Simultaneous pancreas and kidney transplantation: A qualitative study of partners’ experiences

by Katie E. J. Hann, Marco Cinnirella, Clare Bradley, Andrea Gibbons

Chronic health conditions often affect the lives of family members as well as the patient themselves. The current study aimed to explore the experiences of partners of individuals with diabetes and chronic kidney disease (CKD) who received a simultaneous pancreas and kidney transplant (SPKT) to understand the wider impact of SPKTs. Eight partners of recipients of SPKT were interviewed about their experiences before and after the transplant. Interviews were transcribed verbatim and analysed thematically. Participants described how they navigated life with an unwell partner; sub-themes included a) living with pervasive worry, b) the challenge of enhanced responsibilities, and c) the buffering effect of social support. Diabetes complications, such as the experience of severe hypoglycaemia, particularly fuelled worry. Participants felt great relief after their partner’s successful transplant but also faced certain realities around the potential for their partner’s health to deteriorate again. The study highlights the impact of diabetes and CKD on patients’ families and the wider benefit of transplantation, not just for the patient. The pancreas transplant, in addition to the kidney, relieved partners of their worry about hypoglycaemic events and the development of diabetes complications. Partners may benefit from being encouraged to seek support and to maintain their own health and wellbeing.

<i>In vivo</i> monitoring of leukemia-niche interactions in a zebrafish xenograft model

by Anja Arner, Andreas Ettinger, Bradley Wayne Blaser, Bettina Schmid, Irmela Jeremias, Nadia Rostam, Vera Binder-Blaser

Acute lymphoblastic leukemia (ALL) is the most common type of malignancy in children. ALL prognosis after initial diagnosis is generally good; however, patients suffering from relapse have a poor outcome. The tumor microenvironment is recognized as an important contributor to relapse, yet the cell-cell interactions involved are complex and difficult to study in traditional experimental models. In the present study, we established an innovative larval zebrafish xenotransplantation model, that allows the analysis of leukemic cells (LCs) within an orthotopic niche using time-lapse microscopic and flow cytometric approaches. LCs homed, engrafted and proliferated within the hematopoietic niche at the time of transplant, the caudal hematopoietic tissue (CHT). A specific dissemination pattern of LCs within the CHT was recorded, as they extravasated over time and formed clusters close to the dorsal aorta. Interactions of LCs with macrophages and endothelial cells could be quantitatively characterized. This zebrafish model will allow the quantitative analysis of LCs in a functional and complex microenvironment, to study mechanisms of niche mediated leukemogenesis, leukemia maintenance and relapse development.