WVU Medicine St. Joseph's Hospital’s Post

On the occasion of World Organ Donation Day, celebrated on August 13th, Heartfelt thanks to the organ donors and their families, our impeccable donor organ coordination authority - TRANSTAN, donor hospitals & our coordinators who make a second lease of life possible for our sick patients with respiratory failure. The success of these transplants highlights the importance of organ donation and the life-saving potential it holds. In a ground-breaking achievement, Three Back-to-Back successful Lung Transplants in 3 consecutive days giving a new lease of life to three terminally ill patients. The first patient is a 72-year old with a BMI of 18 with progressive lung fibrosis on home oxygen and ventilator support underwent a single lung transplant. The second patient, who had lost 40 kgs due to his advanced disease from post-COVID fibrosis, received bilateral lung transplants. An out-of-hours virtual crossmatch was performed to ensure safety of donor-recipient matching for the third patient who was immunologically sensitized, and who received bilateral lungs. The first two patients are already off the ventilator and making excellent progress, while the third patient is also recovering well. All three cases were performed without the traditional peri-operative use of circulatory support. All credit to our amazing surgical team - Dr Kumud Dhital, Dr Prakash & Dr Ram for their expertise & to our anaesthetic & critical care team headed by Dr Pradeep. Dr. Srinivas Rajagopala, who with his team of transplant pulmonologists, played a crucial role in the management of these patients with very advanced lung failure, will also be spearheading their long-term surveillance and care after hospital discharge. Credit also goes to our staff in Clinical Perfusion, OR technicians, specialist nurses in the OR and ICU, dedicated physiotherapy, and other multi-disciplinary support staff to make this monumental task possible. The smooth course of recovery of all three patients is a testament to the skill and tireless dedication of the broad transplant team. It also reflects on the delivery of the highest standard of care at Kauvery Hospital whilst underscoring the hospital leadership’s unwavering resolve and commitment to provide such advanced medical care to improve patient outcomes. #LungDonation #LungDonationinIndia #LungDisease #LungDiseaseCauses #LungDiseasesSymptoms #LungDiseasePrevention #LungDiseaseTreatment #LungDiseaseAwareness #LungHealth #LungCare #ChronicLungDisease #EngStageLungDisease #LungTransplantation #LungTransplant #Transplantation #Healthcare

You make your hospital sick with worry when you are about to pass away and the bills haven’t been paid yet. Jokes aside, there’s this urban myth that hospitals intubate the dead and maintain life support to make some extra money. While this might have happened someplace sometime, what’s more commonplace is hospitals prolonging the lives of terminally ill patients who are suffering with little to no hope of recovery. The person might be on the verge of death with no hopes of meaningful recovery. Think of an 80-year-old with stage 4 cancer (where it has spread to distant sites in the body) and the doctor draws up a plan of aggressive chemotherapy (medication) coupled with surgery and radiotherapy (irradiation to destroy the tumor). The treatment, if it doesn’t kill the old person, will keep them in suspended animation for some time before they die. But the hospital and doctor make a cool crore or two delaying the inevitable, so why care? Of course, there’s a 1 in a billion chance granny will make a full recovery and your doctor is fully betting on that happening (not for the money, *wink*). Imagine resuscitating a 90-year-old with end-stage renal disease. If this example seems far-fetched, it is. But a lot of similar events as these do happen. Because healthcare has an agent-host problem. The doctor gets paid for the stuff they do. The hospital gets paid for the stuff their doctors do. Nobody gets paid to make sure you do not suffer, especially when you can’t speak and are half comatose. This is why we need hospital ethics committees which convene once a month and where participants eat cake from little saucers with floral designs while pondering over your dying gran’pa. Nope, forget that. What we’re coming to here is that medical professionals are bound to advise patients or their representatives, usually families, on the choices available to them and what each decision entails. The doctor can also tell patients what they would choose if they were in their place and explain why they would make that decision if the patient is undecided and seeks the doctor’s advice on what is best for them. Anyway, if the hospital has a new palliative care unit (where the sick are given loads of morphine and other narcotics Mexican cartels can only dream of, to make you trippy before you die), you know for a certainty your doctor will recommend palliative treatment for you. Also, the only thing that makes hospitals sicker than a dying patient who won’t settle their bills is a dying patient who avails of palliative services elsewhere. Until next time, stay safe, stay away from your friendly neighborhood hospital run by professional investors 😁. 

