, 2013 by Jason Pratt

WSCS13 sunset banner

Mayo Clinic – Fifty Years of Kidney Transplants – Part III

Posted on November 25th, 2013 by Admin

The Numbers, for the Record

Candidates on waiting list for kidneys for transplant (national) - Approximately 97,000

Kidney Transplants at Mayo Clinic

Mayo Clinic - Number of Kidney Transplants (as of June 30, 2013)

Rochester ( since 1963) - 4,822

Arizona (since 1999) -  1,974

Florida (since 2000) -  1,186

Kidney transplant patients at Mayo Clinic are cared for after surgery at special houses. The first, on the Rochester, Minn., campus was called the Gift of Life Transplant House.

Rochester businessman Ed Pompeian knew the personal difficulties of kidney transplants as he worked to create the Gift of Life Transplant House. He had undergone two transplants.

Pompeian envisioned a home-away-from-home atmosphere, to be shared by patients who needed a place to stay while at Mayo Clinic for transplant surgeries. The Gift of Life Transplant House opened in Rochester, Minn., in December 1984. In the past three decades it has expanded into the nation’s largest transplant house program with 84 rooms in two complexes.

A patient may be accompanied by one caregiver. The house offers common facilities that encourage interaction and support among guests. There is a minimal fee for staying at the house, easing the financial burdens on patients.

Similar residences at Mayo campuses in Florida and Arizona also welcome transplant patients.

 

 

 

 

Mayo Clinic and 50 Years of Kidney Transplants – Part II

Posted on November 25th, 2013 by Admin

[Editor's note: We recently looked at benchmarks in kidney transplant history. Today more on the kidney and why it's so important.]

The Kidney’s Critical Role

The kidney’s well-being is essential for the rest of the body. It acts as the main filtering system for wastes and the major factor in excreting them from the body.

With each heartbeat, about one-fifth of the blood supply floods into the kidney. The organ contains enormous numbers of “nephrons’’ containing microscopic tubes. They are sized precisely to strain undesirable waste chemicals from the blood stream.

Each human has two kidneys and easily can survive with a single one. But various genetic diseases, infections or poisons can destroy the nephrons in both kidneys.

Once the kidneys are incapacitated, the damage is life- threatening. Doctors today can offer two main treatments to patients with terminal renal disease – transplantation or dialysis.

Although individual cases differ, Mayo Clinic doctors tend to favor transplants because of better and longer-lasting results. Kidney transplants can be performed at almost any age.

Medical Advances that Made a Difference Over 50 Years

Kidney transplant surgeries are possible due to ongoing, significant biomedical advances. Perhaps the single most important advance involves preventing the recipient’s immune system from rejecting the donated kidney.

Immunosuppressant drugs

• Prednisone – a steroid used in the early days of transplantation and still used today

• Azathioprine – introduced in 1968

• Cyclosporine – approved in 1983 and in wide use today

Blood treatments

Doctors today can “precondition” the recipient’s blood to remove antibodies that would trigger rejection of a donated kidney.

Antibiotics, antimicrobial and related medicines – These drugs help ward off infections in patients with weakened immune systems.

Surgical techniques

Laparoscopy has greatly reduced the size of incisions and shortened recovery times for kidney donors. Mayo surgeons first started using the technique in 1999. It’s sometimes called “bellybutton surgery.” The surgeon inserts a long instrument with a camera through narrow holes in the donor’s abdomen, snips away a healthy kidney and recovers it through another small opening. Previously, the operation involved a much larger incision on one side of the donor’s back.

Fifty Years of Kidney Transplants at Mayo Clinic

Posted on November 25th, 2013 by Admin

Fifty years ago, the prognosis for a patient with kidney failure was threatening to grim.

Transplants of kidneys from one person to another were not mainstream medicine. In fact, a transplant was so extraordinary that TIME magazine described the treatment as “the most daring of all.”

