assessment of TGI’s TruGraf test for renal transplant monitoring, a Mayo Clinic investment in TGI, and working together on co-development of new tests and technologies for things such as exploratory studies in heart and liver transplantation. Physicians and researchers from several Mayo Clinic campuses will participate in the partnership, including its Arizona, Florida, and Rochester, Minnesota locations. “At Mayo, our research in this area is focused on improving long-term kidney graft survival, so that patients would lead healthier lives,” said Mark Stegall, MD, surgeon at Mayo Clinic and a principal investigator on the project. “Genomic analysis of blood can reveal early signs of rejection in transplanted kidneys. The potential clinical utility is to be able to monitor for rejection more frequently than is possible with surveillance biopsies and to individualize immunosuppression in transplant recipients.” “TruGraf’s ability to detect early transplant rejection in patients with stable kidney transplantation function will provide physicians with a tool to help provide the appropriate levels of immunosuppression therapy,” said Roy First, MD, chief medical officer of TGI. “Our first collaborative project together is a case study in individualized medicine in which TruGraf will be used to support decisions around personalized immunosuppression.”
Youth Injured in Motor Vehicle Accidents Have Best Outcomes at Level I Pediatric Trauma Centers Children and adolescents who have been injured in motor vehicle accidents have better outcomes when they are treated at a standalone Level I pediatric trauma center than at general adult trauma centers or adult trauma centers with Level I pediatric qualifications, according to a new study from researchers at Children’s Hospitals and Clinics of Minnesota (Children’s Minnesota). “Although children treated at level one trauma centers receive the highest level of care, these data suggest adolescents treated
at freestanding pediatric hospitals have better outcomes following a motor vehicle accident,” said Nathaniel Kreykes, MD, trauma medical director at Children’s Minnesota. “The conservative approach to pediatric trauma protocols may offer an advantage to injured adolescents as they transition from childhood to adulthood.” Researchers analyzed data from the American College of Surgeons National Trauma Data Bank for 28,145 pediatric patients (16,643 children under the age of 15 and 11,502 adolescents between the ages of 15 and 17) treated at Level I trauma centers between 2009 and 2012. Of those, 19.9 percent were treated at a pediatric trauma center, 21.7 percent were treated at an adult trauma center with pediatric qualifications, and 58.4 percent were treated at a general adult trauma center. Most patients had head and neck injuries (66.2 percent) and many had multiple injuries (42.7 percent). They discovered that mortality rates for children treated at a general adult trauma center were similar to those treated at a pediatric trauma center. However, those treated at an adult trauma center faced a greater risk of complications such as pneumonia. Adolescents treated at a general adult trauma center or an adult trauma center with pediatric qualifications had worse mortality rates than those treated at a pediatric trauma center. Overall, children and adolescents were more likely to be treated with invasive injury management procedures at a general adult trauma center or an adult trauma center with pediatric qualifications than at a pediatric trauma center. “Pediatric trauma centers are exclusively focused on the care of injured children. As such, the care teams are often more comfortable recommending a conservative approach, including observation instead of aggressive treatment or diagnosis, compared to physicians at adult trauma centers who treat fewer pediatric patients,” said Anupam B. Kharbanda, MD, chief of critical care services at Children’s Minnesota and an author of the study. “This, combined with very aggressive use of standardized pediatric care pathways in these centers, likely contributes to the better outcomes we noted in this study.” Capsules to page 12
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