ROCHESTER, Minn. — While immunosuppressive medications are critical to prevent rejection of transplant organs, they also come with plenty of downsides. They can cause harsh side effects, like headaches and tremors, and increase the risk for infection and cancer. But what if there was a way to prevent organ rejection without using these medications?

That goal fuels the work of Mark Stegall, M.D., a longtime Mayo Clinic transplant researcher. He leads a team of researchers developing pioneering therapies to prevent organ rejection without the need for immunosuppression. A recently published study in the American Journal of Transplantation is offering hope for patients.

Using stem cells to prevent organ rejection

Mayo Clinic participated in the multisite phase 3 clinical trial detailed in the study. The goal was to see whether people who simultaneously received both a kidney and stem cell transplant from a closely matched sibling could discontinue all immunosuppressive medications after a year. The results were promising. The study found that 75% of participants were able to stop taking the medication for more than two years. At Mayo Clinic, three patients participated, with two off immunosuppression medications for over three years and one on a low dose.

"I've been involved in transplant research for more than 30 years, and we've done quite a few amazing things. But in the scheme of things, this research is right at the very top. It's been a goal — to be able to safely get transplant recipients off immunosuppression — for longer than I've been doing this. We're very excited about it," says Dr. Stegall, a co-author of the study.

The research being done across Mayo Clinic is part of a growing trend in transplant to explore ways to use cellular therapies to prevent organ rejection. It is also a cornerstone of Mayo Clinic's Transforming Transplant Initiative, which has the bold goal of ensuring everyone who wants a transplant can get one and to make transplants more successful.

To qualify for the clinical trial, the transplant recipients and donors needed to be siblings whose tissue types closely matched. The donor agreed to donate their stem cells in addition to their kidney to their sibling. The recipient receives the transplant, undergoes radiation and then receives the stem cell transplant. The goal was to wean recipients off immunosuppression medication after a year.

'Almost like the transplant didn't happen'

For Minnesota native Mark Welter, the results have been better than he imagined. Four years ago, he needed a kidney transplant due to polycystic kidney disease, an inherited condition that causes cysts to grow on the kidneys. The Mayo Clinic patient volunteered to be a part of the clinical trial in hopes of not having to worry about immunosuppression medication the rest of his life. His younger sister Cindy Kendall immediately stepped forward to donate a kidney and her stem cells to help her brother.

"Being able to see him get off those medications has been amazing," Cindy says. "He just gets to live his life to the fullest. He has been able to see both of his daughters get married and meet his grandchildren."

Watch: Inteview with Mark Welter, Cindy Kendall and Dr. Mark Stegall

Mark has not taken immunosuppression medication for more than three years.

"I feel fantastic. I actually feel like I did before the transplant, which has been the greatest thing," Mark says. "It's almost like the transplant didn't happen."

There is still plenty of work to be done to advance this research. This clinical trial only involved siblings with closely matching tissue types. Researchers want to know if stem cell transplants can prevent rejection in recipients paired with a less closely matched donor.

"Even in closely matched siblings, immunosuppression is needed lifelong. We have seen stopping medications even at eight to 10 years post-transplant leads to rejection. Our goal is to find ways to reduce or stop immunosuppressive medications after transplant so patients can have longer lasting kidneys with fewer side effects," says Andrew Bentall, M.B., Ch.B., M.D., a Mayo Clinic transplant nephrologist.

Journalists: Press kit, including b-roll, photos and interviews are available here. Clinical trial participants and Mayo researchers are available for interviews. Please contact newsbureau@mayo.edu to schedule.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Kelley Luckstein, Mayo Clinic Communications, newsbureau@mayo.edu

The post (VIDEO) Eliminating the need for lifelong immunosuppressive medications for transplant patients appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — Artificial intelligence (AI) has the potential to become a valuable tool for transplant to save more patients' lives. Recent studies have already shown promise in using AI to analyze large sets of data to discover important trends and patterns. In this expert alert, Mayo Clinic transplant experts share how this technology may improve outcomes for patients.