📣 Weekly Guideline Updates… Each Wednesday, I bring you news concerning updates to guidelines and recommendations by professional societies. This list is not all-inclusive, of course, but the following recent updates caught my attention. 🔸From the National Comprehensive Cancer Network (NCCN)... ▪️B-Cell Lymphomas Version 1.2024—Castleman disease has been removed from this guideline and is now published as a separate NCCN guideline. Many global changes made to these guidelines, including a change in the terminology from Follicular Lymphoma (grade 1-2) to Follicular Lymphoma or Classic Follicular Lymphoma. ▪️Castleman Disease Version 1.2024—New guidelines separate from B-cell lymphomas ▪️Ovarian Cancer Including Fallopian Tube Cancer and Primary Peritoneal Cancer Version 1.2024—Considerable changes made from the 2023 guidelines. Of note, following the MIRASOL clinical trial, the combination of mirvetuximab soravtansine and bevacizumab has been included as a category 2B recommendation for treating platinum-sensitive ovarian cancer patients with folate receptor alpha (FRα)-positive tumors. Additionally, for platinum-resistant ovarian cancer with FRα-positive tumors, this combination therapy's categorization has been elevated from 2B to 2A in the updated guidelines. 🔸Society of Critical Care Medicine (SCCM) recently released several updated guidelines, including… ▪️SCCM Guidelines on Recognizing and Responding to Clinical Deterioration Outside the ICU (https://buff.ly/3Sxfayp ) ▪️SCCM 2024 Focused Update: Guidelines on Use of Corticosteroids in Sepsis, Acute Respiratory Distress Syndrome, and Community-Acquired Pneumonia (https://buff.ly/499Fl3D ) ▪️SCCM International Consensus Criteria for Pediatric Sepsis and Septic Shock (https://buff.ly/3u8LRsj ) ▪️SCCM Guidelines on Glycemic Control for Critically Ill Children and Adults 2024 (https://buff.ly/3SxfaOV ) 🔸 International Society of Stereotactic Radiosurgery (ISRS)—Stereotactic body radiotherapy for primary renal cell carcinoma ([https://lnkd.in/em3S-c2R)) 🔸World Health Organization (WHO) guidelines on non-surgical management of chronic primary low back pain in adults in primary and community care settings (https://buff.ly/3Rk9PbY) #WeeklyWednesdayGuidelines #MedicalWriting #ClinicalGuidelines #NCCN #SCCM

Having lost a friend to kidney failure recently, I recall his frustration at the waiting list and lack of access to less than optimal kidneys. Eventually after 5 years, his underlying disease and dialysis treatments succumbed to the wait list, and now he is no more. Access to donated organs is a major issue, and there is much waste involved in the process. Josh Mezrich writes " .... We throw out a lot of organs in this country: thousands of hearts, lungs, livers, and kidneys every year . In 2021, roughly 20,000 deceased donor kidneys were procured for transplant — and more than 20% were discarded. " Typically organs are discarded because they are not deemed healthy enough for transplant by a resident surgeon, but those kidneys could be helpful to those patients with no kidney function at all. The process to decide rapidly on what to do with subpar kidneys is not rapid enough, and many lives are impacted ... and lost. In this essay Mezrich writes about the labyrinthine time-eating processes involved with donor kidney testing and guidelines followed the results in scant time to perform surgeries prior to organ expiration. He proposes how this could be addressed in one example given - " If the biopsies show significant disease and the function of the kidney would be inadequate for a recipient, the receiving center can request both kidneys for a single patient, termed a dual transplant (which has been shown to have good outcomes). If a center accepts a kidney, it can then choose the patient who will benefit the most from the transplant and has a long predicted wait time for a low-risk transplant, with informed consent. That would entail a discussion with the patient about expectations regarding the quality of the kidney, how long and how well it might work, and how much longer they might need to wait for a lower-risk kidney. The ability to match the kidney to a recipient is important, as high-risk kidneys need to go into patients who can tolerate the slow initial function. Centers that opt into the high-risk program will need to maintain an updated list of informed patients who are predicted to benefit from these kidneys, who can be called in as soon an offer becomes available. For them, taking a chance beats remaining on dialysis. " https://lnkd.in/eEecyCbY Disclaimer - Views expressed here are of the Author only #kidney #transplant #dialysis

