43 ms·

Organ transplant patients may not get dementia

290 points by klevertree 5y ago

bawolff 5y ago
The irony of ranting about starting with the most interesting part of your thesis for 5 paragraphs, before actually starting.
- mcguire 5y ago
  It's a good way to hide the fact that your thesis is pretty sketchy. Say you have one result that has replication issues, but don't want to appear too crackpotty or dishonest while emphasizing that brilliant result. So you do a little song and dance beforehand.
mercynn 5y ago
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mercynn 5y ago
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thrill 5y ago
As an opposing anecdata, my aunt got a heart transplant in the late 70's, is still kicking, but has severe dementia now in her mid 70's.
- whoknowswhat11 5y ago
  Wow - that is an absolutely incredible result for a heart transplant! Very unusual situation. Be interesting to understand the specifics - and the team doing this kind of work!
- Traubenfuchs 5y ago
  Does she take calcineurin inhibitors?
  - thrill 5y ago
    I have no idea.
  - deleted 5y ago
    [deleted]
- patall 5y ago
  That would be (most likely) an absolute world record in surviving with a heart transplant. In 2016, someone died with a survival Guinness Record of 33 years [1], your Aunt would exceed that quite far. Current (non-official) US record supposedly is 35 years [2]. I am not saying your are mistaken, just noting that she might be an outlier. [1] https://www.bbc.com/news/uk-england-beds-bucks-herts-35543696 https://www.bbc.com/news/uk-england-beds-bucks-herts-3554369... [2] https://www.wbay.com/2021/06/29/green-bay-man-nations-longest-living-heart-transplant-recipient/ https://www.wbay.com/2021/06/29/green-bay-man-nations-longes...
  - panzagl 5y ago
    Maybe he means just a valve?
  - deleted 5y ago
    [deleted]
erdo 5y ago
These stats are only useful if we know how many people get dementia in the first place. What are the chances of a random control group of 14 over 85 year olds also not getting dementia? If it's very common, and you would usually expect 7 of them to develop dementia, then 0 cases in the test group is potentially impressive. If it's quite rare and you would usually expect only one of the control group to get dementia, then it's not that impressive that the test group had 0, and easily down to chance
- Epenthesis 5y ago
  That's what the first image in the article is purporting to show (~33% of people in the general population over 85 have dementia)
  - erdo 5y ago
    Ha of course it does, thanks :) I don't know why I didn't see that so we could expect about 5 people with dementia in that control group, and the test group got 0, so not bad
    - mcguire 5y ago
      That is a tiny sample.
fbanon 5y ago
Is it safe to buy this stuff over the internet/dark web? I want to try it, maybe it has nootropic effects on healthy brains too.
- somesortofthing 5y ago
  It's an immunosuppressant, and it seems like the mechanism of action is preventing brain cell death. You'd have to be pretty old to benefit at all, and you're risking potentially fatal infection to maybe possibly get some nootropic effects. I really wouldn't risk it if I were you.
  - catlikesshrimp 5y ago
    Dementia can't be cured. Best we can hope for is preventing it. So, meds agaisnt dementia will have the highest impact on populations without overt dementia
- gpm 5y ago
  > 3. There’s something different about how the University of Texas hospital administers calcineurin inhibitors vs. the average hospital. > This is entirely possible. Calcineurin inhibitors are dangerous and difficult to administer correctly, I know nothing about this drug... but probably not a good idea..
- bencollier49 5y ago
  Given that it suppresses organ rejection, my untrained speculation is that it might make you more prone to cancer.
  - macNchz 5y ago
    Yes, per https://www.ncbi.nlm.nih.gov/books/NBK304321/ https://www.ncbi.nlm.nih.gov/books/NBK304321/ > There is sufficient evidence in humans for the carcinogenicity of ciclosporin. Ciclosporin causes cancer of the skin (squamous cell carcinoma), cancer at multiple other sites, and non-Hodgkin lymphoma.
- 5y ago
jhales 5y ago
Isn't Rapamycin generally used as part of an immunosuppressant cocktail for organ transplants? Curious why that isn't mentioned in the article as a contributing factor.
- klevertree 5y ago
  I thought it'd be too much in the weeds. The UTexas paper goes into their prescribing data and comes out with the conclusion that calcineurin inhibitors are the only common factor in their patients who don't get dementia. Rapamycin also does not have any evidence of efficacy on neurodegeneration, while there's evidence for CNI on other forms of neurodegeneration.
  - TedDoesntTalk 5y ago
    What are the side-effects of calcineurin inhibitors ?
    - gzer0 5y ago
      Cyclosporine has some very serious long-term toxicity (especially renal dysfunction and hypertension) and the availability of newer biologic agents has restricted the use of cyclosporine to patients who have not responded to conventional treatment. *Mild tremor is common with both cyclosporine and tacrolimus use, occurring in 35 to 55 percent of patients [ 79,80 ]. *Rarely, patients develop severe headache, visual abnormalities, and seizures. This syndrome is associated with acute hypertension and resembles hypertensive encephalopathy [ 77 ]. *Posterior leukoencephalopathy is usually seen on brain imaging [ 82 ]. *Cyclosporine may contribute to bone loss after organ transplantation [ 88 ]; this effect may be due to the induction of high bone turnover. *Cyclosporine can cause hyperkalemia and hypomagnesemia, via effects on renal tubular function. Hyperuricemia and exacerbation of gout are well-described with cyclosporine. [77]. Schwartz RB, Bravo SM, Klufas RA, et al. Cyclosporine neurotoxicity and its relationship to hypertensive encephalopathy: CT and MR findings in 16 cases. AJR Am J Roentgenol 1995; 165:627. [78]. Eidelman BH, Abu-Elmagd K, Wilson J, et al. Neurologic complications of FK 506. Transplant Proc 1991; 23:3175. [79]. Randomised trial comparing tacrolimus (FK506) and cyclosporin in prevention of liver allograft rejection. European FK506 Multicentre Liver Study Group. Lancet 1994; 344:423. [80]. A comparison of tacrolimus (FK 506) and cyclosporine for immunosuppression in liver transplantation. The U.S. Multicenter FK506 Liver Study Group. N Engl J Med 1994; 331:1110. [81]. Wijdicks EF, Wiesner RH, Krom RA. Neurotoxicity in liver transplant recipients with cyclosporine immunosuppression. Neurology 1995; 45:1962.
datameta 5y ago
The statistical prevalence of dementia is absolutely shocking to me... It is bar none one of the worst experiences one can go through. This [0] is an album that is an auditory approximation of it. I sincerely hope for more discourse and research dedicated to understanding, preventing, and treating it. [0] https://youtu.be/wJWksPWDKOc https://youtu.be/wJWksPWDKOc
- nojs 5y ago
  “The Father” is another excellent portrayal of the emotional turmoil.
- asow92 5y ago
  Is it weird that I was listening to music kind of like this right before clicking on this? https://www.youtube.com/watch?v=aMJyQK4xBUQ https://www.youtube.com/watch?v=aMJyQK4xBUQ
  - asow92 5y ago
    Honestly though I'm sort of loving this music. I'm 29 years old and feel like I have a false nostalgia for this kind of music.