"Physicians once practiced medicine without CT scans and with only limited lab tests. Now, these tools are not only commonplace, but they are also critical to treatment decisions. I predict AI will also become an important decision-making tool for physicians," says Mark Stegall, M.D., a Mayo Clinic transplant surgeon and researcher.

Here are five ways AI promises to improve transplant outcomes.

1. Preventing the need for a transplant

Research efforts are underway to use AI to detect organ failure earlier. AI also can be used to determine which early interventions delay the need for a transplant and, in some cases, prevent the need for one altogether.

"Transplantation is something that helps patients live longer, but it can be filled with potential complications. We always strive to discover ways to help patients recover on their own and have better quality and quantity of life," says Rohan Goswami, M.D., a transplant cardiologist and director of heart transplant research at Mayo Clinic in Florida.

2. Better match organ donors and recipients

Matching organ donors and recipients is complex. There is hope that AI could help improve the matching process. AI also can help determine whether a donated organ would make for a successful transplant. A recent Mayo Clinic study demonstrated how an AI-based scoring system could be used to analyze transplanted kidney biopsies to determine inflammation levels, important information that helps indicate the health of the transplanted kidney.

3. Increasing the number of usable organs

Advances in transplant technology are helping expand the number of organs from deceased donors available for lifesaving transplants. Organ perfusion systems, which are a mechanical device that keep organs viable, allow more time for donor organs to survive outside the body before being transplanted. A study about the use of this new technology to improve organ use rates was recently published by Dr. Goswami and colleagues in the International Journal of Scientific Research. The hope is that AI will help transplant experts better understand which organs would benefit from these technologies before transplant, and which are not suitable for donation.

4. Preventing organ rejection

The risk of organ rejection is one of the biggest challenges in transplant medicine. Researchers are turning to AI to help identify patients most at risk for organ rejection. A recent Mayo study published in the European Heart Journal found that an electrocardiogram could potentially be used to predict the risk of low-grade rejection for heart transplant patients, potentially without requiring a biopsy. There is hope that these advances also will help prevent transplant patient deaths.

5. Improving care after transplant

To help prevent rejection, transplant patients are given immunosuppression medication. Because these medications can cause potentially harmful side effects, it is critical to determine the minimum dose necessary for patients to remain healthy. AI could one day be used to help determine how a patient's body reacts to immunosuppression and guide when medications should be adjusted. A recent Mayo abstract at the International Society of Heart and Lung Transplant discussed the role of AI electrocardiographs as a predictor of high and at-risk patients after a heart transplant occurred. There is hope that AI could eventually make posttransplant care easier for patients, eliminating the need for routine biopsies and blood draws.

Experts stress that the success of AI depends upon the quality of the data it is based upon. The goal is not to replace a clinician's expertise with AI, but to create another tool to ensure patients get the best care possible.

"We don’t use information blindly and will not follow AI tools blindly. One of the great hopes of AI decision tools is that they can help integrate many other tools, such as scans and labs, into a model that provides a fuller picture of the patient," Dr. Stegall says.

Several Mayo Clinic experts are available for interviews, including:

• Rohan Goswami, M.D., a transplant cardiologist at Mayo Clinic in Florida.
• Mark Stegall, M.D., a transplant surgeon at Mayo Clinic in Minnesota.
• Byron Smith, Ph.D., a biostatistician involved in transplant research at Mayo Clinic in Minnesota.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Heather Carlson Kehren, Mayo Clinic Communications, newsbureau@mayo.edu

The post Five ways AI promises to transform organ transplants appeared first on Mayo Clinic News Network.

Artificial intelligence may never replace human insight, expertise and judgment. Then again, no one's complaining about how it can help, especially when it comes to analyzing kidney biopsies, a laborious process that's an intricate mix of art and science. Accurate and thoughtful interpretation of biopsies is of life-changing importance for patients.