Post-COVID Transplants, Long COVID Impacts with Kenneth McCurry, MD & Maryam Valapour, MD, MPP During the latest episode of Lungcast, 2 Cleveland Clinic lung transplant experts joined host Albert Rizzo, MD, American Lung Association (ALA) chief medical officer, to hold an important conversation on optimization of the system of lung allocation in reducing waitlist times and patient death rates. Rizzo’s guests, Maryam Valapour, MD, MPP, and Kenneth McCurry, MD, from the Cleveland Clinic Lung Transplant Team had spoken on the notable changes that lung allocation has undergone in the past 2 decades. In another segment of their interview, McCurry and Valapour discussed post-infectious COVID-19 patients’ eligibility for lung transplants. “I will tell you that in 2021, immediately after the pandemic, the 2 new categories of diagnoses became prevalent as indications for transplant,” Valapour explained. “So 1 was COVID (Acute Respiratory Distress Syndrome) and the second was interstitial lung disease due to COVID. In 2021, 1 out of every 10 lung transplants were performed nationally as a result of the complications from COVID. Those numbers have come down now, but that was kind of the impact of the pandemic on the system.” Valapour added that the total number of transplants went down during the pandemic, noting that clinicians are beginning to go back to pre-pandemic numbers. “At the clinic, we struggled during the pandemic, as most large lung transplant programs did on how to approach this and how to deal with this,” McCurry added. “So prior to the pandemic, essentially all lung transplant programs would decline any patient for transplant who was in acute respiratory failure from ARDS or some sort of other etiology. As we've discussed, long term outcomes are still plagued by issues. Organ access is still difficult and plagued and we have more need than at least current utilization is, although many of us are working on ways of increasing the supply.” McCurry noted that at the time, the Clinic had seen patients who were acutely ill and ventilated as being too risky to consider proceeding with a lung transplant. He explained that this would change with the pandemic. “We, like many other lung transplant programs, struggled initially with how to approach this,” Mccurry said. “Do we accept these patients? Do we not? If we do accept them, should we hold onto the same criteria that we hold ambulatory patients to?...For our hospitalized patients who are quite sick in general, our approach for a decade or more has been to try to ambulate them either on positive pressure ventilation or with ECMO support, so that they're not deconditioned and those sorts of things.” Posted by Larry Cole

In a ground-breaking achievement, successfully performed three consecutive lung transplants in 55hours giving a new lease of life to three terminally ill patients. On the occasion of World Organ Donation Day, celebrated on August 13th, Kauvery Hospital extends heartfelt thanks to the organ donors and their families, our impeccable donor organ coordination authority - TRANSTAN, donor hospitals & our coordinators who make a second lease of life possible for our sick patients with respiratory failure. The success of these transplants highlights the importance of organ donation and the life-saving potential it holds. Lung transplantation is a complex procedure where a diseased lung is replaced with a healthy one from a deceased donor. Despite the challenges, these transplants can significantly improve a patient’s survival and quality of life. Currently, there are two or fewer lung transplants happening within Tamilnadu monthly. The Heart and Lung Transplant team headed by Dr Kumud Dhital at Kauvery Hospital completed three such lung transplants within 55 hours showcasing their expertise and dedication. The first patient is a 72-year old with a BMI of 18 with progressive lung fibrosis on home oxygen and ventilator support underwent a single lung transplant. The second patient, who had lost 40 kgs due to his advanced disease from post-COVID fibrosis, received bilateral lung transplants. An out-of-hours virtual crossmatch was performed to ensure safety of donor-recipient matching for the third patient who was immunologically sensitized, and who received bilateral lungs. The first two patients are already off the ventilator and making excellent progress, while the third patient is also recovering well. All three cases were performed without the traditional peri-operative use of circulatory support. All credit to our amazing surgical team - Dr Kumud Dhital, Dr Prakash Ludhani & Dr Ram for their expertise & to our anaesthetic & critical care team headed by Dr Pradeep. Dr. Srinivas Rajagopala, who with his team of transplant pulmonologists, played a crucial role in the management of these patients with very advanced lung failure, will also be spearheading their long-term surveillance and care after hospital discharge. Credit also goes to our staff in Clinical Perfusion, OR technicians, specialist nurses in the OR and ICU, dedicated physiotherapy, and other multi-disciplinary support staff to make this monumental task possible. The smooth course of recovery of all three patients is a testament to the skill and tireless dedication of the broad transplant team. It also reflects on the delivery of the highest standard of care at Kauvery Hospital whilst underscoring the hospital leadership’s unwavering resolve and commitment to provide such advanced medical care to improve patient outcomes.

