Tag: setup (Page 19 of 43)

Yesterday, 3/21/2024, a xenotransplantation was reported by Reuters here.

“A 62-year-man with end-stage renal disease has become the first human to receive a new kidney from a genetically modified pig, doctors from Massachusetts General Hospital in Boston announced on Thursday.

The four-hour surgery, performed on March 16, “marks a major milestone in the quest to provide more readily available organs to patients,” the hospital said in a statement.

The patient, Richard Slayman of Weymouth, Massachusetts, is recovering well and expected to be discharged soon, the hospital said.”

Let’s delve deeper into this subject. Here’s what Poe had to say about it:

Xenotransplantation refers to the transplantation of organs, tissues, or cells from one species to another, typically from animals to humans. The term “xeno” is derived from the Greek word “xenos,” which means “foreign” or “strange.” In the context of xenotransplantation, it signifies the transfer of biological material across different species.

Here are a few examples of xenotransplantation:

Pig-to-Human Organ Transplants: Pigs are often considered as potential donors for organs such as hearts, kidneys, and livers due to similarities in size and physiological function. Porcine organs can be genetically modified to reduce the risk of rejection in the human recipient.

Islet Cell Transplants: Islet cells, responsible for producing insulin in the pancreas, can be transplanted from pigs to humans as a potential treatment for diabetes. This approach aims to alleviate the need for insulin injections or continuous glucose monitoring.

Xenogeneic Skin Grafts: Temporary or permanent skin grafts from animals like pigs or genetically modified mice can be utilized for treating burn victims or patients with severe skin injuries.

It’s important to note that xenotransplantation is an evolving field with ongoing research and ethical considerations. The potential risks of immune rejection, transmission of zoonotic diseases, and ethical implications surrounding animal welfare and genetic modification are areas of active investigation and discussion.

The “engine” behind this reported Xenotransplantation is a company out of Cambridge, MA named eGenesis. Founded in 2015, it is currently a private company but I speculate it will be taken public in the near future. You can access a link to their web site here: https://egenesisbio.com/

Recently my Brother-In-Law Jerry Seager passed. He had been diagnosed with last-stage AML Leukemia that had progressed so far as to be not treatable. He was 84 years old and led a very full and productive life. Linda and I and scores of others will miss Jerry beyond what words can communicate. See this link for his story: https://app.bluebutterfly.com/memorial/v2/jerry-seager

Tuesday morning my weight ballooned to 158.0 pounds and I felt worse since going on PD. I had asked my dialysis nurse to read Tuesday’s blog about my weight going up (drastically) since going on the latest prescription which she did and talked to my nephrologist. As a result, I have a new dialysis prescription to try out. This one involves manually loading 2L of 2.5 around 6 PM. This load will be drained off by the initial drain cycle of the evening and be followed by four cycles of 2.7L each but no additional fill at the end.

Remember that every time my prescription changes, the requirements for what fluids in what amounts per bag change also. So now I need enough 2L manual bags for one per day and enough other inventory to cover four fills of 2.7L each. Since I normally only inventory manual 2l bags to conduct adequacy tests, I only have 3 boxes or 15 bags on hand. While I was in the clinic having my thumb drive reprogrammed for the new prescription, I called Fresenius Logistics and have an additional five boxes of the manual bags scheduled for delivery next Tuesday. I have found Fresenius very easy to work with in this regard.

Now I’m trying to decide if I need to do a manual drain to get rid of this excess fluid loading me down?

Recall that this past Thursday I met with my Dialysis Team. As a result of my latest PET indicating that my Transport flipped from High to Low, my prescription was altered. Part of this change was to leave one liter of fluid in my stomach after my daily treatment where it would be removed first upon hooking up for treatment in the evening.

After unhooking every morning, I now have three data points on my weight. My weight had run consistently at 146.8 or 147.8 for weeks and months. The last three readings are 150.0, 152.2, and 155.8. According to a Perplexity search, PD fluid typically weighs about 1 Kilogram per liter depending on the solution. So retaining a liter of fluid should raise my weight by about 2.2 pounds (one kilo). This would make my current weight to be about 150 lbs max (147.8 + 2.2 = 150). This would infer that my first weight is “in there” while the 152.2 and certainly the 155.8 are out in left field.

BTW, my closing screen on the Liberty Cycler, the machine that conducts the PD treatment, indicates clearly that 1007 mL of fluid constituted the last fill. Associated with the 155.8 weight was a negative microfiltration of 494 indicating that some fluid over the 1007 was left in after treatment but this would not explain the 155.8. Bottom line, I don’t have a clue what is going on. Standby! And I don’t see how I can do a StatDrain either. This morning my wt was 155.2 with  positive microfiltration of over 800.

