DR. JOHN P. ROBERTS, MD

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This research focused on how well patients with diabetes do after getting a kidney transplant, comparing those who received kidneys from deceased donors to those who got them from living donors. The study found that patients with diabetes waiting for a kidney transplant are more likely to face failures while on the waiting list, specifically 2.27 times more likely, and those who received living donor transplants lived an average of 18.2 years compared to 14.1 years for deceased donor transplants. This matters because living donor transplants not only improve survival rates but also reduce the time spent waiting for a transplant, showing the need to increase access to living donor options for these patients. Who this helps: Patients with diabetes and end-stage renal disease.

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This study looked at the outcomes of liver transplants for patients with colorectal cancer that has spread to the liver, a condition that's often hard to treat. Out of 222 patients listed for a transplant, 158 received one, with 48% getting theirs from living donors and 52% from deceased donors. Three years after their transplant, 67% of patients were alive, and 44% had no signs of cancer, which shows progress but still falls short of other transplant benchmarks, highlighting the need for better nationwide criteria for selecting patients and managing organ quality. Who this helps: This research benefits patients needing liver transplants for colorectal cancer, as well as doctors involved in these procedures.

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This study looked at patients with a specific genetic change in the WFS1 gene that leads to conditions affecting hearing and vision. Researchers analyzed data from 11 patients and found that while the average age for being diagnosed with vision problems was 10 years, hearing loss was typically diagnosed much earlier, around age 2. All patients used hearing aids, and some had cochlear implants, with a noticeable delay of about 4 years from the hearing loss diagnosis to starting to use hearing aids. Who this helps: This research benefits patients and their families by improving understanding of how these genetic conditions progress, which can lead to better management strategies.

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This study looked at how medical centers across the U.S. manage pain for people who donate part of their liver. Researchers found that 67.6% of centers perform both right and left lobe surgeries and most have specific pain management guidelines. In fact, 78.4% had protocols in place for managing pain before surgery, while 83.8% had them for after, with common medications being acetaminophen for pain relief post-surgery and regional anesthesia techniques like transversus abdominis plane blocks being widely used. Who this helps: This helps liver donors by ensuring they receive effective pain management during and after surgery.

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This study looked at how well patients do after receiving a liver transplant from deceased donors and evaluated a scoring system called MELD, which helps determine who gets a transplant. The researchers found that patients with a MELD score of 12 or higher had a 46% lower risk of dying after the transplant compared to those still waiting for a liver. This is important because it updates the previous guideline that suggested a MELD score of 15 as the cutoff for transplant eligibility, showing that patients with lower scores may also benefit significantly. Who this helps: This helps patients who are waiting for a liver transplant, particularly those with MELD scores of 12 to 14.

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This study focused on the long-term health and well-being of people who donate part of their liver to others in need. Experts gathered to create guidelines that will help monitor and support these living donors, addressing their medical, psychological, and social needs. This is important because it ensures that donors can stay healthy and maintain a good quality of life after their donation, making more people willing to consider being donors in the future.

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This study looked at kidney transplant candidates who had to be vaccinated against COVID-19 to stay active on the waiting list. It found that patients living in areas with lower health equity measures were almost twice as likely to get deactivated for not being vaccinated, and those on government insurance were even more likely to be inactivated. This matters because it raises concerns about fairness in vaccination requirements for vulnerable patient groups. Who this helps: This helps patients on organ transplant waiting lists and advocates for health equity.

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This study examined the costs associated with services that help patients become eligible for kidney transplants in the U.S. Over five years, hospitals spent a median of $5 million on these services, with specific costs like $9,000 for each new patient added to the waitlist and $26,000 for living donor evaluations. This research highlights the need for better funding to manage higher patient volumes and improve access to kidney transplants. Who this helps: This helps patients waiting for kidney transplants and the healthcare systems that serve them.

