Dr. Ashtar Chami (AC), from Emory University Hospital, discusses her abstract for the National Kidney Foundation’s 2013 Spring Clinical Meetings (SCM13), Autosomal Dominant Polycystic Kidney Disease (PKD) evaluated for Renal Transplantation. A Single Center Experience at the Emory Transplant Center, with Dr. Kenar Jhaveri (eAJKD), eAJKD Blog Editor.
eAJKD: Why don’t you tell us a little about your research and abstract being presented at NKF 2013 Spring Meetings?
AC: As a transplant nephrologist, I noticed that most of the ADPKD patients who had been transplanted did much better than most other transplant patients. Since ADPKD accounts for 8.3% of deceased donor transplants and 11.7% of living donor transplants performed in the US, I felt it was important to look specifically at these patients. Upon review of the literature, I noticed that there little written regarding outcomes of polycystic kidney disease patients and transplantation. I am fortunate enough to be at a center where I could collaborate with Dr. Chapman who has one of the largest cohort of polycystic kidney disease patients. We decided to start with a retrospective study looking at patients who were evaluated for a transplant at Emory University and assess their pre- and post-transplant course, their total kidney volumes and their complications related to ADPKD.
eAJKD: ADPKD patients that got transplanted had high frequency of hernia repairs, nephrectomies and NODAT. Why do you think they develop NODAT more than the non ADPKD patients getting transplanted?
AC: An increased incidence of NODAT has been reported in the past but our data confirms this in a larger population. When we analyze the data further, we plan to control for such factors as body mass index to see if the association still exists. We will also be looking to see whether this increase is related to liver cyst volume or the presence of pancreatic cysts. Since ADPKD patients have abnormalities in mTOR signaling pathways, this may predispose them to insulin resistance especially in the setting of steroid use. We plan to explore this pathway further.
eAJKD: Where do you and your group go from here?
AC: We are planning on collecting data on rejection rates in ADPKD patients who have been transplanted, and determine whether they are more likely to have rejections when compared to a control population to determine if there is a difference in their immune phenotypes. We will also be assessing total kidney volumes post transplantation and assessing the response in cyst growth on different immunosuppressive agents. It is a good idea to continue building on our large cohort of ADPKD patients that get transplanted and start a prospective observation of these patients’ outcomes.
Click here for a full list of SCM13 abstracts of poster presentations.
Check out more eAJKD coverage of the NKF’s 2013 Spring Clinical Meetings!