Kidney transplants still are serious operations today. But, since Mayo Clinic’s first transplant in 1963, the surgeries have become accepted medical practice. In many cases, transplantation now is the treatment of choice for patients whose kidneys are failing. It often is preferred over chronic “hemodialysis,” which relies on an artificial kidney outside the patient’s body to filter the blood and prolong life.

Mayo transplant teams have used advances in surgical techniques, drugs that suppress rejection and, of course, experience with thousands of patients to change a “daring” operation into a safe procedure.

Today at Mayo Clinic, a kidney transplant patient has a 98 percent chance of surviving one year; furthermore, the chance of surviving 10 years is in the mid-70 percent range. Continued progress in the field is accelerating the survival rate.

Timeline
1963 – First kidney transplant by Mayo Clinic surgeons, performed at Saint Marys Hospital.

1967 – First Mayo kidney transplant using organ from deceased donor.

1987 – First multiple-organ transplants involving kidneys. One paired a pancreas with a kidney and the other involved a liver.

1994 – Kidney transplants for children relocated to the newly opened Mayo Eugenio Litta Children’s Hospital.

1999 – Mayo Clinic surgeons acquire a kidney from a donor by laparoscopy for the first time. Mayo Rochester records its 2,000th kidney transplant. Mayo Clinic in Arizona begins transplanting kidneys.

2000 – Mayo Clinic opens The William J. von Liebig Transplant Center, a specialty clinic for organ transplants, in the 10th floor of the Charlton Building. Mayo Clinic in Florida starts a kidney transplant program.

2004 – Mayo Clinic reaches a milestone of 3,000 kidney transplants.

2013 – Mayo Clinic in Arizona completes its 2,000th kidney transplant.

2013 – Mayo Clinic celebrates 50 years of kidney transplants with more than 4,800 procedures.

 

"Tragic and sad." – Dr. Eric Green on funding uncertainties.

Posted on October 15th, 2013 by Admin

Dr. Eric Green, NHGRI

I write this two weeks after Mayo Clinic's Individualizing Medicine Conference. The first keynote talk at that conference, on Sept. 30, was Dr. Eric Green, head of the National Human Genome Research Institute. Following his talk, he spoke with Mayo Clinic Radio about how genomics is transforming medicine (the theme of the conference). He flew out that afternoon and the next day the government, including the institutes of NIH, shut down. So, this was undoubtedly his last interview before federal health science went dark.

When asked about the impact of the sequester and the then looming shutdown on research, he quickly responded, "Tragic, it's absolutely tragic."  Now I suppose you would expect that kind of response from a director whose main job is to ensure sustainability of his organization through continued funding, but what he said after that was what resonated with me. Referring to the five-point-eight percent cut to the NHGRI budget under sequestration, he said "That would be tolerable if   genomics was some kind of boring, not very exciting and we didn't see a real potential for improving human health.

"If there was ever a moment in time where we should be pushing the accelerator (it's now)...the opportunities are boundless.  And to not have enough fuel in our tank to push the accelerator hard is truly tragic. And it's particularly sad because in many ways the United States has led in genomics and we've written the playbook. And what's sad is the U.S.. is not funding science as aggressively as other countries and these countries are going to use our playbook and move this faster than us. And that seems to me really tragic."

And the next day, other than its hospital and a skeleton staff,  the NIH was silent.

Tweeting on Individualized Medicine

Posted on October 2nd, 2013 by Admin

SRO at the Mayo-ABC Twitter chat

Perhaps it was the topic - translating individualized medicine and what it means for medicine. Maybe it was the positive mood of the conference attendees here in Rochester. Whatever it was, it seemed to infect the noon Twitter chat held by Mayo's External Relations group...along with the Personalized Medicine Coalition in Washington, and hosted by Dr. Richard Besser, back at his desk at ABC News in New York. About half of those you see at the laptops are Mayo doctors, most taking their first stab at Tweeting. Response and participation was great: over 1,000 Tweets, over 200 participants, and more then 5 million accounts reached.

