Stories about: organ transplant

Transplant surgeon seeks to avoid transplants

First in a two-part series on metabolic liver disease. Read part 2.

Khashayar Vakili, MDIn the clinical world, Boston Children’s Hospital surgeon Khashayar Vakili, MD, specializes in liver, kidney and intestinal transplant surgeries, while in the lab he is doing work which, for some patients, could eliminate the need for a transplant surgeon altogether.

Vakili has been working at Boston Children’s for six years. During his transplant surgery fellowship, he spent several months learning about pediatric liver transplantation from Heung Bae Kim, MD, director of the Boston Children’s Pediatric Transplant Center, which prompted his interest in the field.

“When the opportunity to join the transplant team presented itself, I did not hesitate to accept,” he says.

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App-solute adherence: Using mobile technology to prevent transplant rejection

A new smartphone app could help teenagers remember to take their medications on time. Image courtesy of www.thatsnicephotography.co.uk

After an organ transplant, patients need to adjust to a lot of strict routines. This is hard, especially for teenagers who are trying to navigate adolescence. Some young patients say it’s difficult to remember when they need to take all their medications to prevent organ rejection, especially when they’re not feeling ill. Others complain that their parents’ constant harping to follow their care team’s instructions makes them want to do the exact opposite.

No matter the reason, thousands of teenagers are at risk of compromising their grafted organ.

Researchers at Boston Children’s Pediatric Transplant Center are developing a smartphone application that they hope will help adolescents understand the importance of taking care of themselves. But they realize that it’s not enough to take a clinical approach and it give an app makeover. In other words, to truly make an impact on teenagers, the app needs to be more than an electronic version of their parents.

“We really need to create ways to communicate with young patients that’s right for their age and treatment stage,” says Kristine McKenna, PhD, a psychologist with the Pediatric Transplant Center. “If you’re too patriarchal, or if you try to dumb things down too much, teens pick up on that and resent it. But if it’s too high-level they can become overwhelmed.”

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Immune system to Epstein-Barr virus-fueled cancers: “I’ve got an eye on you”

In the vast majority of us, the Epstein-Barr virus (above) causes mild illness and never bothers us again. However, it can lay dormant in small numbers of B cells for years, waking up if the immune surveillance keeping it in check is broken and fueling lymphomas. (NCI)

Some 90 percent of us are exposed to the Epstein-Barr virus (EBV) at some point in our lives. While the immune system’s T cells rapidly clear most EBV-infected B cells, about one in a million infected cells escapes destruction. Within these cells, the virus enters a latent phase, kept in check by the watchful eye of so-called memory T cells.

This uneasy relationship usually holds steady for the rest of our lives, unless something suppresses the immune system – such as infection with HIV or use of anti-rejection drugs after a transplant – and breaks the surveillance. The virus can then reawaken and drive the development of certain B cell cancers.

How do our T cells keep their watch?

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