In a ground-breaking achievement, successfully performed three consecutive lung transplants in 55hours giving a new lease of life to three terminally ill patients. On the occasion of World Organ Donation Day, celebrated on August 13th, Kauvery Hospital extends heartfelt thanks to the organ donors and their families, our impeccable donor organ coordination authority - TRANSTAN, donor hospitals & our coordinators who make a second lease of life possible for our sick patients with respiratory failure. The success of these transplants highlights the importance of organ donation and the life-saving potential it holds. Lung transplantation is a complex procedure where a diseased lung is replaced with a healthy one from a deceased donor. Despite the challenges, these transplants can significantly improve a patient’s survival and quality of life. Currently, there are two or fewer lung transplants happening within Tamilnadu monthly. The Heart and Lung Transplant team headed by Dr Kumud Dhital at Kauvery Hospital completed three such lung transplants within 55 hours showcasing their expertise and dedication. The first patient is a 72-year old with a BMI of 18 with progressive lung fibrosis on home oxygen and ventilator support underwent a single lung transplant. The second patient, who had lost 40 kgs due to his advanced disease from post-COVID fibrosis, received bilateral lung transplants. An out-of-hours virtual crossmatch was performed to ensure safety of donor-recipient matching for the third patient who was immunologically sensitized, and who received bilateral lungs. The first two patients are already off the ventilator and making excellent progress, while the third patient is also recovering well. All three cases were performed without the traditional peri-operative use of circulatory support. All credit to our amazing surgical team - Dr Kumud Dhital, Dr Prakash Ludhani & Dr Ram for their expertise & to our anaesthetic & critical care team headed by Dr Pradeep. Dr. Srinivas Rajagopala, who with his team of transplant pulmonologists, played a crucial role in the management of these patients with very advanced lung failure, will also be spearheading their long-term surveillance and care after hospital discharge. Credit also goes to our staff in Clinical Perfusion, OR technicians, specialist nurses in the OR and ICU, dedicated physiotherapy, and other multi-disciplinary support staff to make this monumental task possible. The smooth course of recovery of all three patients is a testament to the skill and tireless dedication of the broad transplant team. It also reflects on the delivery of the highest standard of care at Kauvery Hospital whilst underscoring the hospital leadership’s unwavering resolve and commitment to provide such advanced medical care to improve patient outcomes.