"The kidney is a pretty complicated structure, and rating the biopsy, taking that data and using it to assess what's already happened and what will happen is complicated," says Mark Stegall, M.D., a Mayo Clinic transplant surgeon. "When a pathologist reads a biopsy, he or she is looking mostly for an overall diagnosis and not detailed quantification of changes in every single part of the biopsy. However, there's a lot of data that is lost that could be helpful in predicting outcomes if we had a way of measuring it."

That's where a deep neural network can help.

The development of deep or convolutional neural networks — a type of machine learning, otherwise known as artificial intelligence (AI) — has made it possible for researchers to conduct more advanced analyses of medical images. Neural networks need human training, however. They need to know what to look for and analyze, and they take vast amounts of computing capacity and storage space.

Read the rest of the article on Advancing the Science.
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Other Mayo Clinic medical research websites:

• Research at Mayo Clinic
• Discovery’s Edge
• Advancing the Science
• Forefront
• Mayo Clinic Center for Individualized Medicine
• Center for Regenerative Medicine
• Center for the Science of Health Care Delivery

The post Science Saturday: Teaching a computer to read a kidney biopsy appeared first on Mayo Clinic News Network.

On the next Mayo Clinic Radio program, Mollie Luhman, a living kidney donor, and Dr. Mark Stegall, a surgeon at Mayo Clinic who helped perform the transplant, will share their story. Also on the program, Dr. Michael Zaccariello, a psychologist at Mayo Clinic, will help explain why attention deficit hyperactivity disorder (ADHD) is on the rise. And Dr. Donald Hensrud, a preventive medicine specialist at Mayo Clinic, will discuss nutrition do’s and don’ts.

Here's your Mayo Clinic Radio podcast.

The post Organ donation story / ADHD on the rise / nutrition do’s and don’ts: Mayo Clinic Radio appeared first on Mayo Clinic News Network.

On the next Mayo Clinic Radio program, Mollie Luhman, a living kidney donor, and Dr. Mark Stegall, a surgeon at Mayo Clinic who helped perform the transplant, will share their story. Also on the program, Dr. Michael Zaccariello, a psychologist at Mayo Clinic, will help explain why attention deficit hyperactivity disorder (ADHD) is on the rise. And Dr. Donald Hensrud, a preventive medicine specialist at Mayo Clinic, will discuss nutrition do’s and don’ts.

To hear the program, find an affiliate in your area.

Use the hashtag #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Access archived shows or subscribe to the podcast.

The post Mayo Clinic Radio: Living donor kidney transplant appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — A kidney transplant is a life-changing and life-saving procedure. Yet, a new study conducted by Mayo Clinic and the University of Michigan shows that only one-third of patients who ultimately receive a living donor kidney transplant receive it pre-emptively (i.e., before starting dialysis). Less than two-thirds receive a transplant either pre-emptively or within a year of starting dialysis.

Existing research suggests that less time spent on dialysis before transplant can improve patient outcomes and survival after transplant. However, this new research shows there has been no increase in the utilization of what is known as timely living donor kidney transplants, which includes pre-emptive and early transplants, since 2006. The study “Under-utilization of timely kidney transplants in those with living donors,” was published recently in the American Journal of Transplantation.

MEDIA CONTACT: Ginger Plumbo, Mayo Clinic Public Affairs, 507-284-5005, Email: newsbureau@mayo.edu.

“Early referral to transplant evaluation and access to information about living donor kidney transplantation is key to a successful timely transplant and to improved long-term outcomes,” says Mark Stegall, M.D., a professor of surgery at Mayo Clinic and senior author of the manuscript. “One important area where people lack education is on how to communicate with family and friends about their need for a kidney transplant and the fact that live donors offer, on average, a better outcome than deceased donor transplantation.”

“Past studies and patient data have shown that we can improve a person’s quality of life and chance of surviving end-stage renal disease if we can avoid or minimize the amount of time they spend on dialysis,” says Ankit Sakhuja, M.B.B.S., a graduate of Mayo Clinic Renal Transplant Fellowship. He also currently is an assistant professor and director of the kidney paired donation program in the Division of Nephrology at the University of Michigan.

