Sunday, January 28, 2018

Have PKD and Travel? Need Dialysis? There is an App for That, Implantable Bionic Kidney, 3D Printed Kidney helps Transplant Procedure

Living with PKD

From Luxora Leader

How saving a author‘s life helped my dialysis app go international

Javier Artigas

When Javier Artigas began needing kidney dialysis and found himself jobless, he developed an app to make it easier for people to get treatment when travelling. But his breakthrough came completely by chance, after he saved the life of a famous Argentine writer.

Without a job, Javier Artigas needed money to support his family, so he decided to rent out space in his Montevideo home on the home-sharing site, Airbnb.

It went well. One of his guests was the well-known Argentine writer, Hernán Casciari. But two days into his stay, Casciari had a heart attack. He needed to get to hospital quickly.

As chance would have it, Artigas‘s wife, Alejandra, worked for the Uruguayan senate, and was able to organise a police escort to speed up the journey. Instead of 40 minutes it took just 12. That, and the blood they donated, saved Casciari‘s life.

Later, once he had recovered and returned to Argentina, the writer left Javier and his wife a five-star review.

“Excellent house for sedentary travellers prone to myocardial infarctions. The area is beautiful and has direct access to the best hospitals. Javier and Alejandra instantly become guardian angels who will save your life without even knowing you. They will rush you to the hospital in their own car while you‘re dying and stay in the waiting room while doctors give you a bypass. They don‘t want you to feel lonely, they bring you books to read and they let you stay in their house extra nights without charging you. Highly recommend.”

But Artigas was more than a good host and Casciari‘s newly found guardian angel – he knew from personal experience just how hard it can be to be ill when you‘re far away from home.
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In 2007, Artigas was diagnosed with polycystic kidney disease, which caused his kidney function to decline rapidly. By 2014, he required haemodialysis treatment three times a week to do the work his kidneys no longer could. Each dialysis session – during which his blood would pass through an external waste-removing filtration machine before returning to his body – took four hours.

For patients like Artigas, their dialysis sessions need to be set in stone to prevent dangerous toxins from building up in the blood. Regular appointments cannot be missed, so visiting a foreign country where you may not speak the language, understand medical regulations, or be able to find affordable treatment, is a huge challenge.

Artigas‘s job involved lots of travel to Latin American and African countries where there was a further problem – finding somewhere safe to have dialysis, with uncontaminated water. After he revealed his condition and his need for dialysis to his employers he lost his job.

“I had four children and I didn‘t know what to do,” he says. “Nobody was going to hire me. To be unemployed was a whole unknown world for me. I went into a crisis because I was my family‘s breadwinner – a deep emotional crisis.”

It‘s estimated that chronic kidney disease (CKD) affects one in 10 people around the world, with millions dying every year due to lack of affordable treatment.

Artigas eventually managed to find work in IT, but this also involved some foreign travel. On one occasion he was sent to Córdoba, Argentina, where he had arranged a dialysis session, but when he arrived he was told that there was no record of his appointment. He had no access to the vital treatment he needed because he wasn‘t a resident of Argentina.

After almost 12 hours of desperate searching, terrified he was going to die from the toxins in his blood, he managed to find a hospital willing to provide him with dialysis.


People used to try and find a dialysis centre first, and then plan their holiday – we do it the other way aroundJavier Artigas

“On my way back, on that 2,000km trek, I started thinking about this problem,” he says.

It was a wake-up call. He decided he wanted to do something to help dialysis users, and in 2015 he developed an app, Connectus, to connect kidney patients with treatment centres when away from home.

“People used to try and find a dialysis centre first, and then plan their holiday,” says Artigas. “We do it the other way around. You find the beach where you want to go and we‘ll find the dialysis centre for you.”

Connectus initially launched in August 2015 as a small web platform, costing just $1,700. It focused on connecting patients from Uruguay with a small number of dialysis centres in Argentina and Brazil, the most popular destinations for Uruguayan tourists.