Here's what caught my eye in kidney care this week— and why it matters. 1️⃣ The 2024 Rose Bowl parade will feature two floats that highlight living organ donation!🌹 The best part? Donors, recipients and transplant advocates will be walking with the floats. The OneLegacy float theme will honor the culture and traditions of the Hopi and Native American peoples. The Core Kidney Foundation float design will feature a garden display and purple butterflies to symbolize lupus nephritis, inspired by UCLA Nephrology Chief Dr. Anjay Rastogi. 𝐖𝐡𝐲 𝐢𝐭 𝐦𝐚𝐭𝐭𝐞𝐫𝐬: The groups hope to disrupt the norm by using the global stage to make 2024 a kidney health awareness year, encouraging people to check and monitor their kidney health. Will you be watching? 2️⃣ A new tool may help predict when patients may discontinue home dialysis. 🏠 A poster shared by researchers Eric Weinhandl, Wael Hussein, and Graham Abra, MD at ASN last month presented data on the effectiveness of a standardized discontinuation ratio (SDR). They defined the SDR as the ratio of actual vs. expected discontinuations from home dialysis during a 13-week study period. 𝐖𝐡𝐲 𝐢𝐭 𝐦𝐚𝐭𝐭𝐞𝐫𝐬: As Dr. Weinhandl pointed out, "Home dialysis attrition is a significant challenge. Attrition slows growth and discourages both nurses and patients who devote great effort to training." The team also said that many current measures are not ideal for real-time quality monitoring. 3️⃣ Renal Care 360º announced its first partnership in Texas with Kidney and Primary Care of Texas. 🏴󠁵󠁳󠁴󠁸󠁿 The clinic is based in San Antonio and led by Drs. Srinath Tamirisa and Julio Araujo, who each have over two decades of experience in clinical practice. 𝐖𝐡𝐲 𝐢𝐭 𝐦𝐚𝐭𝐭𝐞𝐫𝐬: RC360 serves 30,000 patients nationwide with programs including its Connected Care Program and SPARK education platform. 4️⃣ 3D eye scans could help track the progression of kidney disease — and might even help drug development. 👀 A research team from The University of Edinburgh studied whether 3D images of the retina, taken using a technology called optical coherence tomography (OCT), could be used to identify and accurately predict the progression of kidney disease. The team looked at OCT images from 204 patients at different stages of kidney disease, including transplant patients. They found that patients with CKD had thinner retinas compared with healthy volunteers. The study also showed that thinning of the retina progressed as kidney function declined. 𝐖𝐡𝐲 𝐢𝐭 𝐦𝐚𝐭𝐭𝐞𝐫𝐬: These changes were reversed when kidney function was restored following a successful transplant. What if we could use this technology to indicate how the kidney responds to new treatments or lifestyle changes? *** What did I miss? Let us know! 👇🏻 -- Sources: [1] https://lnkd.in/eGahC6yk [2] https://lnkd.in/e_rq5AxD [3] https://lnkd.in/eA78qC7N [4] https://lnkd.in/eJJyVWCU

I trust this post finds you well and engaged in the pursuit of cutting-edge advancements in healthcare. Today, I am thrilled to shed light on BiomLife® by Ruhvenile®, a groundbreaking solution that has the potential to be a game-changer in the critical realm of sepsis research and treatment. BiomLife® has been used on 6000 (six thousand) sepsis patients and growing… Understanding the Severity of Sepsis: Sepsis remains a life-threatening condition with profound implications for patient outcomes. The urgency to enhance our understanding of sepsis and develop more effective treatment strategies has never been more crucial. Enter BiomLife®: A Catalyst for Sepsis Solutions: BiomLife® is not just a product; it's a beacon of hope in the fight against sepsis. Here's how BiomLife® can be a transformative force in the battle against this critical medical challenge: Comprehensive Specimen Collection: BiomLife® is meticulously engineered to collect specimens comprehensively, offering researchers and healthcare professionals a versatile tool to study the diverse facets of sepsis pathology. From blood samples to tissues, BiomLife® accommodates the varied nature of sepsis research. Extended Sample Integrity: Preserving the integrity of sepsis samples is paramount for accurate research outcomes. BiomLife® ensures the prolonged viability of samples, allowing for more precise and reliable sepsis research findings. Revival of Microbes: BiomLife's innovative transportation system is designed to revive a wide range of microbes, including those associated with sepsis. This capability enriches the depth of microbial studies related to sepsis, offering a more comprehensive understanding of its progression. Flexible Temperature Preservation: Acknowledging the sensitivity of sepsis samples, BiomLife® allows for flexible temperature preservation. This not only ensures the preservation of sample integrity but also supports sustainable research practices. Impact on Lives: Swift and Accurate Diagnosis: BiomLife® contributes to the development of more accurate and timely diagnostic tools for sepsis, a pivotal factor in improving patient outcomes. Precision Treatment Strategies: By preserving samples for an extended period, BiomLife® supports the development of precision treatment strategies for sepsis, leading to more effective interventions and better patient survival rates. Global Collaboration for Sepsis Solutions: BiomLife's global adoption fosters collaboration among researchers and healthcare professionals worldwide, creating a connected community dedicated to advancing sepsis research and treatment. Join the Fight: Sepsis demands urgent attention and innovative solutions. BiomLife stands ready to be a catalyst for change. If you're passionate about making a difference in sepsis research and treatment, I invite you to explore how BiomLife can elevate your endeavors. For more information, visit our website at www.ruhvenile.com. info@ruhvenile.com, +91 858 703 3367