  - aksss 5y ago
    That's cool, thanks for the tip. It's also on Spotify: https://open.spotify.com/show/3YvkqDkpemZOvwSlLbq3c3?si=4e1766133e9049fa https://open.spotify.com/show/3YvkqDkpemZOvwSlLbq3c3?si=4e17...
- GhettoComputers 5y ago
  Music can help dementia and Alzheimer’s. https://youtu.be/G7vkKHYosuQ https://youtu.be/G7vkKHYosuQ
  - datameta 5y ago
    Yes, absolutely! My grandfather, even in the very late stages, could deeply enjoy music from his youth and appeared to regain some lucidity while listening to it.
canjobear 5y ago
Correlation.
- JamesBarney 5y ago
  Are you're implying that there is a third factor that both reduces risk of dementia by 10x and increases risk of kidney failure by 10x? I think that's highly unlikely. Or theoretically getting dementia a decade later could protect against organ failure a decade earlier. But I really don't think that's it. If this data is right there is probably an effect. I agree with the author that the mostly likely reason this isn't true is because of bad data.
  - mattkrause 5y ago
    Two things I would want to dig into: - How are the patients selected for transplants? Scarce organs are probably not given to patients who have other serious impairments as well. - How were the (non)-dementia patients assessed? No formal diagnosis of dementia != no dementia.
    - JamesBarney 5y ago
      > - How are the patients selected for transplants? Scarce organs are probably not given to patients who have other serious impairments as well. Even though being healthy helps move you up the list of organ transplant recipients. It would still be really strange if people who got organ transplants were healthier than the general population, who mostly do not need organ transplants. >- How were the (non)-dementia patients assessed? No formal diagnosis of dementia != no dementia. But it would be weird if organ transplant recipients were 10x less likely to get a diagnosis of dementia (assuming the same base rates). I would think because of their heavy interaction with the healthcare system they'd have a high rate of diagnosis.
  - omgwtfbyobbq 5y ago
    Autoimmune issues may fit that bill in people with the right genetics. They can cause and/or contribute to CKD, which could push someone into kidney failure with other insults (eg dehydration), and can also contribute to dementia.
OscarCunningham 5y ago
Not everyone who needs an organ transplant gets one. So could it be that recipients are privileged in some way that also prevents them getting dementia?
- asow92 5y ago
  Also wondering if lifestyle choices of those post-op have anything to do with this. i.e. better diet, exercise, etc.
- bbulkow 5y ago
  Very nice to read a balanced paper, but a hospital might very well ( and, I think, illegally ) give some transplant people priority. Isn't that what happened to Steve jobs? No one is supposed to jump the queue, but he did. If 'queue jumping' is illegal, and happening at one hospital, I could imagine that as the kind of stunning bias shown in the data, and everyone involved would say it isn't happening
  - bink 5y ago
    As I recall it he didn't so much "queue jump" as he used his private plane to travel to another state within a specific window of time from where he lived, which most people who lived outside of the transplant state couldn't do. So he was able to get on multiple transplant waiting lists.
  - wombatpm 5y ago
    Transplants are coordinated regionally. Jobs just purchased homes in multiple areas with shorter wait times than California. One of the advantages of being rich.
    - hpagey 5y ago
      Incorrect. You don't have to be rich. I am currently being evaluated for deceased donor transplant outside my home state of California. You just have to register at another center and you are allowed to multi list. Some states have residency requirements but lot of them do not.
jannyfer 5y ago
It'd be nice to take out the clickbaity "here's why" from the title.
_game_of_life 5y ago
Initially I thought that the reason for this would be that most people with transplants live less than 10 years, and eligibility requirements of who gets transplants (and therefore who gets calcineurin inhibitors) might further complicate the results. Wow, was I ever wrong. This article says it's not too uncommon for people to live 30 years after their transplant. Other articles say that even the obese are eligible for transplantation now. Very impressive. https://wexnermedical.osu.edu/blog/how-long-do-transplanted-organs-last https://wexnermedical.osu.edu/blog/how-long-do-transplanted-... That being said, I know life extension and nootropics and all that jazz is a really popular topic with tech bros, so its worth noting the side effects of calcineurin inhibitors are really bad. It's also neat ciclosporin was isolated from some scandanavian fungus living in the soil. Makes me sad thinking about how once we are able to significantly understand and appreciate genetics and related biotechnology later this century, half of the species on earth will already be gone, their amazing biological traits and compounds lost forever.
- fortran77 5y ago
  > Other articles say that even the obese are eligible for transplantation now. Very impressive. I would hope that would be before any right-weight candidate had been ruled out. Otherwise it's grossly unfair.
  - aklemm 5y ago
    Maybe if obesity resulted merely from character flaws, but clearly there’s something environmental going on. Nonetheless, would it be unfair to give transplants to manual laborers and motorcycle riders as their chances of dying early are high?
- pkaye 5y ago
  Sirolimus and Tacrolimus are two other common anti-rejection medicines. They were found in Easter Island and Japanese soil samples respectively.
  - actually_a_dog 5y ago
tantalor 5y ago
Apples & oranges
tacobelllover99 5y ago
Couldn't read after they said Huffpo is Journalism
deleted 5y ago
[deleted]
caymanjim 5y ago
This is an interesting pop-science read, but who is Trevor Klee? As far as I can tell, he's a college exam tutor who's written a few "how to pass the GRE" booklets. He's writing about trying to start a biomedical business around this idea, but if his LinkedIn is accurate, he's never had a job beyond tutoring college students. His list of "failed projects," linked to from the blog, contains a bunch of similar biomed business ideas, none of which have anything at all to do with each other on a technical level ("Using RNAi for agriculture", "Exploring ketamine for blood pressure"). This basically reads as "I got a masters in molecular bio, have never worked in the field, and want you to give me money for my next crackpot idea". That doesn't mean the idea is wrong, but this guy isn't the one who's gonna make it happen.
- tibbetts 5y ago
  Anybody asking me for money to cure Alzheimer’s I just at this point assume is Theranos 2.0. There are plenty of well informed life sciences investors with very deep pockets.
  - 300bps 5y ago
    Yeah I’d be as likely to buy a magical anti-dementia rock as invest in this.
- cellis 5y ago
  I don’t know much about how the biotech industry works, but are you saying that he should “work in the field” before pitching this idea? In software that would be almost laughed at as a suggestion, if the idea is indeed promising.
