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Diseased kidneys are ripe for transplant
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This week– and had they stayed on dialysis in Australia, 10 would be expected to die each year, says Nicol. “The series of patients show this is a real possibility – it can be done, and it can be done safely,” says Göran Klintmalm, president of the American Society of Transplant Surgeons. However, this kind of transplant is highly controversial. As New Scientist went to press, the Japanese government was collecting opinions from transplant surgeons in a move that could determine whether the procedure continues. And Nicol says his work was “hammered” when he presented it to transplant surgeons in the US. Part of the problem is that transplant recipients who receive kidneys that have had a cancer removed run the risk of the cancer returning. So far, the cause of death of one Japanese patient –Ripe for transplant?– who received a restored kidney may have been a recurrence of cancer in the organ, and one Australian patient is being closely followed after a suspicious mark appeared on the kidney nine years after the transplant. But also at issue is whether removing a whole kidney rather than just the tumour jeopardises the health of donors. One study “repaired” kidneys into RACHEL NOWAK 42 patients whose average age was suggests that for small cancers, removing the tumour alone IT IS a grim dilemma: spend years 50. Five years later, 79 per cent of reduces the likelihood of patients them were still alive (American more on a kidney transplant developing chronic kidney disease Journal of Transplantation, DOI: waiting list, and possibly die 10.1111/j.1600-6143.2007.02145.x). later on (The Lancet Oncology, before you ever reach the top, or vol 7, p 735). In Australia, the Meanwhile, an Australian accept a diseased organ that has medical teams treating patients team led by David Nicol at been patched up. who donate and receive kidneys Princess Alexandra Hospital With the wait for healthy are kept completely separate, in Brisbane, has transplanted kidneys standing at two to six years in the US and Australia, and repaired kidneys into 49 patients. which removes the potential for a conflict of interest, says Nicol. But The recipients were followed for 16 years in Japan, two surgeons in Japan, Mannami treated both an average of three and a half have been quietly transplanting sets of patients. years, during that time four died diseased kidneys from living Even more controversially, from conditions unrelated to donors, who have had a kidney whereas Nicol has only used the transplant (British Journal removed because of a small kidneys from patients with small of Urology International, DOI: cancer or some other disorder. cancers, Mannami has used 10.1111 j. 1464-410X.2007.07400. The organs are first repaired, for kidneys with nephrotic example, by removing the cancer, x). The patients were all over 60, syndrome, for example, in which before being transplanted into the kidneys leak large amounts of someone with kidney failure. “A team in Japan transplanted protein. Here it’s even more Since 1991, a team led by repaired kidneys into 42 debatable whether the best Makoto Mannami of Uwajima patients. Five years later, treatment for the donor is to Tokushukai Hospital in Ehime, 79 per cent were still alive” remove a kidney. ● Japan, has transplanted
Even patched up it’s still a kidney
12 | NewScientist | 29 March 2008
SOUNDBITES ‹ You could perceive that they’re saying this out of a real lack of understanding, or you could say that they’re doing it to ratchet up tension.› Stephen Minger of King’s College London, on church leaders in the UK using their Easter sermons to condemn legislation allowing the use of hybrid human-animal embryos for research (The Guardian, London, 25 March)
‹ I’ve seen people die and die and die. The only discharge you get from this place is to the mortuary.› Siyasanga Lukas, a 20-year-old TB patient at the Jose Pearson TB hospital in Port Elizabeth, South Africa, on how patients are kept behind electrified razorwire fences to keep them from infecting others (The New York Times, 25 March)
‹ You drink, therefore you publish less. Or those who are already unsuccessful as scientists may drink more to forget.› Tomáš Grim of Palacký University in Olomouc, Czech Republic, on his finding that the more beer a scientist drinks, the less likely they are to publish or be cited by others (The Prague Post, 19 March)
‹ Her death is on this nation’s conscience because we deported her when it was against every humanitarian instinct to do so.› The Archbishop of Wales, Barry Morgan, on the death of Ghanaian woman Ana Sumani, who had been receiving treatment for cancer at a UK hospital until she was deported two months ago (The Times, London, 21 March)
‹ He was always thinking about what could come next, but also about how life could be improved in the future. It’s a vision that I think we could use more of today.› George Whitesides of the US National Space Society on Arthur C. Clarke, who died on 19 March, aged 90 (BBC Online, 19 March)