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This study looked at the costs involved in obtaining livers from deceased donors for transplants in the United States from 2013 to 2018. Researchers found that the costs varied widely among different organ procurement organizations, averaging around $31,659 per liver, with the lowest at $11,393 and the highest at $65,556. The study revealed that costs could be lower if more livers were procured locally, but imported livers tended to be more expensive after a certain point. Who this helps: This helps patients needing liver transplants and the doctors involved in their care.

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This 12-center North American study followed 360 patients who received a living donor liver transplant for liver cancer, including many whose tumors exceeded the standard size and number limits (Milan criteria). Ten-year survival exceeded 60% even for patients outside the criteria, and a newer scoring tool called the NYCA score correctly identified most of these "out-of-criteria" patients as low or acceptable risk. Living donor transplant offers good long-term outcomes for a broader group of liver cancer patients than current criteria allow.

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This study examined the role of a specific mutation (G34S) in a gene related to autism, which leads to problems with a protein called δ-catenin, crucial for brain cell communication. Researchers found that this mutation causes a significant decrease in δ-catenin levels, disrupting normal brain signaling and resulting in social behavior issues in mice, a common trait observed in autism. They also discovered that blocking a related enzyme (GSK3β) can restore normal δ-catenin function and improve social behaviors, suggesting a potential pathway for treatment. Who this helps: This helps patients with autism and their caregivers by providing insights that could lead to better treatment options.

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This research studied how a substance called acetate affects the survival of T-cells, which are important for the immune system. The team found that acetate increases a protein called CD30, which helps stabilize another protein that affects cell death. Specifically, they discovered that when CD30 is present, it helps keep T-cells alive by promoting proteins that prevent cell death. Who this helps: This research helps patients by potentially improving treatments for conditions where T-cell responses are crucial, such as infections or cancer.

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This study looked at how a specific genetic mutation linked to autism affects brain function and social behavior. Researchers found that the G34S mutation reduces the levels of a protein called δ-catenin, leading to changes in brain signaling that can cause social difficulties; for example, in mice with this mutation, δ-catenin levels and social behaviors were significantly impaired. Importantly, they discovered that a drug that blocks a specific enzyme could restore normal function and improve social behavior in these mice. Who this helps: This research benefits patients with autism and may inform treatments for improving social skills.

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This study examined the effects of avoiding steroids after liver transplants from living donors, comparing outcomes for two groups: one that used steroids routinely and another that did not. Researchers found that about 22.9% of patients who avoided steroids experienced early organ rejection, compared to 17% who received steroids, which is not a significant difference. Both groups had similar survival rates of around 94% for steroid avoiders and 91% for those on steroids three years post-transplant, indicating that avoiding steroids does not pose additional risks for liver transplant patients. Who this helps: This helps patients undergoing living donor liver transplants.

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This study looked at how a new method called normothermic machine perfusion (NMP) affects liver transplants in real-world situations, rather than controlled clinical trials. It found that patients receiving NMP needed significantly less emergency medication and fewer blood transfusions during and after surgery, experienced shorter stays in the intensive care unit, and had better early liver function results. Specifically, NMP recipients used about 4 fewer units of red blood cells and spent about 25 hours less in the ICU compared to those using traditional storage methods. Who this helps: This helps patients undergoing liver transplants and the medical teams caring for them.

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This study looked at liver transplants from donors who died after their heart stopped beating (DCD) in patients with severe liver disease (MELD score over 35). The findings showed that five-year survival rates were similar between DCD liver transplants (85%) and those from brain-dead donors (86%) in one group, but lower overall for DCD transplants (65% compared to 75% for brain-dead donors) in a larger group, indicating challenges with DCD organs. This matters because it shows that while DCD transplants can be used in certain patients, they may have higher risks and lower long-term survival compared to traditional donor organs. Who this helps: This research benefits patients with severe liver disease who may need a transplant, especially when suitable donors are scarce.