  - coldtea 5y ago
    No, in software terms, he's saying that is somebody comes and tells you "Software that has enough spaces, never crashes", and he "happens" to be selling the "Extra-spaces-adder" IDE, then maybe don't believe him...
  - mcguire 5y ago
gzer0 5y ago
It is very difficult to engineer animals with symptoms mimicking human dementia so they can effectively be trialed with drugs before testing on people. This is the exact reason dementia / Alzheimer’s research is littered with dozens of high-profile failed clinical trials; after billions and decades poured into this area and nothing to show. I would be interested to see non-murine, primate-based(?) clinical findings before I get my hopes up again. We have seen this pattern too many times; a compelling agent, pathway, or signaling mechanism is found, targeted, and shows great promise in mice, even sometimes in primates. And once we get to human trials it fails because we cannot replicate dementia accurately in these test vehicles.
- easytiger 5y ago
  There is a genetic component that seems very much ignored too
- genewitch 5y ago
  I'm not seeing much mention of diet and gut biome in these comments, over the last decade they're linking satisfactorily the gut to so many different ailments in later life, including Alzheimer's and dementia. Additionally studies are linking diet/gut Flora to stuff like autism, some inflammatory diseases, etc. If I was born 15 years later I'd probably have gone into that field of study as it probably makes the most fiscal sense - from a national medicine standpoint - to combat these disorders and diseases at the actual source. I wonder if there's been a metastudy on the median lifespan going up and incidence of these cognitive or neurological disorders. That is, now that humans on average are living longer, perhaps our diets are more important; and with his knowledge we can get some enhancements on regulations from the FDA or something.
burning_hamster 5y ago
I am not sure I buy into the author's calcineurin/mitochondria hypothesis. There is a much more direct causal link as auto-immunity has been implicated in AD progression for years, e.g. [1-11]. I can't find the paper right now, but I once saw a very compelling longitudinal study where they regularly measured cognitive performance as well as several immunity markers in older subjects. Basically, every transient increase in antibody levels (IIRC, but they may have been tracking some other marker of immune system activation) was followed by a step decline in cognitive performance. [1] Lopez (1991) Serum auto-antibodies in Alzheimer's disease [2] Aisen (1996) Inflammation and Alzheimer disease [3] D'Andrea (2005) Add Alzheimer’s disease to the list of autoimmune diseases [4] Carter (2010) Alzheimer's Disease: A Pathogenetic Autoimmune Disorder Caused by Herpes Simplex in a Gene-Dependent Manner [5] Reddi et al (2011) Autoimmunity in Alzheimer’s disease: increased levels of circulating IgGs binding Aβ and RAGE peptides [6] Sardi et al (2011) Alzheimer's disease, autoimmunity and inflammation. The good, the bad and the ugly [7] Marchese (2013) Autoimmune Manifestations in the 3xTg-AD Model of Alzheimer's Disease [8] Li et al. (2018) Dementia and Alzheimer's disease risks in patients with autoimmune disorders [9] Arshavski (2020) Alzheimer’s Disease: From Amyloid to Autoimmune Hypothesis [10] Itzhaki et al (2020) Do infections have a role in the pathogenesis of Alzheimer disease? [11] Lim et al (2020) Alzheimer Disease Pathogenesis: The Role of Autoimmunity
- renewiltord 5y ago
  Sorry, haven’t read these yet, but any antibodies? Like any immune response makes you duller and at greater risk? Eek.
  - burning_hamster 5y ago
    Like I said, I can't find the study right now, and I originally saw the data anywhere between 5-10 years ago. They may also have been measuring some cytokine. Even without AD, memories really aren't reliable over that time span. The point the authors were trying to make is that if you have AD, any inflammation, even asymptomatic ones, will potentially worsen your cognitive performance. The most interesting feature of that graph was to me that the cognitive performance actually remained fairly constant in between infections/inflammations, and decline was not gradual but in a step-wise fashion.
mhalle 5y ago
As a liver transplant recipient (7.5 years out), I find how transplant patients are stereotyped in this somewhat informal article a bit misleading. First, transplants are about as close to a life-changing miracle as you can imagine. By which I mean night and day change for a reasonable subset of patients. The fact that we now have anything like access to interchangeable parts that can let people live extremely normal lives is absolutely remarkable. Before transplant there were times when I was too weak to walk. One month after transplant I could walk a mile, three months after five miles. There is zero question I'd be dead by now without my transplant. I might have lived a year or so more with my old one, but it would have been an unpredictable high-wire act between GI bleeds, encephalopathy, coma, and fear that any simple action might trigger an emergency trip to the emergency room. Internal bleeding and encephalopathy put my in a coma for three days and, when I came out, this PhD computer scientist couldn't remember my own kids' names. Now I'm writing this. I am simply so fortunate to be able to have this second chance in life. As for the misleading parts, "Organ transplant patients are, by their nature, sick patients." Yes, but that's why they get transplants. Many get better. Look at livers. Viral hepatitis (in my case, Hep C) is one of the most common reasons for liver transplant. But we can cure Hep C. I was one of the first people cured before transplant with Gilead's Hep C antivirals. The new liver fixed my cirrhosis. Now I get sick less often than my kids, and my life is extremely normal except for a couple pills a day (tacrolimus) and lab tests every three months. I was a mild hemophiliac, and that was cured by the new liver as well. If you looked at my lab tests, besides a low platelet count, I would look perfectly normal. And especially for livers, which deal with processing a lot of foreign substances in the body, so it probably more tolerant than other organs, the lifespan on them may be quite long. Older liver transplant patients can sometimes even drop their immunosuppressants completely. So, for people who have curable diseases, the health of a transplant patient can be quite good, potentially better than their peers. There's no specific reason they as a single less healthy class (as opposed to a set of classes, which also includes people who abuse alcohol or have diseases we can't cure). To answer some other questions in the discussion, the transplant process tries hard to keep someone from being able to literally buy their way onto the transplant list. For livers, priority of transplant goes by a lab test called MELD which estimates 90 day mortality. You have to be sicker than other people but healthy enough not to waste an organ. It's a fairly macabre competition. There are, however, advantages to those with means. In the US, organ transplant is administered nationally but organs are still basically allocated regionally. If you can travel to another region in the country with a surplus of organs, you can get a transplant sooner. I did it. It saved my life. You also need to go through a battery of tests to make sure you are, basically, a good host for the rare organ. In general you have to stop substance abuse. You need to lose weight. You need to take a physical which can disqualify you. You need to have a social support mechanism to help take care of you after surgery (in the hospital, after discharge, and long term). Finally, you need to have insurance that will cover the potentially million dollar surgery and and complications that might follow. And that means there's another hidden process that happens in the insurance company to assess whether you're a good risk or not. Most of those conditions strictly require wealth. All of them benefit from it, especially access to health care. On the other hand, it isn't clear that access to health care is strongly correlated with an absence of dementia, is it?
