From the Editor’s Desk

Dr. Ramesh Prasad

Welcome to the Spring/Summer 2023 edition of Transplant Digest. We are settling in to our new clinic space on the 8th floor of 61 Queen Street East, with all its brand new facilities, and hope you have had a chance to either visit the new clinic or take a peak. As the COVID-19 pandemic hopefully draws to a close, we are actively planning for how we can manage increased patient numbers, and increased patient complexity. Remember, new transplant activity hardly stopped during the pandemic! We now have over 1800 patients. Fortunately, most (but not all) of our immunosuppressed patient population survived the pandemic, but we can’t afford to take anything in life for granted. Please keep your vaccination up to date.

In this issue, we have articles on white blood cells, thinking traps, World Kidney Day, blood pressure monitoring cuffs, and managing blood sugar, as well as a transplant quiz and a special interview with kidney transplant recipient and hockey star David Ayres. We are always looking for contributions from patients, so please feel free to contact us with your ideas if you like to write and are passionate about something transplant-related. Transplant Digest is all about you.

World Kidney Day story continued from page 1 ing for the unexpected, supporting the vulnerable”. The following journal article summary showcases the increase in natural disasters that have the potential to disproportionably affect individuals with kidney disease:

Kidney health for all: preparedness for the unexpected in supporting the vulnerable

The World Kidney Day Joint Steering Committee

As the rate of natural disasters and other devastating events caused by human activities increases, the burden on the health and well-being of those affected by kidney disease has been immeasurable. Health system preparedness, which involves creating a resilient system that is able to deal with the health needs of the entire community during times of unexpected disruptions to usual care, has become globally important. In the wake of the COVID-19 pandemic, there is a heightened awareness of the amplification of negative effects on the renal com-

Contact Information

Dr. Ramesh Prasad – Editor

Meriam Jayoma-Austria, RN, BScN, C.Neph.CNewsletter Coordinator

Please send your comments or suggestions of topics for future publication to: meriam.jayoma@unityhealth.to

St. Michael’s Hospital Kidney Transplant Program

(across the hospital)

61 Queen Street East, 9th Floor Toronto, Ontario, M5C 2T2 Phone: 416-865-3665

Disclaimer Note:

Views presented in this newsletter are those of the writers and do not necessarily reflect those of St. Michael’s Hospital or the University of Toronto. Subject matter should not be construed as specific medical advice and may not be relevant. For all questions related to your health please contact your health care provider.

munity. Paradoxically, the complex medical needs of those who have kidney diseases are not met by systems handling crises, often compounded by an acute increase in burden via new patients as a result of the crisis itself. Disruptions in kidney care as a result of unexpected events are becoming more prevalent and likely to increase in the years to come. It is therefore only appropriate that the theme for this year’s World Kidney Day will focus on Kidney Health for All: preparedness for the unexpected in supporting the vulnerable.

Transplantation services and donation chains in times of crisis are placed on hold, creating disruption for patients urgently awaiting the procedure. (Canadian Blood Services suspended Kidney Paired Donation during the early COVID pandemic) Patients living with a functioning graft or with chronic kidney disease of various forms may experience unavailability immunosuppressive medications. A sudden high demand for acute dialysis may impact dialysis availability for patients on chronic dialysis. If patients are forced to flee, these challenges are aggravated by unsafe and precarious conditions during their journey and/or at their destination.

The crisis itself does not only affect patients with pre-existing kidney disease. In fact, it may lead to significant numbers of patients with acute kidney injury, such as crush injury, which for instance can result in acute kidney injury (AKI) or kidney failure, adding an additional burden to units.

In case of an emergency, it is important for patients to be prepared and informed on how to react in case of emergencies. Hemodialysis and transplant patients should:

• Plan of an emergency; this can help save their lives. Prepare an emergency checklist.

• Obtain prescriptions ahead of time. Keep a list of their medical needs, medicines, and dosages.

• Maintain a list of important contact information i.e., phone numbers of back-up dialysis units, doctors, different options of dialysis units and Emergency Medical Services.

• Keep a two-week extra supply of their required medicines in their original bottles and keep a 7–14-day emergency diet stock.

• Prepare an emergency kit in a waterproof bag (containing key information and items, such as a medicine list, doctor, transplant coordinator, pharmacist, insurance, bottles of water, and other supplies. “

Further emergency preparedness information is available on the National Kidney Foundation website.