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Researchers discussed ways to improve living kidney donation, which is the best treatment for people with kidney failure but has not increased in the U.S. in over 20 years. They found that offering rewards for donors could save up to 40,000 lives each year and reduce medical costs, and surveys showed that voters support compensating donors. Experts agreed that to boost donations, barriers in the donor process must be removed, living donor exchanges should be expanded, and donors should not have to pay any costs related to the donation.

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This study asked whether kidney transplants from incompatible live donors carry additional risk for patients over age 60 compared to younger patients. Older recipients had higher mortality and lower rates of acute rejection, but the impact of being in an incompatible transplant versus a compatible one was similar at all ages. Age alone should not be used to deny patients access to incompatible living donor transplantation.

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Living donor liver transplantation can reduce deaths on the waitlist, but its use in the U.S. remains low. This consensus conference report from the American Society of Transplantation identified barriers to wider adoption and outlined best practices for selecting candidates and engaging potential donors. The goal is to increase access to living donor transplants across more transplant centers.

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This study looked at the effects of poor growth and being underweight on people with cystic fibrosis (CF) waiting for liver transplants. It found that nearly 1 in 3 children and adults on the transplant list had growth issues or were underweight, which significantly increased their risk of dying while waiting—particularly for children, where that risk was nearly four times higher for those with both problems. Understanding these issues is crucial because improving nutrition in these patients can help enhance their chances of survival while waiting for a transplant and after the surgery. Who this helps: This helps patients with cystic fibrosis, their families, and healthcare providers focusing on their nutrition and transplant readiness.

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This study looked at patients waiting for liver transplants and how their willingness to accept organs from donors at increased risk for certain infections affects their chances of getting a transplant. Researchers found that patients who agreed to receive organs from these donors were 2.3 times more likely to receive a transplant within about 11 months, compared to an average wait of 14 months for those who did not consent. Additionally, consenting patients had a 44% lower risk of dying while waiting for a transplant, showing that fear of potential infection risks may negatively impact patients' access to life-saving organs. Who this helps: This helps patients on the liver transplant waiting list.

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This study looked at the rising costs associated with kidney transplantation evaluations and managing waiting lists in the U.S. between 2012 and 2017. It found that Medicare costs for kidney transplants increased from $0.95 billion in 2012 to $1.32 billion in 2017, with the average cost per transplant going up from $81,000 to $100,000. This matters because as the waiting list for kidney transplants expands, costs are expected to rise even more, which could significantly impact Medicare spending on kidney health. Who this helps: This helps patients awaiting kidney transplants and healthcare providers managing their care.

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This study looked at the long-term outcomes for people who donated a part of their liver and found that they generally stay healthy, with survival rates similar to that of non-donors. However, two related studies presented their findings differently, with one creating unnecessary fear through misleading comparisons. It’s important for medical data to be shared honestly so that both potential donors and medical professionals can make informed decisions about living liver donation. Who this helps: This helps patients considering live liver donation and their doctors.

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This study looked at the effects of a new RSV vaccine given to pregnant women to protect their newborns from respiratory syncytial virus (RSV), a serious illness for infants. Out of 406 pregnant women, 80.5% received the vaccine, which produced strong antibody responses in both the mothers and their babies, with infant antibody levels 9.7 to 16.8 times higher than those of babies whose mothers did not get the vaccine. The vaccine was mostly safe, with minor side effects reported, particularly with aluminum-containing formulations. Who this helps: This benefits pregnant women and their infants by potentially reducing the risk of severe RSV illness in newborns.

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This study examined how different surgical techniques for liver donation affect the immediate and short-term health of living donors. After reviewing 21 studies, researchers found that complications were more common for donors undergoing right hepatectomy (27%) compared to left hepatectomy (21%). Donors who had left hepatectomy also stayed in the hospital for about 1.4 days less. The findings suggest that left hepatectomy leads to better outcomes and should be the preferred method for donor surgeries. Who this helps: This helps living liver donors by highlighting which surgical option may lead to fewer complications and shorter recovery times.