supperburg 5y ago
People talk about inflammation vs metabolism. They are linked. Inflammatory signals can turn cellular metabolism up or down. African sleeping sickness is an infection that results in a person going into a kind of coma. The parasite constantly changes its molecular interface with the host which is supposed to confuse the hosts immune system. This places a huge burden on the immune system and results in the host becoming hungry all the time, despite already being full. These patients will stuff themselves while growing progressively more tired. And eventually they fall asleep permanently. Inflammatory signals slow metabolism or something to that effect and this change in metabolism causes the body to feel as though it’s starved of energy and so the patients feel hunger. Inflammation and metabolism are linked. A man with schizophrenia was cured after a bone marrow transplant. The New York Times wrote about it recently. Symptoms of age including cognitive decline have been reversed in mice and humans through blood dilution/ blood transfusion probably due to reduction in the concentration of inflammatory molecules in the blood that are produced by ones own body. Inflammation/metabolism is the biggest medical revolution on the horizon. Especially since COVID has made it a grant-worthy topic now and doctors can’t deny that chronic fatigue syndrome is real anymore. It’s funny how all those people who insisted that CFS wasn’t real are now nowhere to be found to answer for their mistake.
- erentz 5y ago
  > It’s funny how all those people who insisted that CFS wasn’t real are now nowhere to be found to answer for their mistake. Oh a many of them are still out there. Now pushing CBT and GET as a cure all for Long COVID.
  - circlefavshape 5y ago
    I have direct experience of this. My wife has had long covid for the last year, has had dozens of medical tests, and none of them have showed up anything except for POTS. I can understand why a neurologist would suggest CBT. All my wife's test results are normal, so the neurologist has no remedies available. People do get psychosomatic illnesses, and in those cases CBT does help. That doesn't mean that my wife has a psychosomatic illness, but there's no test for that either - can't hurt to try (FWIW this is not the way my wife saw it - she was pretty furious and felt like the neurologist was demeaning her condition)
leokeba 5y ago
I'm surprised the author does not mention taking steps to verify the "unique University of Texas protocol" hypothesis. It really looks like the most probable alternative explanation, and it doesn't seem very difficult for someone already in the medical industry to get in touch with one of the people there who could be able to verify it. Maybe I'm missing something ?
- krisoft 5y ago
  > Maybe I'm missing something ? I'm afraid it appears so. The article says they contacted the authors of both publications but haven't got a response back yet. Relevant bit: "For my own part, I’ve contacted authors of both papers, but haven’t received substantive responses from either. I’ll update this post when/if I do."
p00l00 5y ago
Im surprised nobody has suggested MicroRNA. In particular mir-29. But that remains to be thoroughly interpreted. https://www.frontiersin.org/articles/10.3389/fnins.2020.00564/full https://www.frontiersin.org/articles/10.3389/fnins.2020.0056...
- deleted 5y ago
  [deleted]
yosito 5y ago
Results aside, I give this article points for clear and persuasive writing!
irthomasthomas 5y ago
Related: Type 3 Diabetes https://en.wikipedia.org/wiki/Type_3_diabetes https://en.wikipedia.org/wiki/Type_3_diabetes
treeman79 5y ago
Theory. People who take immune suppressing drugs have less dementia. Perhaps undiagnosed autoimmune conditions are a cause / trigger for dementia. My experience. Had out of control undiagnosed autoimmune condition. Started developing major dementia. Eventually (20 years) got autoimmune diagnosed and under control. Also started blood thinners. Dementia resolved quickly.
- eliasmacpherson 5y ago
  It's not just you that has a theory around this, if you view allergies around histamine as autoimmune conditions: Here's some pseudoscience, you may also find the parent comment interesting. https://news.ycombinator.com/item?id=27993001 https://news.ycombinator.com/item?id=27993001
bedobi 5y ago
Wikipedia: > Calcineurin inhibitors and azathioprine have been linked with post-transplant malignancies and skin cancers in organ transplant recipients. Non-melanoma skin cancer (NMSC) after kidney transplantation is common and can result in significant morbidity and mortality. The results of several studies suggest that calcineurin inhibitors have oncogenic properties mainly linked to the production of cytokines that promote tumor growth, metastasis and angiogenesis. Bummer
- wolverine876 5y ago
  I'm not sure I'd take medical advice from there. Are there no better sources?
catlikesshrimp 5y ago
My nose suspects the system (TU) was triaging agaisnt dementia, somehow, and the author didn't notice. Next study, designed for comparing transplantation correlation to dementia, should use a dementia scale before and after the trasplant. The article is not a scientific paper. I hope scientific papers were so honest about conflict of interest and autocritic as this author is in this article.
golem14 5y ago
Could it be that patients with early stage dementia are somewhat less likely to ask for or receive transplants?
Gatsky 5y ago
This is unfortunately almost certainly bunk. There is a large selection and survivorship bias. To be an 85+ yo and be alive with an organ transplant you have to be pretty special. That generally means you have kept your transplant for at least 30 years and survived the early days of suboptimal immunosuppressants and perioperative care. Also transplant recipients are managed very carefully by their physicians, who constantly tweak their medication, blood pressure, blood sugar etc. Also people who manage to live with their transplants for long periods are presumably highly selected for diligence, education, wealth, compliance, mental health etc.
ouid 5y ago
So we think it's because of the immunosuppression then?
mogadsheu 5y ago
It's like the consolation prize/participation ribbon of major operation. Congrats, your kidney's been replaced and you'll have to be on immunosuppressants for the rest of your life, but at least you won't get dementia.

