Two leading experts spoke at the recent sessions of the Grand Rounds series at Weill Cornell Medicine-Qatar (WCM-Q) to discuss innovations in kidney transplantation and the use of shockwave therapy to manage musculoskeletal injuries in athletes.

Innovation in kidney transplantation

WCM-Q alumnus Dr Essa Abuhelaiqa, now a nephrology and transplant nephrology consultant at Hamad Medical Corporation (HMC), gave a presentation on the evolution of kidney transplant techniques and strategies to expand the pool of kidney donors. Dr Abuhelaiqa, who graduated from WCM-Q in 2011, is also an assistant professor of clinical medicine at WCM-Q.

Dr Abuhelaiqa explained that the one-year allograft survival rates for kidney transplants improved from less than 50% in the 1960s to over 90% today.

Similarly, he said that the rates of acute rejection of the transplanted organ dropped from over 80% to around 10% over the same period. These improvements are largely the result of the development of drug therapies for managing the body’s immune response.

While the improving success of kidney transplants is good news, the number of kidneys required still vastly outstrips the supply, leading to many premature deaths each year.

One successful innovation is a pair exchange model, where donors who are not a match for their loved one are tested against other donors in the same position until a two-way match is found.

It is also possible to establish longer chains of multiple couples, effectively creating a universally beneficial network of exchange that maximises the chances of finding positive matches. The success rates of these chains can be dramatically boosted by bringing an unpaired altruistic donor into the group.

Other ways to increase the number of donated kidneys include government programmes that make it easy to opt-in for organ donation, nationwide publicity campaigns, and opt-out programmes, where culturally appropriate.

Shockwave therapy

In a separate webinar, Dr Adam Tenforde, associate professor at Harvard Medical School and director of Shockwave and Running Medicine at Spaulding Rehabilitation Hospital in Boston, gave a presentation on the current evidence supporting the use of shockwave therapy in the management of musculoskeletal conditions.

The presentation, titled Advances in Shockwave for Management of Musculoskeletal Injuries in Athletes, also explained how to apply knowledge of the technique in clinical practice.

Dr Tenforde reviewed how musculoskeletal conditions are common among athletes, are often difficult to treat and recur frequently. Shockwave therapy, which directs low-energy acoustic waves to injured tissues to stimulate the body’s natural healing processes and break up scar tissue, is an attractive treatment modality because it is non-invasive, can be performed in outpatient settings and has evidence from research studies to support its use.

While early shockwave therapy devices were large, require the use of nerve blocks and often recommended immobilisation, current devices are the size of a desktop computer, highly mobile and do not have the same need for nerve blocks or prolonged immobilisation.

The therapy has proven effective as a treatment for many conditions, including Achilles tendinopathy, proximal hamstring tendinopathy, greater trochanteric pain syndrome (which affects the hip, thigh, and/or buttock), tibialis posterior tendinopathy, medial tibial stress syndrome, and plantar fasciitis, among others.

Both lectures were delivered as live webinars and were accredited by the Ministry of Public Health Department of Healthcare Professions Accreditation Section and by the Accreditation Council for Continuing Medical Education (ACCME).

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