A month later, the Massachusetts Institute of Technology gave Connectus its prestigious Best Innovative Healthcare Solution award. This was a big success, but the breakthrough that enabled Artigas to expand the project to serve people in nearly 150 countries, providing access to more than 14,500 dialysis machines, came about in the most unexpected way – as a result of Hernán Casciari‘s Airbnb review.

Unbeknown to Artigas, an Airbnb representative in Miami had forwarded the review to Joe Gebbia, the company‘s multi-billionaire co-founder, who read it and sent Artigas an email.

On 31 December 2015, Artigas and his wife were driving to a beach 100km east of Montevideo to celebrate New Year when Gebbia‘s email arrived. It said he would like to fly to Uruguay to stay with Artigas‘s family.

At first, Artigas thought it was a hoax. But he handed the phone to his wife, and she replied to the email. Within an hour Gebbia had booked his flight. He would spend New Year‘s Eve in the air and arrive on New Year‘s Day.

As the two men got to know each other, Artigas asked what had driven Gebbia to make his sudden visit to Uruguay.

“He said, ‘I‘ve come here because I want to hear first-hand your story. I want to know every detail. I want to know your blood type. Everything you‘ve gone through.”

Artigas had not planned on talking to Gebbia about his app, Connectus, but he had already heard about it and asked lots of questions about that too.

Gebbia spent most of his time in Montevideo relaxing and reading in the garden. Then one day he told Artigas to go to his computer and look for an email from San Francisco.

“I thought it was going to be payment for his stay at my house – I wasn‘t going to charge him. Then all of a sudden I see that there‘s a contract to go into business with his company. I couldn‘t believe it,” he says.

Since then Connectus Medical has gone from strength to strength. It‘s not the only app or website of its kind, but it has now been used by nearly 250,000 patients.

Artigas‘s precarious finances have stabilised and his health has also improved.

Kidney disease runs in the Artigas family. Javier‘s 22-year-old daughter has it, and his father died of it at the age of 48, only a few years older than Artigas is now.

On 9 August 2017, Artigas had a kidney transplant that changed his life. Two days later, on the anniversary of his father‘s death, while recovering in the intensive care unit, his doctor played him El Chiquilín de Bachín on the bandoneon, to help him relax. Little did the doctor know, El Chiquilín de Bachín – The Little Boy from the Tavern – was what his father used to call him.

It was a special moment. As he embarked on a new life with a functioning kidney he felt that his father was there, urging him to use the opportunity to the full.

He now no longer needs dialysis, but he continues to work to make life easier for those who do.




Artificial Kidney Development

From Times Life Style, By Paul Becker

Scientists Have Developed A Bionic Kidney That Can Replace Kidney Dialysis



A team of researchers in the University of California are on a path-breaking revolution that can actually solve all the kidney related issues. The researcher’s team are on the development procedure of artificial kidney which is implantable. This artificial kidney can actually work as same as the real kidneys.

If the development of artificial kidney is successful, there would actually be no need of dialysis. There has been a huge rate of success in the kidney transplant procedures for the patients with severe kidney or renal diseases.

The recent researches have proved it that 93 percent of the people with kidney transplant are just working fine after a year and 83 percent are even working after 3 years without showing any kind of issues.

According to the data of 2016, more than 25,000 kidneys are gone through the transplantation procedure each year but on the other side more than100,000 people are in the need of kidney transplant each year.

On an average, a patient has to wait for five to ten years for a healthy and suitable kidney

Dialysis is another artificial process that eliminates the toxins from the bloodstream but it cannot filters out all the toxins and this procedure must be performed on a regular basis when it is done at home via peritoneal dialysis and if it is hemodialysis, the patient has to visit the clinic three times a week. Shuvo Roy, a professor in the UCSF Department of Bioengineering and Therapeutic Sciences and co-inventor of the device, explains this artificial kidney as the best alternative to dialysis and other external devices that can hamper the regular lifestyle or limit the mobility of the patience.