290 points by klevertree 5y ago

The irony of ranting about starting with the most interesting part of your thesis for 5 paragraphs, before actually starting.

mcguire 5y ago
It's a good way to hide the fact that your thesis is pretty sketchy. Say you have one result that has replication issues, but don't want to appear too crackpotty or dishonest while emphasizing that brilliant result. So you do a little song and dance beforehand.

mercynn 5y ago

I am from California USA I was diagnosed of HERPES Virus in 2016 and I have tried all I can to get cured but all to no avail, until i saw a post in a health forum about a herbalist man who prepare herbal medication to cure all kind of diseases including HERPES virus, at first i doubted if it was real but decided to give it a try , when i contact this herbalist via his email and he prepared a HERPES herbal cure and sent it to me via UPS delivery company service, when i received this herbal cure, he gave me step by directions on how to apply it, when i applied it as instructed, i was totally cured of this deadly virus within 14days of usage, I am now free from the deadly virus called herpes, all thanks to doctor UMA, Contact this great herbal doctor via his email dr.umaherbalcenter@gmail.com call or whatsapp him on his mobile number +2347035619585 He also have the herb to cure: (1) CANCERS, (2) DIABETES, (3) HIV/AIDS, (4) PENIS ENLARGEMENT, (5) PREGNANCY, (6) DIABETES, (7) EX BACK.

mercynn 5y ago

thrill 5y ago

As an opposing anecdata, my aunt got a heart transplant in the late 70's, is still kicking, but has severe dementia now in her mid 70's.

whoknowswhat11 5y ago
Wow - that is an absolutely incredible result for a heart transplant! Very unusual situation. Be interesting to understand the specifics - and the team doing this kind of work!
Traubenfuchs 5y ago
Does she take calcineurin inhibitors?
- thrill 5y ago
  I have no idea.
- deleted 5y ago
  [deleted]
patall 5y ago
That would be (most likely) an absolute world record in surviving with a heart transplant. In 2016, someone died with a survival Guinness Record of 33 years [1], your Aunt would exceed that quite far. Current (non-official) US record supposedly is 35 years [2]. I am not saying your are mistaken, just noting that she might be an outlier. [1] https://www.bbc.com/news/uk-england-beds-bucks-herts-35543696 https://www.bbc.com/news/uk-england-beds-bucks-herts-3554369... [2] https://www.wbay.com/2021/06/29/green-bay-man-nations-longest-living-heart-transplant-recipient/ https://www.wbay.com/2021/06/29/green-bay-man-nations-longes...
- panzagl 5y ago
  Maybe he means just a valve?
- deleted 5y ago
  [deleted]

erdo 5y ago

These stats are only useful if we know how many people get dementia in the first place. What are the chances of a random control group of 14 over 85 year olds also not getting dementia? If it's very common, and you would usually expect 7 of them to develop dementia, then 0 cases in the test group is potentially impressive. If it's quite rare and you would usually expect only one of the control group to get dementia, then it's not that impressive that the test group had 0, and easily down to chance

Epenthesis 5y ago
That's what the first image in the article is purporting to show (~33% of people in the general population over 85 have dementia)
- erdo 5y ago
  Ha of course it does, thanks :) I don't know why I didn't see that so we could expect about 5 people with dementia in that control group, and the test group got 0, so not bad
  - mcguire 5y ago
    That is a tiny sample.

fbanon 5y ago

Is it safe to buy this stuff over the internet/dark web? I want to try it, maybe it has nootropic effects on healthy brains too.

somesortofthing 5y ago
It's an immunosuppressant, and it seems like the mechanism of action is preventing brain cell death. You'd have to be pretty old to benefit at all, and you're risking potentially fatal infection to maybe possibly get some nootropic effects. I really wouldn't risk it if I were you.
- catlikesshrimp 5y ago
  Dementia can't be cured. Best we can hope for is preventing it. So, meds agaisnt dementia will have the highest impact on populations without overt dementia
gpm 5y ago
> 3. There’s something different about how the University of Texas hospital administers calcineurin inhibitors vs. the average hospital. > This is entirely possible. Calcineurin inhibitors are dangerous and difficult to administer correctly, I know nothing about this drug... but probably not a good idea..
bencollier49 5y ago
Given that it suppresses organ rejection, my untrained speculation is that it might make you more prone to cancer.
- macNchz 5y ago
  Yes, per https://www.ncbi.nlm.nih.gov/books/NBK304321/ https://www.ncbi.nlm.nih.gov/books/NBK304321/ > There is sufficient evidence in humans for the carcinogenicity of ciclosporin. Ciclosporin causes cancer of the skin (squamous cell carcinoma), cancer at multiple other sites, and non-Hodgkin lymphoma.
5y ago

jhales 5y ago

Isn't Rapamycin generally used as part of an immunosuppressant cocktail for organ transplants? Curious why that isn't mentioned in the article as a contributing factor.

klevertree 5y ago
I thought it'd be too much in the weeds. The UTexas paper goes into their prescribing data and comes out with the conclusion that calcineurin inhibitors are the only common factor in their patients who don't get dementia. Rapamycin also does not have any evidence of efficacy on neurodegeneration, while there's evidence for CNI on other forms of neurodegeneration.
- TedDoesntTalk 5y ago
  What are the side-effects of calcineurin inhibitors ?
  - gzer0 5y ago
    Cyclosporine has some very serious long-term toxicity (especially renal dysfunction and hypertension) and the availability of newer biologic agents has restricted the use of cyclosporine to patients who have not responded to conventional treatment. *Mild tremor is common with both cyclosporine and tacrolimus use, occurring in 35 to 55 percent of patients [ 79,80 ]. *Rarely, patients develop severe headache, visual abnormalities, and seizures. This syndrome is associated with acute hypertension and resembles hypertensive encephalopathy [ 77 ]. *Posterior leukoencephalopathy is usually seen on brain imaging [ 82 ]. *Cyclosporine may contribute to bone loss after organ transplantation [ 88 ]; this effect may be due to the induction of high bone turnover. *Cyclosporine can cause hyperkalemia and hypomagnesemia, via effects on renal tubular function. Hyperuricemia and exacerbation of gout are well-described with cyclosporine. [77]. Schwartz RB, Bravo SM, Klufas RA, et al. Cyclosporine neurotoxicity and its relationship to hypertensive encephalopathy: CT and MR findings in 16 cases. AJR Am J Roentgenol 1995; 165:627. [78]. Eidelman BH, Abu-Elmagd K, Wilson J, et al. Neurologic complications of FK 506. Transplant Proc 1991; 23:3175. [79]. Randomised trial comparing tacrolimus (FK506) and cyclosporin in prevention of liver allograft rejection. European FK506 Multicentre Liver Study Group. Lancet 1994; 344:423. [80]. A comparison of tacrolimus (FK 506) and cyclosporine for immunosuppression in liver transplantation. The U.S. Multicenter FK506 Liver Study Group. N Engl J Med 1994; 331:1110. [81]. Wijdicks EF, Wiesner RH, Krom RA. Neurotoxicity in liver transplant recipients with cyclosporine immunosuppression. Neurology 1995; 45:1962.