Mayo Clinic and University of Michigan researchers examined data from the United Network for Organ Sharing to evaluate the use of timely kidney transplants from 2000 to 2012 for 68,128 patients who received living donor transplants. Although data showed an improvement in the use of pre-emptive and early living donor transplants between 2000 and 2006, there has been no improvement since.

“Patients who are receiving transplants from compatible living donors should, theoretically, not need to go on dialysis at all,” says Dr. Sakhuja. “In comparison, patients with no living donors may wait for a deceased donor organ for a long time. But in reality, we see a wide variation in the timing of transplants and no improvement in the use of timely transplants from living donors, despite the potential availability and known benefits.”

Factors that influence a person’s chance of receiving a timely living kidney transplant are thought to include lack of available living donors, decreased number of living donors, lack of insurance, lack of education or knowledge, delayed diagnosis and delayed referral.

Paired donations and direct donation represent two viable and available options for timely living kidney transplant. Yet both can be influenced by early referral and by a patient’s understanding of their situation and the transplant evaluation process. The use of timely kidney transplant can vary greatly from one transplant center to another, based on factors including the patient population, the transplant team and its comfort in evaluating living donors, and providing prompt transplant evaluations for patients. But according to Dr. Stegall, approximately 80 percent of kidney transplants at Mayo Clinic in the past 15 years have been from living donors, with 40 percent of those being pre-emptive living donor transplants.

Currently, more than 600,000 people suffer from end-stage renal disease and are candidates for dialysis or kidney transplant. To learn more about living donor kidney transplants, visit www.mayoclinic.org/transplant.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to medical research and education, and providing expert, whole-person care to everyone who needs healing. For more information, visit http://www.mayoclinic.org/about-mayo-clinic or https://newsnetwork.mayoclinic.org/.

The post No Increase in The Utilization of Timely Living Donor Kidney Transplants appeared first on Mayo Clinic News Network.

The named professors are:

Jennifer Westendorf, Ph.D., a researcher in the Department of Orthopedic Surgery, has received the Margaret Amini Professorship in Orthopedic Regenerative Medicine Research. She also serves as vice chair of the Department of Biochemistry and Molecular Biology, and as a professor at Mayo Clinic College of Medicine in biology and biochemistry/molecular biology and orthopedics.

Margaret Redfield, M.D., a cardiologist in the Division of Cardiovascular Diseases in Mayo Clinic’s Department of Internal Medicine, has been recognized as the Walter and Leonore Annenberg Professor in Cardiology and Critical Care. She is also the director of Mayo’s Circulatory Failure Program and co-director of the Cardiorenal Research Laboratory.

MEDIA CONTACT: Karl Oestreich, Mayo Clinic Public Affairs, 507-284-5005, newsbureau@mayo.edu.

Mark McNiven, Ph.D., is a researcher in the Division of Gastroenterology and Hepatology in the clinic’s Department of Internal Medicine. He has been named the George M. Eisenberg Professorship and Bernard Pollack Professorship. He also serves as director for the Gastrointestinal Cancer Program at Mayo Clinic Cancer Center and director of the Mayo Center for Biomedical Discovery.

James Maher, III, Ph.D., a researcher in the Department of Biochemistry and Molecular Biology, and dean of Mayo Graduate School, has been awarded theGeorge M. Eisenberg Professorship and Bernard Pollack Professorship.

Lewis Roberts, M.B., Ch.B., Ph.D., is a physician in the Division of Gastroenterology and Hepatology in the Department of Internal Medicine. He has received the Peter and Frances Georgeson Professorship in Gastroenterology Cancer Research.

Daniel Billadeau, Ph.D., a researcher in the Division of Oncology Research, has been recognized as the Edmond A. and Marion F. Guggenheim Professor. He has joint appointments in the Department of Medical Oncology and the Department of Biochemistry and Molecular Biology, and holds the academic rank of professor of immunology and professor of biochemistry and molecular biology at the Mayo Clinic College of Medicine.