Yes, it is true that getting a well matched donor and transplanting kidney from them is still the best treatment option for the ESRD but unfortunately, the shortage of organ donors is a big issue and here comes the advantage of a bionic kidney. The best part of opting for artificial kidney instead of choosing kidney transplant is that it does not need the patients to be on the immunosuppressive drugs to avoid rejection.

Roy has claimed that this device can help a huge number of the people who are now on the list of dialysis and kidney transplant procedures. This device is a perfect solution for a long span of time and it could be the best alternative to the kidney transplant procedure.

Now it’s time to know how this device works actually-

Bio-artificial kidney performs most of the tasks just like the normal kidneys. The tasks include filtration, balancing and many other biological functions of normal kidneys.

This device is powered by body’s natural blood pressure and that’s the reason why it doesn’t need any external tubes that are commonly associated with the artificial kidneys that are wearable.

These artificial kidneys are developed with the silicon nanotechnology which makes the compact filtering membranes which is actually very much reliable.

The novel molecular coatings used in this system protects the silicon membranes and makes them completely compatible with the blood.

People with the bionic kidney implants may still need to take hormonal supplements on a regular basis just like they need to have in the case of dialysis.

“The long-term challenges center around keeping the device operating trouble-free after implantation beyond a few months,” said Roy. “Some problems won’t become clear until we do clinical trials.”




Technology

From TCT Magazine, by Sam Davies

axial3D printed kidney model provides solution to complex procedure

axial 3D kidney mode



A 3D printed kidney model, manufactured by axial3D, has enabled surgeons to successfully perform a complex transplant operation on a young mother in Belfast.

Pauline Fenton, 22, was suffering from end-stage kidney disease and was dialysis-dependant when her father, William, 45, was confirmed to be a suitable living donor, but was blood group incompatible. The discovery of a Bosniak 2F renal cyst on William’s donor kidney further complicated proceedings. Potentially cancerous, it would need treatment before the incompatible transplant could be carried out.

Surgeons at Belfast City Hospital turned to 3D printing for a helping hand, CT scanning the kidney, and printing a replica model. It allowed the surgical team to determine the size and location of the cyst, and plan the procedure accordingly. Once the cyst had been removed, Pauline could then receive the replacement kidney.

“We planned and rehearsed the surgery precisely, using an exact replica of the donor kidney containing the size and position of cyst, so my team knew the precise procedure required in the operating theatre,” commented Tim Brown, Consultant Transplant Surgeon at Belfast City Hospital. “This level of insight is just not achievable with standard pre-operative imaging. This father’s gift of life to his daughter proves the benefit of living organ donation but in this case, I’m certain 3D printing also played a part in helping us to give this young mother an improved quality of life and the opportunity to see her child grow up.”

Belfast-based axial3D were the company on hand to 3D print the replica kidney, harnessing the expertise of its specialist team to deliver an accurate and ultimately life-changing model. The company has long-been promoting the adoption of additive manufacturing within the medical sector, and in recent weeks established a Scientific Advisory Board to oversee its own medical 3D printing activities.

With cost-saving at the forefront of the NHS agenda now more than ever, axial3D believes there’s plenty of scope for 3D printing’s incorporation into state medical centres, and uses the Pauline Fenton case as a prime example. The average cost for a patient on dialysis is more than £30,000 per year, which is reduced to £5,000 post-transplant. 3D printing can mean that price reduction is reached quicker, and safely.

“We work with surgeons with the core aim to improve patient outcomes; reduce operating times and ultimately help advance surgical education and planning for the future,” said Daniel Crawford, Founder of axial3D. “We’re proud that our technology can have profound positive impacts on improving the quality and length of patients’ lives and we’re delighted that our work provided significant benefit for this family.

“It is vital that our amazing surgeons have access to the best and most innovative solutions to support them in planning for very complex procedures. 3D printing offers an exciting opportunity for hospitals to reduce costs, elevate care, and most importantly, improve patient outcomes. Now that 3D prints are available via the NHS in Northern Ireland, we look forward to supporting more surgeons and patients with this technology.”

1 comment:

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