I met with my dialysis team yesterday as planned to go over my early March labs. As anticipated, a central point of discussion was what to do in response to the change in my transport function. The following was decided: Reduce the number of dwells to 4 from 5, increase dwell time to 2 hours from 1.5 hours, and add a one-liter dwell during the day. The daytime one liter will be accomplished by loading a liter into my stomach in the morning, where it will remain all day until I hook back up to the cycler at night where it will be first removed before any normal fill and dwells occur.

A downside to having a liter of dialysis fluid in your gut during the day is the possibility of some of it being reabsorbed back into the body. Since the fluid also contains a fair amount of sugar, I was told it MAY impact glucose control.

I was politely chided by my dietitian Rachel to up my protein intake which I will accomplish by attempting to consume more red meat and more protein bars.

First of April, we will run yet another adequacy test the output which will be an updated Kt/V which hopefully will move upward from the current 1.8 more towards 2.0, the ultimate minimum goal.

The lead picture is from Poe in response to the Prompt: “picture of Popeye pondering his new dialysis prescriptions’

As advertised, yesterday at 1000, I visited my GP for my annual physical. There is nothing untoward to report. First of all, the check-in nurse couldn’t believe I was 85 because I was walking unassisted, getting up on the examination table unassisted, and responding quickly and accurately to all of her many questions. My EKG was strong and normal; every other parameter checked was great. My blood pressure was 110 over 69; it is obvious I have no white coat syndrome. We got all the prescriptions I needed in order, and now everything is good. I received notification from ExpressScripts that they also received the order, which is always good.

So, from my GP, “See you in three months!” (Picture is from Poe in response to Prompt “picture of Popeye happy over annual physical with GP”

Recently, AI has been at the forefront of many heated discussions in the press. I have embraced it with the understanding that, like humans, it is not perfect but, in most cases, better than existing research tools. I recently quizzed Perplexity about the field of research into new and diverse methodologies to treat CKF with the following interesting results:

Recent discoveries in the field of nephrology have been made with the help of artificial intelligence (AI), which is increasingly being used to improve various aspects of kidney transplantation and treatment. A study from the University of Texas at Dallas, reported on July 14, 2023, revealed a new mechanism for kidney cell renewal. This discovery pertains to a “housekeeping” process within kidney cells that ejects unwanted components, which could have significant implications for understanding kidney function and diseases2.AI is also being utilized to transform organ transplantation. For instance, Mayo Clinic transplant specialists are confident that AI will be a valuable tool to improve the complex organ donor and recipient matching process. AI’s ability to analyze large datasets is expected to uncover important trends and patterns that can aid in early detection of organ failure, improve matching processes, and potentially increase the number of organs usable for transplant3. Moreover, The Kidney Project has made strides in developing a prototype bioartificial kidney, which aims to free patients from dialysis machines and transplant waiting lists. This project has successfully tested a functional prototype, which combines a hemofilter and a bioreactor, and is powered by blood pressure alone without the need for blood thinning or immunosuppressant drugs4.In addition to these practical applications, AI is also being recognized as a new field of knowledge for nephrologists. It offers the potential to improve diagnostic accuracy, treatment, and prediction of kidney diseases. Machine learning algorithms, a subset of AI, can be trained to recognize patterns in patient data to identify early signs of kidney disease, which could lead to timely diagnoses and treatments5.These advancements in AI and its applications in nephrology are paving the way for increased automation, standardization, and speed in medical evaluations, which will ultimately enhance precision medicine and improve patient care135.

It. should be very apparent that researchers are indeed employing AI in their efforts to improve life for those experiencing or on the path to experience CKF. The lead picture was generated by my AI assistant Poe in response to the Prompt “Picture of Popeye pondering the concept of artificial intelligence.”

My wife and I just had a whirlwind weekend. Our grandson, wife, and seven-month-old great-granddaughter flew in from Seattle for a short visit. We drove about 70 miles to Dallas Love Field to pick them up. It wasn’t too bad traffic-wise Saturday or going back up Monday, but coming back we got in lots of slow and start-stop traffic on the 820. It was very nice seeing them and getting acquainted with the new GGD. Our golden retriever behaved himself extremely well.

Have several activities coming up this week. On Wednesday I have a Fresenius supply delivery and an annual physical. Thursday I have a dialysis team meeting, and Friday I’m scheduled to turn in our tax records to our CPA so she can do our 2023 Federal taxes. I also uncovered a new topic that should prove to be of interest to readers of this blog that I intend to develop tomorrow. Stay tuned.