Akshaya Jayachandran

A Skit we performed for Women In Nephrology (WIN-ICON) India conference at Chennai in Sep 2025.

Up next!

CKD & Protein: Is Your Diet a Solution or a Silent Stressor? 🥩🔍
On October 14, we're discussing protein diets and outcomes in CKD/ESRD which still remains an enigma. ☀️📚 #NephJC

pubmed.ncbi.nlm.nih.gov/40876553/

#Skytorial by @nephromommy-akshu.bsky.social
Akshaya's signing off 👋

10/10
Final #NephJC thoughts 🤔💭

While the study was a success, it is still a harsh reality that there exist many barriers to even getting a transplant. Much work is needed to safely simplify the procedure and make being IS - free a reliable reality for all kidney transplant patients!
#NephJC

9/10
I want more info: 👓📖

Please go through the insightful summary by Akshaya Jayachandran @nephromommy-akshu.bsky.social and Natalia Nombera @roxnonna23.bsky.social 🔖📖

🎨Beautiful visual abstract by Bogdan @thekidneywhisperer.bsky.social
#NephJC

www.nephjc.com/news/chimera...

8/10
#NephJC Quote of the fortnight from @brianrifkin.bsky.social 💬
Immune tolerance is nice, but unpredictable and requires constant vigilance to prevent rejection.
Would modifying graft kidneys to make them less antigenic be a better bet?
#NdphJC

7/10
Chat consensus? 🎬
Although the study shows that the MDR-101 regimen induces chimerism and functional immune tolerance in HLA-matched living donor KTRs leading to complete IS elimination, it is far from being widely applicable. It’s too costly and works only in highly HLA matched KTRs.
#NephJC

6/10
Give me something clever to say 🤓

Here’s what caught my attention!
@kidneyboy.bsky.social comparing life on dialysis vs pig transplant 🐖+ IS vs Live donor transplant 🫘and IS free! Definitely stuff worthy of a sci-fi movie! 👽

5/10
A figure paints 🖼️ 1000 words!
KDQOL-SF36 data showed huge improvement in Burden of Kidney Disease and Mental Health Composite Scores at two and three years when patients were off IS. This demonstrates that even low-dose IS negatively impacts patient quality of life. 🙆💊
#NephJC

4/10
One post results 📊
75% (15/20) of KTRs achieved functional immune tolerance (IS-free for two years) using the mixed chimerism strategy with MDR-101💉
The study showed 100% patient/graft survival and zero GVHD cases over three years, with improved quality of life. 4/20 KTRs resumed IS. #NephJC

3/10
One Post Methods 👩‍🏫
Phase 3, prospective, open-label, randomized, multicenter trial - USA/Canada. Included kidney transplant recipients (KTR) from a 2-haplotype HLA-matched, living donors.

Primary outcome - functional immune tolerance - staying off all IS for at least 24 months. 💊
#NephJC

2/10
What’d I miss?
Transplant immunosuppression (IS) causes significant drug toxicities, infection, cancer risks & huge costs 💸. “Functional tolerance” is a state in which the recipient’s immune system accepts the graft without additional IS. It has remained the "Holy grail" of transplant! #NephJC

1/10
Welcome to #TenPostNephJC
Last #NephJC we discussed tolerance induction in HLA matched 🫘 transplants with donor Hematopoietic stem cells (MDR-101).
Missed the Chimeri-chat? No worries - We’re quite “tolerant” to those who missed their IS(Informative Session)!

pubmed.ncbi.nlm.nih.gov/39922283/

What great cha

Excellent article
Fantastic write up for the summary
Great chat with good turn out

This is a good week for #NephJC

Thanks everyone

Yeah that’s exactly what I’m saying - it was probably smooth coz these patients were a HLA matched carefully curated low risk group - and it’s generalisably will be difficult! In any random patient, withdrawing IS would be definitely high risk - may lead to Acute rejections. #NephJC

Yeah but wouldn’t a pig kidney with IS and the unnamed virus still be better than NO kidney !? #NephJC

And we would probably have to just “imagine” the aforementioned future because I don’t see MDR-101 being applicable to even normal risk transplants anytime soon ! They’ll have too much to lose !

Great chat Saivani !
😃
#NephJC

The problem here is that - as attractive as being IS free sounds - it comes with a huge load right from patient selection, ensuring HLA compatibility, putting a huge burden on donors (making the MDR 101) and a very high risk IS withdrawal trial - with risk of rejection for the KTRs #NephJC

But I don’t see it going beyond the small privileged group of HLA matched patients !

There are too many IFs and BUTs involved
#NephJC

#NephJC

Yes that’s the main issue !
Most patients of Chronic GNs remain undiscovered pre transplant and we wouldn’t know their NKD until they present with a recurrence on stopping IS !

The conditioning regimen and bespoke cell product are highly specialized and costly. How do we translate this success to resource-limited centers? Cost & logistics make MDR-101 a first-world solution for now. #NephJC

Yeah that seems pretty average ! And yet despite losing chimerism all those transplanted guys have somehow remained IS free ! Thats again a “HOW” question ! #NephJC

Sorry ! My bad ! Will put up our twinning pics for the next #NephJC chat 😁 ! #NephJC

The historical control group was apparently used for sample size calculations and for the endpoint (tolerance) defn/ assessment- they’ve nothing to do with the study as such Joel ! They’ve mentioned the historical control group SRTR had similar baselines to the actual treatment arm pts ! #NephJC

Hey bestfriend ! Welcome to today’s #NephJC !
This chimerism topic takes me back to a few months ago when we were reading from the Indian transplant book for exam about the mesenchymal stem cell transplant protocol From Gujarat ! 😅 and wondering who comes up with these ideas !!

That’s probably coz the intent is to cut down on IS ! We don’t want Is side effects, hence we’ve stopped actually discovering new IS anymore! #NephJC

Yeah we immunosuppress with tac/ steroid / MMF only unless there is a complication ! #NephJC

Chimerism and Immune Tolerance: Can We Says Goodbye to Immunosuppression? — NephJC This week, we will discuss the use of creating chimeras to induce immune tolerance and its potential to decrease or eliminate the need for immunosuppression in kidney transplant recipients.

Check out the insightful summary by Dr Akshaya Jayachandran @nephromommy-akshu.bsky.social and Dr Natalia Nombera @roxnonna23.bsky.social #NephJC

I am on the left - twinning with a dear friend of mine !

Hey I'm Akshaya Jayachandran, #NephJC intern 2025, and a young Nephrologist from CMC Vellore, India. No COIs. From an economy where IS costs remain a major reason for drug noncompliance leading to graft loss, this trial - if successfully done in higher risk transplants, would be a boon!

Be like Matt. Shoot us a dime so we can keep the #FOAMed flowing

Chimerism and Immune Tolerance: Can We Says Goodbye to Immunosuppression? — NephJC This week, we will discuss the use of creating chimeras to induce immune tolerance and its potential to decrease or eliminate the need for immunosuppression in kidney transplant recipients.

Chimerism might just be the 🔑 to immune tolerance and ending the need for immunosuppression 🚫💊after transplantation 🫘.
Join the discussion 9/30/25 at 9 pm EST on Bluesky #NephSky #MedSky #NephJC
www.nephjc.com/news/chimera-tolerance-njqe334

You were fabulous and the memes were on point!
Great job @roxnonna23.bsky.social
Now time for some much needed rest!! 😇✨

#NephJC