datameta 5y ago

The statistical prevalence of dementia is absolutely shocking to me... It is bar none one of the worst experiences one can go through. This [0] is an album that is an auditory approximation of it. I sincerely hope for more discourse and research dedicated to understanding, preventing, and treating it. [0] https://youtu.be/wJWksPWDKOc https://youtu.be/wJWksPWDKOc

nojs 5y ago
“The Father” is another excellent portrayal of the emotional turmoil.
asow92 5y ago
Is it weird that I was listening to music kind of like this right before clicking on this? https://www.youtube.com/watch?v=aMJyQK4xBUQ https://www.youtube.com/watch?v=aMJyQK4xBUQ
- asow92 5y ago
  Honestly though I'm sort of loving this music. I'm 29 years old and feel like I have a false nostalgia for this kind of music.
- aksss 5y ago
  That's cool, thanks for the tip. It's also on Spotify: https://open.spotify.com/show/3YvkqDkpemZOvwSlLbq3c3?si=4e1766133e9049fa https://open.spotify.com/show/3YvkqDkpemZOvwSlLbq3c3?si=4e17...
GhettoComputers 5y ago
Music can help dementia and Alzheimer’s. https://youtu.be/G7vkKHYosuQ https://youtu.be/G7vkKHYosuQ
- datameta 5y ago
  Yes, absolutely! My grandfather, even in the very late stages, could deeply enjoy music from his youth and appeared to regain some lucidity while listening to it.

canjobear 5y ago

Correlation.

JamesBarney 5y ago
Are you're implying that there is a third factor that both reduces risk of dementia by 10x and increases risk of kidney failure by 10x? I think that's highly unlikely. Or theoretically getting dementia a decade later could protect against organ failure a decade earlier. But I really don't think that's it. If this data is right there is probably an effect. I agree with the author that the mostly likely reason this isn't true is because of bad data.
- mattkrause 5y ago
  Two things I would want to dig into: - How are the patients selected for transplants? Scarce organs are probably not given to patients who have other serious impairments as well. - How were the (non)-dementia patients assessed? No formal diagnosis of dementia != no dementia.
  - JamesBarney 5y ago
    > - How are the patients selected for transplants? Scarce organs are probably not given to patients who have other serious impairments as well. Even though being healthy helps move you up the list of organ transplant recipients. It would still be really strange if people who got organ transplants were healthier than the general population, who mostly do not need organ transplants. >- How were the (non)-dementia patients assessed? No formal diagnosis of dementia != no dementia. But it would be weird if organ transplant recipients were 10x less likely to get a diagnosis of dementia (assuming the same base rates). I would think because of their heavy interaction with the healthcare system they'd have a high rate of diagnosis.
- omgwtfbyobbq 5y ago
  Autoimmune issues may fit that bill in people with the right genetics. They can cause and/or contribute to CKD, which could push someone into kidney failure with other insults (eg dehydration), and can also contribute to dementia.

OscarCunningham 5y ago

Not everyone who needs an organ transplant gets one. So could it be that recipients are privileged in some way that also prevents them getting dementia?

asow92 5y ago
Also wondering if lifestyle choices of those post-op have anything to do with this. i.e. better diet, exercise, etc.
bbulkow 5y ago
Very nice to read a balanced paper, but a hospital might very well ( and, I think, illegally ) give some transplant people priority. Isn't that what happened to Steve jobs? No one is supposed to jump the queue, but he did. If 'queue jumping' is illegal, and happening at one hospital, I could imagine that as the kind of stunning bias shown in the data, and everyone involved would say it isn't happening
- bink 5y ago
  As I recall it he didn't so much "queue jump" as he used his private plane to travel to another state within a specific window of time from where he lived, which most people who lived outside of the transplant state couldn't do. So he was able to get on multiple transplant waiting lists.
- wombatpm 5y ago
  Transplants are coordinated regionally. Jobs just purchased homes in multiple areas with shorter wait times than California. One of the advantages of being rich.
  - hpagey 5y ago
    Incorrect. You don't have to be rich. I am currently being evaluated for deceased donor transplant outside my home state of California. You just have to register at another center and you are allowed to multi list. Some states have residency requirements but lot of them do not.

jannyfer 5y ago

It'd be nice to take out the clickbaity "here's why" from the title.

_game_of_life 5y ago

Initially I thought that the reason for this would be that most people with transplants live less than 10 years, and eligibility requirements of who gets transplants (and therefore who gets calcineurin inhibitors) might further complicate the results. Wow, was I ever wrong. This article says it's not too uncommon for people to live 30 years after their transplant. Other articles say that even the obese are eligible for transplantation now. Very impressive. https://wexnermedical.osu.edu/blog/how-long-do-transplanted-organs-last https://wexnermedical.osu.edu/blog/how-long-do-transplanted-... That being said, I know life extension and nootropics and all that jazz is a really popular topic with tech bros, so its worth noting the side effects of calcineurin inhibitors are really bad. It's also neat ciclosporin was isolated from some scandanavian fungus living in the soil. Makes me sad thinking about how once we are able to significantly understand and appreciate genetics and related biotechnology later this century, half of the species on earth will already be gone, their amazing biological traits and compounds lost forever.

fortran77 5y ago
> Other articles say that even the obese are eligible for transplantation now. Very impressive. I would hope that would be before any right-weight candidate had been ruled out. Otherwise it's grossly unfair.
- aklemm 5y ago
  Maybe if obesity resulted merely from character flaws, but clearly there’s something environmental going on. Nonetheless, would it be unfair to give transplants to manual laborers and motorcycle riders as their chances of dying early are high?
pkaye 5y ago
Sirolimus and Tacrolimus are two other common anti-rejection medicines. They were found in Easter Island and Japanese soil samples respectively.
- actually_a_dog 5y ago

tantalor 5y ago

Apples & oranges

tacobelllover99 5y ago

Couldn't read after they said Huffpo is Journalism

deleted 5y ago

[deleted]

caymanjim 5y ago

This is an interesting pop-science read, but who is Trevor Klee? As far as I can tell, he's a college exam tutor who's written a few "how to pass the GRE" booklets. He's writing about trying to start a biomedical business around this idea, but if his LinkedIn is accurate, he's never had a job beyond tutoring college students. His list of "failed projects," linked to from the blog, contains a bunch of similar biomed business ideas, none of which have anything at all to do with each other on a technical level ("Using RNAi for agriculture", "Exploring ketamine for blood pressure"). This basically reads as "I got a masters in molecular bio, have never worked in the field, and want you to give me money for my next crackpot idea". That doesn't mean the idea is wrong, but this guy isn't the one who's gonna make it happen.