www.newscientist.com
This week– and had they stayed on dialysis in Australia, 10 would be expected to die each year, says Nicol. “The series of patients show this is a real possibility – it can be done, and it can be done safely,” says Göran Klintmalm, president of the American Society of Transplant Surgeons. However, this kind of transplant is highly controversial. As New Scientist went to press, the Japanese government was collecting opinions from transplant surgeons in a move that could determine whether the procedure continues. And Nicol says his work was “hammered” when he presented it to transplant surgeons in the US. Part of the problem is that transplant recipients who receive kidneys that have had a cancer removed run the risk of the cancer returning. So far, the cause of death of one Japanese patient –Ripe for transplant?– who received a restored kidney may have been a recurrence of cancer in the organ, and one Australian patient is being closely followed after a suspicious mark appeared on the kidney nine years after the transplant. But also at issue is whether removing a whole kidney rather than just the tumour jeopardises the health of donors. One study “repaired” kidneys into RACHEL NOWAK 42 patients whose average age was suggests that for small cancers, removing the tumour alone IT IS a grim dilemma: spend years 50. Five years later, 79 per cent of reduces the likelihood of patients them were still alive (American more on a kidney transplant developing chronic kidney disease Journal of Transplantation, DOI: waiting list, and possibly die 10.1111/j.1600-6143.2007.02145.x). later on (The Lancet Oncology, before you ever reach the top, or vol 7, p 735). In Australia, the Meanwhile, an Australian accept a diseased organ that has medical teams treating patients team led by David Nicol at been patched up. who donate and receive kidneys Princess Alexandra Hospital With the wait for healthy are kept completely separate, in Brisbane, has transplanted kidneys standing at two to six years in the US and Australia, and repaired kidneys into 49 patients. which removes the potential for a conflict of interest, says Nicol. But The recipients were followed for 16 years in Japan, two surgeons in Japan, Mannami treated both an average of three and a half have been quietly transplanting sets of patients. years, during that time four died diseased kidneys from living Even more controversially, from conditions unrelated to donors, who have had a kidney whereas Nicol has only used the transplant (British Journal removed because of a small kidneys from patients with small of Urology International, DOI: cancer or some other disorder. cancers, Mannami has used 10.1111 j. 1464-410X.2007.07400. The organs are first repaired, for kidneys with nephrotic example, by removing the cancer, x). The patients were all over 60, syndrome, for example, in which before being transplanted into the kidneys leak large amounts of someone with kidney failure. “A team in Japan transplanted protein. Here it’s even more Since 1991, a team led by repaired kidneys into 42 debatable whether the best Makoto Mannami of Uwajima patients. Five years later, treatment for the donor is to Tokushukai Hospital in Ehime, 79 per cent were still alive” remove a kidney. ● Japan, has transplanted
Even patched up it’s still a kidney
12 | NewScientist | 29 March 2008
SOUNDBITES ‹ You could perceive that they’re saying this out of a real lack of understanding, or you could say that they’re doing it to ratchet up tension.› Stephen Minger of King’s College London, on church leaders in the UK using their Easter sermons to condemn legislation allowing the use of hybrid human-animal embryos for research (The Guardian, London, 25 March)
‹ I’ve seen people die and die and die. The only discharge you get from this place is to the mortuary.› Siyasanga Lukas, a 20-year-old TB patient at the Jose Pearson TB hospital in Port Elizabeth, South Africa, on how patients are kept behind electrified razorwire fences to keep them from infecting others (The New York Times, 25 March)
‹ You drink, therefore you publish less. Or those who are already unsuccessful as scientists may drink more to forget.› Tomáš Grim of Palacký University in Olomouc, Czech Republic, on his finding that the more beer a scientist drinks, the less likely they are to publish or be cited by others (The Prague Post, 19 March)
‹ Her death is on this nation’s conscience because we deported her when it was against every humanitarian instinct to do so.› The Archbishop of Wales, Barry Morgan, on the death of Ghanaian woman Ana Sumani, who had been receiving treatment for cancer at a UK hospital until she was deported two months ago (The Times, London, 21 March)
‹ He was always thinking about what could come next, but also about how life could be improved in the future. It’s a vision that I think we could use more of today.› George Whitesides of the US National Space Society on Arthur C. Clarke, who died on 19 March, aged 90 (BBC Online, 19 March)
www.newscientist.com