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This study looked at a rare liver condition called nodular regenerative hyperplasia in people who had liver transplants. Out of 3,711 transplant recipients, only 49 (about 1.3%) developed this condition, and among them, 32.7% died over an average follow-up of nearly 85 months. Those who had symptoms related to high blood pressure in the liver when diagnosed had a much higher mortality rate of 51.8%, compared to just 10.5% for those with liver test changes but no symptoms. Understanding these patterns is important because it helps identify who might be at greater risk and improve care for patients. Who this helps: This helps patients who have had a liver transplant and their doctors.

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This study looked at how compensating people who donate kidneys could help solve the shortage of available organs in the U.S. Currently, only enough kidneys are donated to help 15,000 patients each year, but about 62,000 patients could be saved if more kidneys were available. By offering around $77,000 per donor, the government could ensure enough donations to prevent 47,000 patients from suffering on dialysis, saving families and taxpayers roughly $1.5 million in expenses per kidney recipient. Who this helps: Patients with kidney failure and their families.

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This study looked at how fathers' mental health, specifically depression, affected their parenting and their children's development during the COVID-19 pandemic. Researchers found that fathers who faced greater challenges during the pandemic, like financial and health problems, reported higher depressive symptoms. This was linked to less warm and responsive parenting, and both the fathers' mental health and pandemic-related challenges were associated with lower cognitive scores and emotional issues in their children. Who this helps: This benefits fathers, their children, and healthcare providers by highlighting the importance of supporting fathers' mental health during crises.

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This consensus guidance article reviews available evidence and draws on kidney donation experience to provide practical recommendations for evaluating anonymous living liver donors—people who donate to strangers rather than a specific recipient. The authors address donor selection criteria, allocation of nondirected grafts, and ethical considerations to ensure safe expansion of this practice. The guidance aims to standardize an emerging practice that could meaningfully increase the supply of living donor livers.

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This study looked at patients who needed a second liver transplant (re-LT) after their first liver transplant from a living donor. Out of over 1,000 patients studied, 10.3% needed a re-transplant, and those who had to undergo this procedure had worse survival rates—only 44% were alive after 10 years compared to 68% for those who did not need a re-transplant. These findings highlight the challenges and risks involved in needing a second transplant, particularly for patients who develop complications like hepatitis C or infections. Who this helps: This helps patients who are considering or have undergone living donor liver transplants, as well as their doctors.

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This study looked at how using opioids before a liver transplant affects survival after the procedure. Researchers found that out of 751 liver transplant patients, 16% had an opioid prescription when they received their transplant. Those patients were 2.4 times more likely to die after the transplant compared to those who did not use opioids, highlighting the serious risks involved. Who this helps: This information helps doctors and medical teams when deciding pain management strategies for liver transplant patients.

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This study looked at how kidney transplant surgeons approach the transplantation of women who have survived breast cancer. Out of 129 surgeons surveyed, about 75% believed that the current guidelines for these patients are insufficient, and nearly 90% would support reducing waiting times for women at low risk of cancer returning. These results highlight the importance of updating guidelines to ensure better treatment options for breast cancer survivors who need kidney transplants. Who this helps: This helps patients who are breast cancer survivors and need kidney transplants.

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This study investigated how beta-amyloid, a protein linked to Alzheimer's disease, affects certain receptors in the brain that are important for communication between nerve cells. Researchers found that beta-amyloid specifically interacts with two types of receptors (α7 and α4β2) but not a third type (α3β4), leading to issues with synaptic function. By selectively activating the α7 and α4β2 receptors, they could reverse some of the damage caused by beta-amyloid, improving signaling in brain cells. Who this helps: This research benefits patients with Alzheimer's disease by offering new insights into potential treatments.