tibbetts 5y ago
Anybody asking me for money to cure Alzheimer’s I just at this point assume is Theranos 2.0. There are plenty of well informed life sciences investors with very deep pockets.
- 300bps 5y ago
  Yeah I’d be as likely to buy a magical anti-dementia rock as invest in this.
cellis 5y ago
I don’t know much about how the biotech industry works, but are you saying that he should “work in the field” before pitching this idea? In software that would be almost laughed at as a suggestion, if the idea is indeed promising.
- coldtea 5y ago
  No, in software terms, he's saying that is somebody comes and tells you "Software that has enough spaces, never crashes", and he "happens" to be selling the "Extra-spaces-adder" IDE, then maybe don't believe him...
- mcguire 5y ago

gzer0 5y ago

It is very difficult to engineer animals with symptoms mimicking human dementia so they can effectively be trialed with drugs before testing on people. This is the exact reason dementia / Alzheimer’s research is littered with dozens of high-profile failed clinical trials; after billions and decades poured into this area and nothing to show. I would be interested to see non-murine, primate-based(?) clinical findings before I get my hopes up again. We have seen this pattern too many times; a compelling agent, pathway, or signaling mechanism is found, targeted, and shows great promise in mice, even sometimes in primates. And once we get to human trials it fails because we cannot replicate dementia accurately in these test vehicles.

easytiger 5y ago
There is a genetic component that seems very much ignored too
genewitch 5y ago
I'm not seeing much mention of diet and gut biome in these comments, over the last decade they're linking satisfactorily the gut to so many different ailments in later life, including Alzheimer's and dementia. Additionally studies are linking diet/gut Flora to stuff like autism, some inflammatory diseases, etc. If I was born 15 years later I'd probably have gone into that field of study as it probably makes the most fiscal sense - from a national medicine standpoint - to combat these disorders and diseases at the actual source. I wonder if there's been a metastudy on the median lifespan going up and incidence of these cognitive or neurological disorders. That is, now that humans on average are living longer, perhaps our diets are more important; and with his knowledge we can get some enhancements on regulations from the FDA or something.

burning_hamster 5y ago

I am not sure I buy into the author's calcineurin/mitochondria hypothesis. There is a much more direct causal link as auto-immunity has been implicated in AD progression for years, e.g. [1-11]. I can't find the paper right now, but I once saw a very compelling longitudinal study where they regularly measured cognitive performance as well as several immunity markers in older subjects. Basically, every transient increase in antibody levels (IIRC, but they may have been tracking some other marker of immune system activation) was followed by a step decline in cognitive performance. [1] Lopez (1991) Serum auto-antibodies in Alzheimer's disease [2] Aisen (1996) Inflammation and Alzheimer disease [3] D'Andrea (2005) Add Alzheimer’s disease to the list of autoimmune diseases [4] Carter (2010) Alzheimer's Disease: A Pathogenetic Autoimmune Disorder Caused by Herpes Simplex in a Gene-Dependent Manner [5] Reddi et al (2011) Autoimmunity in Alzheimer’s disease: increased levels of circulating IgGs binding Aβ and RAGE peptides [6] Sardi et al (2011) Alzheimer's disease, autoimmunity and inflammation. The good, the bad and the ugly [7] Marchese (2013) Autoimmune Manifestations in the 3xTg-AD Model of Alzheimer's Disease [8] Li et al. (2018) Dementia and Alzheimer's disease risks in patients with autoimmune disorders [9] Arshavski (2020) Alzheimer’s Disease: From Amyloid to Autoimmune Hypothesis [10] Itzhaki et al (2020) Do infections have a role in the pathogenesis of Alzheimer disease? [11] Lim et al (2020) Alzheimer Disease Pathogenesis: The Role of Autoimmunity

renewiltord 5y ago
Sorry, haven’t read these yet, but any antibodies? Like any immune response makes you duller and at greater risk? Eek.
- burning_hamster 5y ago
  Like I said, I can't find the study right now, and I originally saw the data anywhere between 5-10 years ago. They may also have been measuring some cytokine. Even without AD, memories really aren't reliable over that time span. The point the authors were trying to make is that if you have AD, any inflammation, even asymptomatic ones, will potentially worsen your cognitive performance. The most interesting feature of that graph was to me that the cognitive performance actually remained fairly constant in between infections/inflammations, and decline was not gradual but in a step-wise fashion.

mhalle 5y ago

As a liver transplant recipient (7.5 years out), I find how transplant patients are stereotyped in this somewhat informal article a bit misleading. First, transplants are about as close to a life-changing miracle as you can imagine. By which I mean night and day change for a reasonable subset of patients. The fact that we now have anything like access to interchangeable parts that can let people live extremely normal lives is absolutely remarkable. Before transplant there were times when I was too weak to walk. One month after transplant I could walk a mile, three months after five miles. There is zero question I'd be dead by now without my transplant. I might have lived a year or so more with my old one, but it would have been an unpredictable high-wire act between GI bleeds, encephalopathy, coma, and fear that any simple action might trigger an emergency trip to the emergency room. Internal bleeding and encephalopathy put my in a coma for three days and, when I came out, this PhD computer scientist couldn't remember my own kids' names. Now I'm writing this. I am simply so fortunate to be able to have this second chance in life. As for the misleading parts, "Organ transplant patients are, by their nature, sick patients." Yes, but that's why they get transplants. Many get better. Look at livers. Viral hepatitis (in my case, Hep C) is one of the most common reasons for liver transplant. But we can cure Hep C. I was one of the first people cured before transplant with Gilead's Hep C antivirals. The new liver fixed my cirrhosis. Now I get sick less often than my kids, and my life is extremely normal except for a couple pills a day (tacrolimus) and lab tests every three months. I was a mild hemophiliac, and that was cured by the new liver as well. If you looked at my lab tests, besides a low platelet count, I would look perfectly normal. And especially for livers, which deal with processing a lot of foreign substances in the body, so it probably more tolerant than other organs, the lifespan on them may be quite long. Older liver transplant patients can sometimes even drop their immunosuppressants completely. So, for people who have curable diseases, the health of a transplant patient can be quite good, potentially better than their peers. There's no specific reason they as a single less healthy class (as opposed to a set of classes, which also includes people who abuse alcohol or have diseases we can't cure). To answer some other questions in the discussion, the transplant process tries hard to keep someone from being able to literally buy their way onto the transplant list. For livers, priority of transplant goes by a lab test called MELD which estimates 90 day mortality. You have to be sicker than other people but healthy enough not to waste an organ. It's a fairly macabre competition. There are, however, advantages to those with means. In the US, organ transplant is administered nationally but organs are still basically allocated regionally. If you can travel to another region in the country with a surplus of organs, you can get a transplant sooner. I did it. It saved my life. You also need to go through a battery of tests to make sure you are, basically, a good host for the rare organ. In general you have to stop substance abuse. You need to lose weight. You need to take a physical which can disqualify you. You need to have a social support mechanism to help take care of you after surgery (in the hospital, after discharge, and long term). Finally, you need to have insurance that will cover the potentially million dollar surgery and and complications that might follow. And that means there's another hidden process that happens in the insurance company to assess whether you're a good risk or not. Most of those conditions strictly require wealth. All of them benefit from it, especially access to health care. On the other hand, it isn't clear that access to health care is strongly correlated with an absence of dementia, is it?

