Kevin J. Fowler

Thank you Eric for taking the time to read the article. As I point out in the article, it is time for the transplant community to acknowledge we need to move towards improving QOL and participation in life. Survival is not enough. You understand the issue completely with home dialysis.

Happy to have a discussion on the subject with you. I firmly believe QOL + participation in life is where the community should prioritize.

I completely agree with your statement. I think the implementation of PROMs allow patients to be heard. Speaking for myself, I have often felt unheard. When patients felt heard, I think the process becomes easier for both parties.

Thank you very much for reading the article.

Frontiers Publishing Partnerships | Life After Kidney Transplantation: The Time for a New Narrative The first successful kidney transplant in December 1954 between the Herrick brothers ushered in a new field of medicine. Over the almost seventy years, tho...

I would like to thank Maarten Naesens, MD for the opportunity to write my position statement on where the field of transplantation needs to shift to. Now is the time to improve quality and participation of life after transplant. bit.ly/4jQToAP #openaccess

Sad but true. #nephjc

Thanks for allowing me to part of the conversation. My final thoughts: This research underscores that AMR is a continuum and the leading cause of graft failure. There is a critical need to understand AMR + develop preventive strategies and treatments so that grafts are not lost. #nephjc

Agreed, and the further phenotyping will help lead to treatments for AMR. Kidney transplant physicians need more tools to preserve kidney transplants. The SONG initiative showed that kidney transplant recipients feared going on dialysis more than dying #nephjc

and resarch that will lead to treatments that are FDA approved. #nephjc

FSGS is now viewed as a continuum. I think rejection is moving in that direction as well. It is a mult-factorial issue that needs to be address in a similar manner. #nephjc

Yes. #nephjc

Good question that I hope is answered with future research. #nephjc

Exactly. It is beginning to occur with IgAN + it is really need in kidney transplantation. #nephjc

I will add another hopeful thought. Some of the medications approved for DKD are now being studied in kidney transplantation. They have anti-inflammatory properties that may dampen the inflammatory cascade. #nephjc

There is no consensus. Some programs do DSA testing for high risk patients, some for cause, and some annually. I believe the lack of FDA approved treatments has result in a lack of consensus. #nephjc

A very important kidney transplant precision study. Understand the various phenotypes + deliver targeted effective treatments #nephjc

I wish surveillance DSA testing was done more often. It doesn't identify all of the problems but it is a good start. #nephjc

U of Wisconsin represented the US for adult recipients. Pediatric recipients were included as well. #nephjc

It is my theory that it does. #nephjc

I have seen many friends lose their kidney transplants prematurely. None of the current treatments in the US are FDA approved. Moreover, generally peaking recipients don't receive AMR education. #nephjc

Speaking from professional experience surveillance DSA testing is not done routinely. I now have a annual DSA test surveillance test #nephjc

I will add this for discussion. The role of inflammation is very important. I work out routinely on my Elliptical since my transplant. I wish there were studies about the role of reducing inflammation + whether that may reduce the inflammation process #Nephjc

I am a fan of understanding it so that treatments can be found for AMR #nephjc

I have. Very important work to help strategy populations at risk + to develop AMR treatments #nephjc

I admire your commitment!! #nephjc

#nephjc COI Biogen Worked in kidney transplant since 2017. Consulted for CSL Behring on AMR + now with Biogen KTX since August 2004

Malignant stupidity is a nice choice of words. I would add narcissistic stupidity as well.

I remember it well.

You are most welcome #nephjc

You are welcome @hswapnil.medsky.social ! #nephjc