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This review looks at living donor liver transplants where the left lobe of the liver is removed from a living donor to help a recipient. The study found that although complications can occur after the transplant, they do not impact the long-term survival of the donor’s liver or the patient. This is important because it shows that living donor transplants can be a reliable solution to the shortage of available organs. Who this helps: Patients needing a liver transplant.

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This study looked at how the COVID-19 pandemic affected people in the U.S. waiting for kidney transplants, particularly those with end-stage renal disease (ESRD). Researchers found that the reduction in kidney transplants due to the pandemic could lead to an estimated 119 to 478 additional deaths among patients on the waiting list. These findings highlight the critical importance of maintaining transplant activity during crises, as many patients rely on timely procedures to survive. Who this helps: This helps patients waiting for kidney transplants and their families.

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This study looked at the costs of obtaining organs from deceased donors who don't meet typical donor standards, using five years of US organ procurement data. It found that procuring one kidney costs about $55,000 on average, while getting both kidneys from one donor can reduce the cost to about $36,000 each. This matters because even though these nonstandard donors are more expensive, kidney transplants from them are still considered cost-effective, which could help address the shortage of available organs for transplant. Who this helps: Patients in need of kidney transplants.

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This study looked at how effective non-surgical treatments are for children who develop bile duct problems after a liver transplant. Out of 49 children treated over 30 years, 57% of those with bileduct narrowing and 57% with leaks saw long-term success without needing additional surgeries. This is important because it shows that many pediatric patients can avoid the risks of further surgery while still recovering from these complications. Who this helps: This helps pediatric liver transplant patients and their families.

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This study looked at the costs associated with organ procurement organizations (OPOs) in the U.S. over five years. It found that organ procurement is a $1 billion operation with over 26,000 transplants each year, where more than 60% of the costs are overhead. Interestingly, smaller OPOs that import more kidneys have higher costs and lower performance, while the profits suggest that OPOs are financially stable and not contributing to the organ shortage. Who this helps: This information benefits policymakers and healthcare administrators working to improve organ donation and transplantation systems.

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This study looked at how many people needed emergency surgery during the COVID-19 pandemic compared to before. Researchers found that emergency surgery presentations dropped by 31%, from about 28 patients a week before the pandemic to 23 a week during it. Additionally, the patients who did show up were generally younger, more likely to have private insurance, and had less severe health issues when they arrived, which indicates that certain vulnerable groups might have been missing out on necessary care. Who this helps: This benefits patients, especially those in vulnerable populations who may struggle to access timely medical care.

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This study examined how a specific part of the AMPA receptor, called GluA1, is regulated during changes in brain connections, particularly how it gets removed from the cell surface. Researchers found that a particular chemical change (phosphorylation) to GluA1 helps keep more receptors on the cell surface by preventing them from being taken back inside the cell. Specifically, when GluA1 is phosphorylated at a certain site, the binding of a protein that facilitates internalization is reduced, which leads to an increase in surface receptors. Who this helps: This benefits patients with neurological conditions related to synaptic function, as understanding this process could lead to better treatments.

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This study looked at different scoring systems to identify the best ways to choose donors and recipients for liver transplants from individuals whose heart has stopped (known as donation after circulatory death, or DCD). The researchers found that a new scoring system, called the universal-comprehensive DCD score, was better at predicting the success of these transplants compared to previous scores, achieving an accuracy rate of 63.5% in a large group of patients. The findings highlight the need for customized scoring methods that consider local conditions to make the best use of DCD organs. Who this helps: This helps doctors and transplant teams make better decisions for patients in need of liver transplants.

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Researchers quantified how having pre-existing donor-specific antibody affects early complications after incompatible living donor kidney transplantation. Stronger antibody mismatches were associated with higher rates of delayed graft function and acute rejection, but the downstream impact of these complications on long-term survival was not worse than in compatible transplants. These risks should inform preoperative counseling but need not preclude transplantation.