supperburg 5y ago

People talk about inflammation vs metabolism. They are linked. Inflammatory signals can turn cellular metabolism up or down. African sleeping sickness is an infection that results in a person going into a kind of coma. The parasite constantly changes its molecular interface with the host which is supposed to confuse the hosts immune system. This places a huge burden on the immune system and results in the host becoming hungry all the time, despite already being full. These patients will stuff themselves while growing progressively more tired. And eventually they fall asleep permanently. Inflammatory signals slow metabolism or something to that effect and this change in metabolism causes the body to feel as though it’s starved of energy and so the patients feel hunger. Inflammation and metabolism are linked. A man with schizophrenia was cured after a bone marrow transplant. The New York Times wrote about it recently. Symptoms of age including cognitive decline have been reversed in mice and humans through blood dilution/ blood transfusion probably due to reduction in the concentration of inflammatory molecules in the blood that are produced by ones own body. Inflammation/metabolism is the biggest medical revolution on the horizon. Especially since COVID has made it a grant-worthy topic now and doctors can’t deny that chronic fatigue syndrome is real anymore. It’s funny how all those people who insisted that CFS wasn’t real are now nowhere to be found to answer for their mistake.

erentz 5y ago
> It’s funny how all those people who insisted that CFS wasn’t real are now nowhere to be found to answer for their mistake. Oh a many of them are still out there. Now pushing CBT and GET as a cure all for Long COVID.
- circlefavshape 5y ago
  I have direct experience of this. My wife has had long covid for the last year, has had dozens of medical tests, and none of them have showed up anything except for POTS. I can understand why a neurologist would suggest CBT. All my wife's test results are normal, so the neurologist has no remedies available. People do get psychosomatic illnesses, and in those cases CBT does help. That doesn't mean that my wife has a psychosomatic illness, but there's no test for that either - can't hurt to try (FWIW this is not the way my wife saw it - she was pretty furious and felt like the neurologist was demeaning her condition)

leokeba 5y ago

I'm surprised the author does not mention taking steps to verify the "unique University of Texas protocol" hypothesis. It really looks like the most probable alternative explanation, and it doesn't seem very difficult for someone already in the medical industry to get in touch with one of the people there who could be able to verify it. Maybe I'm missing something ?

krisoft 5y ago
> Maybe I'm missing something ? I'm afraid it appears so. The article says they contacted the authors of both publications but haven't got a response back yet. Relevant bit: "For my own part, I’ve contacted authors of both papers, but haven’t received substantive responses from either. I’ll update this post when/if I do."

p00l00 5y ago

Im surprised nobody has suggested MicroRNA. In particular mir-29. But that remains to be thoroughly interpreted. https://www.frontiersin.org/articles/10.3389/fnins.2020.00564/full https://www.frontiersin.org/articles/10.3389/fnins.2020.0056...

deleted 5y ago
[deleted]

yosito 5y ago

Results aside, I give this article points for clear and persuasive writing!

irthomasthomas 5y ago

Related: Type 3 Diabetes https://en.wikipedia.org/wiki/Type_3_diabetes https://en.wikipedia.org/wiki/Type_3_diabetes

treeman79 5y ago

Theory. People who take immune suppressing drugs have less dementia. Perhaps undiagnosed autoimmune conditions are a cause / trigger for dementia. My experience. Had out of control undiagnosed autoimmune condition. Started developing major dementia. Eventually (20 years) got autoimmune diagnosed and under control. Also started blood thinners. Dementia resolved quickly.

eliasmacpherson 5y ago
It's not just you that has a theory around this, if you view allergies around histamine as autoimmune conditions: Here's some pseudoscience, you may also find the parent comment interesting. https://news.ycombinator.com/item?id=27993001 https://news.ycombinator.com/item?id=27993001

bedobi 5y ago

Wikipedia: > Calcineurin inhibitors and azathioprine have been linked with post-transplant malignancies and skin cancers in organ transplant recipients. Non-melanoma skin cancer (NMSC) after kidney transplantation is common and can result in significant morbidity and mortality. The results of several studies suggest that calcineurin inhibitors have oncogenic properties mainly linked to the production of cytokines that promote tumor growth, metastasis and angiogenesis. Bummer

wolverine876 5y ago
I'm not sure I'd take medical advice from there. Are there no better sources?

catlikesshrimp 5y ago

My nose suspects the system (TU) was triaging agaisnt dementia, somehow, and the author didn't notice. Next study, designed for comparing transplantation correlation to dementia, should use a dementia scale before and after the trasplant. The article is not a scientific paper. I hope scientific papers were so honest about conflict of interest and autocritic as this author is in this article.

golem14 5y ago

Could it be that patients with early stage dementia are somewhat less likely to ask for or receive transplants?

Gatsky 5y ago

This is unfortunately almost certainly bunk. There is a large selection and survivorship bias. To be an 85+ yo and be alive with an organ transplant you have to be pretty special. That generally means you have kept your transplant for at least 30 years and survived the early days of suboptimal immunosuppressants and perioperative care. Also transplant recipients are managed very carefully by their physicians, who constantly tweak their medication, blood pressure, blood sugar etc. Also people who manage to live with their transplants for long periods are presumably highly selected for diligence, education, wealth, compliance, mental health etc.

ouid 5y ago

So we think it's because of the immunosuppression then?

mogadsheu 5y ago

It's like the consolation prize/participation ribbon of major operation. Congrats, your kidney's been replaced and you'll have to be on immunosuppressants for the rest of your life, but at least you won't get dementia.