Jae Oh, M.D., is a cardiologist in the Division of Cardiovascular Diseases. He has been named the Samsung Professor of Cardiovascular Diseases in recognition of his research and work, which includes current appointments as director of the Echocardiography Core Laboratory, director of the Pericardial Disease Clinic, and co-director of Integrated Cardiac Imaging. He is also a professor of medicine at Mayo Clinic College of Medicine.

Fergus Couch, Ph.D., chair of the Division of Experimental Pathology and Laboratory Medicine and professor of laboratory medicine and pathology, has been awarded the Zbigniew and Anna M. Scheller Professorship of Medical Research. He is jointly appointed in the Department of Biochemistry and Molecular Biology and the Department of Health Sciences Research. In 2013, he was named Mayo Clinic Investigator of the Year. The Investigator of the Year Award is presented to individuals who have made a significant advance in practice-changing research, a strong record of extramural funding, and a strong record of research mentorship.

Vincent Rajkumar, M.D., a hematologist in the Division of Hematology at Mayo Clinic in Rochester, has received the Edward W. and Betty Knight Scripps Professorship in Medicine in Honor of Dr. Edward C. Rosenow, III. He has joint appointments in the Department of Hematology and the Department of Laboratory Medicine and Pathology, and serves as chair of the Myeloma, Amyloid, and Dysproteinemia Group for Mayo Clinic Cancer Center.

Bradley Leibovich, M.D., is chair for the Department of Urology. He has been awarded the David C. Utz, M.D., Professorship of Urology.

Joseph Dearani, M.D., a cardiovascular surgeon and chair of the Division of Cardiovascular Surgery, has been recognized as the Sheikh Zayed Professorship in Cardiovascular Diseases Honoring George M. Gura, M.D. He is jointly appointed in the Division of Transplantation Surgery, and is a professor of surgery at Mayo Clinic College of Medicine.

Rosa Rademakers, Ph.D., a neuroscience researcher at Mayo Clinic in Florida, has been named the Mildred A. and Henry Uihlein, II, Professor of Medical Research. She is a professor of neuroscience at Mayo Clinic College of Medicine with full faculty privileges in neuroscience at Mayo Graduate School.

Claudia Lucchinetti, M.D., is a neurologist and chair of the Department of Neurology, as well as assistant director of the Mayo Clinic Center for Multiple Sclerosis and Demyelinating Diseases. She is a recipient of the Mary Lowell Leary Professorship. Dr. Lucchinetti recently completed her tenure as chair of the CNBT NIH study section from 2012-2014.

Leonard Petrucelli, Ph.D., chair of the Department of Neuroscience at Mayo Clinic’s Florida campus, has been awarded the Ralph B. and Ruth K. Abrams Professorship, and has full faculty privileges in molecular neuroscience at Mayo Graduate School.

Jan Buckner, M.D., chair of the Department of Oncology, has been recognized as the Betty J. Foust, M.D., and Parents’ Professor. He also serves as deputy director of clinic practice for Mayo Clinic Cancer Center.

Mark Stegall, M.D., is a physician with joint appointments in Transplantation Surgery and the Department of Immunology. He has been named the James C. Masson Professor of Surgery Research. He also serves as director of the Transplant Immunology Research Laboratory.

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to medical research and education, and providing expert, whole-person care to everyone who needs healing. For more information, visit http://www.mayoclinic.com or https://newsnetwork.mayoclinic.org.

The post Mayo Clinic awards sixteen named professorships appeared first on Mayo Clinic News Network.

Among the more than 120,000 Americans waiting for an organ transplant, thousands are told their likelihood of rejection is too high to take the risk. However, at Mayo Clinic, some of these highly-sensitized patients are still being given their second chance at life. Dennis Douda shows us how.   [TRT 4:13 ]

Journalists: The full package and additional b-roll are available in the downloads. To access the script, click here.   

This is a special report produced for the Mayo Clinic 150th Anniversary Collection of Stories. To view other stories and learn about Mayo Clinic's sesquicentennial, please click here.

The post Lowering Rejection Risk in Organ Transplants (pkg) appeared first on Mayo Clinic News Network.