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UAB Performs First Transplant of Pig Kidney to Brain-Dead Human by SteVe SPencer
UAB Xenotransplant team. From left, front row: Jayme Locke, MD, Katie Stegner, Lindsey Banks, Amy Johnson, MD, Sara Macedon; Back row: Babak Orandi, MD, Jordan Lee, MD, Paige Porrett, MD, Brett Findley, Natalie Budd, Douglas Anderson, MD, Drew Shunk, MD, JennyAnn Eads
One of the biggest tragedies in modern healthcare is that, while transplants are hugely effective for failing kidneys with a 96 percent success rate, there are only about 25,000 kidneys available annually with 800,000 patients who need them. Doctors have to deal with the heartbreak of having patients who might die before they can receive an organ for transplant. The UAB Marnix E. Heersink School of Medicine took a big step toward solving this problem and potentially
Leadless Pacemaker for Patients with AV Block by Jane
ehrhardt
“I’m a huge fan. It’s revolutionary,” says Amit Shah, MD, about leadless pacemakers. Shah, who is a clinical cardiac electrophysiologist with Cardiology Consultants, has deployed approximately 200 of these devices in the last three years, with about 80 of them being the newest version by Medtronic, called Micra AV, approved by the FDA in February 2020. “Now with the Micra AV, any patient with heart block—which is the majority of the patients for pacemakers—is a candidate for a leadless pacemaker. It has re-
ally opened the door in terms of patients who would benefit from it,” Shah says. The original Micra Transcatheter Pacing System (TPS), now called Micra VR, is predominantly for patients afflicted with atrial fibrillation (AFib). Implanted directly into the right ventricle, the world’s smallest pacemaker delivers electrical impulses that pace the heart through an electrode at the end of the device. The Micra AV serves to synchronize. The device doesn’t pace the atrium, but it does adjust pacing in the ventricle to co-
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The Micra AV is the size of a big vitamin capsule. The Micra AV is implanted into the right ventricle.
ordinate with the atrium. “It’s a detection device to help keep the atrium and ventricles synchronized with each other,” Shah says. “As long as the patient’s atrial activity is normal, this is a wonderful device.”
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saving hundreds of thousands of lives when they performed the first successful transplant of genetically modified pig kidneys into a brain-dead human. The results of the surgery were released in a peer-reviewed paper in January. The surgery, which was performed in September, was the result of years of work and research in the UAB Xenotransplantation Program, which was launched in 2016 with a $19.5 million grant from United Therapeutics Corp. Pigs are considered a good candidate for xenotransplantation because
The two leadless options cannot yet pace the atrium. Only the traditional pacemaker can pace and synchronize the four chambers. “Down the road, we’re hoping for leadless atrial pacing and even leadless left ventricular pacing, which will be a game changer,” Shah says. The two leadless pacemakers match in all but one thing. “Everything about them is identical, their implant technique, their profile,” Shah says. “It’s just a software difference and one little sensor. But with that little sensor, the Micra AV gives
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