Mayo-Illinois Collaborations in Individualized Medicine

Posted on October 1st, 2013 by Admin

UIUC Leaders visiting the Center for Individualized Medicine

University of Illinois Chancellor Phyllis Wise and her administrative team attended Mayo Clinic's Individualizing Medicine Conference this week and held meetings on ongoing collaborations between the two institutions. The group from Urbana-Champaign included (l-r) Associate Vice Chancellor Jennifer Eardley; Gianrico Farrugia, M.D., director of the Center for Individualized Medicine at Mayo; Vice Chancellor Peter Schiffer; Chancellor Wise; Provost Ilesanmi Adesida; and Bryan White, Ph.D., who served as co-chair of the conference. Mayo and Illinois have been collaborating for years on medical genomic projects under the banner of the Mayo Illinois Alliance for Technology Based Health Care. Recently extensive work has been done in microbiome research and dozens of students and researchers have traveled between the campuses to work together.

Getting Genomic-Drug Alerts into the Electronic Medical Record

Posted on October 1st, 2013 by Admin

"Getting the what in the what?" That's going to be a problem if health care professionals are asking that question in the future. Many medical centers are finding that patients have allergies or will be put at considerable risk if given the wrong drug for their genetic makeup or even the standard dose of the right drug. Pharmacogenomic screening prior to prescribing medications will one day be a normal practice. It's the mantra of giving the right dose of the right drug at the right time. One size, one standard pharmaceutical practice, does not fit all. Your genome can often provide the answer. At Mayo's Individualizing Medicine Conference today, we've been hearing about how pharmacogeneomic screens are done at St. Jude Children's Hospital (thanks Dr. Mary Relling) and how those results are immediately going into those patients' electronic medical record.

The problem comes in if patients aren't exposed to appropriate screens --- or if they don't have an EMR. With an EMR, any physician can see almost immediately through a genomic-drug alert in the record (at Mayo a red flag pops up) that a patient should not be given drug X. This avoids a trial and error system of letting the patient's physiology reject the drug while exhibiting associated side-effects. We are used to hearing the slogan "There's an app for that." Well, soon we'll be able to say "There's a test for that" -- before you take a drug, any drug. There's relevance for you.

Hot Topics for Genomics for Remainder of the Decade

Posted on September 30th, 2013 by Admin

Dr. Eric Green summed up his plenary talk at Mayo's Individualizing Medicine conference by sharing his vision for what we'll see (and he and his colleagues will do) in genomics research and application before 2020.

Hot Areas in Genomic Medicine:

  • Cancer genomics
  • Pharmacogenomics…(genomic-guided prescriptions)
  • Ultra-rare genetic disease diagnosis
  • Prenatal and Newborn sequencing and analysis
  • Clinical geonmics information systems (computer/bioinformatics)
  • Genomic medicine… "It's not hypothetical anymore."

Dr. Eric Green – NIH Genomic Leader

Posted on September 30th, 2013 by Admin

Dr. Eric Green, head of the National Human Genome Research Institute, is now on the stage...explaining how "genomics is becoming increasingly relevant to the patient." He says this discipline is a marathon, that began 13 years ago with the initial mapping of the human genome. Now he talks of "base pairs to bedside" or "double helix to health"...and points to the strategic plan for his institute, published in 2011. He is now outlining advancements in our understanding of the genome, it's biology, how it impacts human biology and then how it can impact medical practice. Finally, he says, we must measure and demonstrate how genomics improves health care.

He also says we've learned much in the last decade, including the epigenomic code -- the impact of proteins on our genetic behavior based on environmental influences. He is essentially setting the stage for what will come later in the conference -- all of the knowledge thus far, he says, is a "Cliff Notes" version of the human genome and we have a lot more to learn -- including the differences in individual human genomes.