The Culture of Different MKTG_150064494_2018 Service Line Big Book Full_FIN | Page 76

The Culture of Different
PA G E 74
NEPHROLOGY
A Complementary
Understanding
Early in his career, pediatric nephrologist Bradley Dixon, MD, found
himself at the bedside of a 6-week-old baby with atypical hemolytic
uremic syndrome, or aHUS. The infant’s complement system was
attacking his endothelial cells, triggering massive clotting in the
capillaries of multiple organs. Untreated, the disease would lead to
kidney failure and eventual death.
Peer-to-Peer
Adherence (From left) Transplant psychologists Cindy Buchanan,
PhD, and Elizabeth Steinberg, PhD, lead a weekly
video chat with teens who have undergone solid organ
transplant. Focused on adherence, the chats let teens
share strategies with each other.
“Transplant is not a cure,”
remarks Elizabeth Steinberg,
PhD, a licensed clinical
psychologist with the Transplant
Program at Children’s Hospital
Colorado. “It’s trading one
disease for another.” Education helps, but hearing
it from an adult only goes so
far — especially when teens
have heard it a million times.
Drs. Buchanan and Steinberg
created a virtual group where
they can hear it from each other. Predicting post-
transplant success
The post-transplant disease
is a lot more manageable, but
it still requires a battery of
medi cations. Remembering
to take them can be difficult,
particularly for teens. Each week for five weeks, teens
with transplants connect via
secure telemedicine software
to a video chat led by one of the
doctors. They talk about setting
goals, overcoming barriers,
negotiating peer pressure and
other topics — but it’s not the
topic that matters so much as
the fact that they’re talking
about it together.
“We talk a lot about adherence
strategies, whether that’s
establishing a routine,
using pillboxes or a tracking
system, or doing some type
of reinforcement or reward,”
says Cindy Buchanan, PhD, the
Transplant Program’s other
licensed clinical psychologist.
“We don’t know yet what this is
going to do for their adherence
levels,” says Dr. Buchanan, “but
we do know they’re enjoying it.”
Adherence is the biggest
behavioral issue facing not only
teens who have had a transplant,
but also those waiting. Through
a multidisciplinary grant, Drs.
Steinberg and Buchanan are
collaborating with transplant
surgeons to identify issues like
noncurrent immunizations or drug
use that could delay placement
on the list. These pre-transplant
screening tools also gather data
on risk factors that could impact
post-transplant success.
“The more we can predict those
factors, the better we can
intervene,” says Dr. Buchanan.
“We’re clinical psychologists, but
we’re also research psychologists,
so we’re always looking for ways
to improve.”
"We've had two cases of aHUS in the
last three months," says pediatric
nephrologist Bradley Dixon, MD,
who specializes in the condition.
"For an ultra-rare disease, the
fact that we've had two in recent
memory really says something."
“It was a rare condition, poorly defined and understood, but we were
able to recognize it and make it better,” Dr. Dixon recalls. “That really
sparked my interest in complement.”
Pediatric nephrologist Bradley Dixon, MD, and immunologist
Ashley Frazer-Abel, PhD, talk over a case at Exsera BioLabs at
the University of Colorado School of Medicine.
He developed one of the nation’s first comprehensive platforms
for clinical laboratory testing for aHUS. Now at Children’s Hospital
Colorado, Dr. Dixon numbers among the world’s foremost clinical
experts on aHUS and other kidney diseases of the complement system.
Working with leading researchers — such as University of Colorado
immunologist and Director of Exsera BioLabs, Ashley Frazer-Abel,
PhD, who is breaking new ground in the study of complement
proteins — he hopes to conduct several clinical trials of new and
better ways to diagnose and treat aHUS and other complement-
mediated renal diseases.
“We’ve traditionally had little to offer these patients from a
treatment perspective,” he says. “Which is why, with so many new
advances in diagnostics and treatment in the pipeline, now is such
an exciting time to care for them.”
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