Three patients at a Los Angeles County dialysis center developed serious infections last summer because of improper cleaning and disinfection of a reusable medical device called a dialyzer, researchers reported Tuesday. The dialyzer -- in effect, an artificial kidney -- removes toxic substances from the blood in patients whose own kidneys are not functioning.  All three infections were traced to one machine, and the center has decided to stop using that type of machine, which is more difficult to disinfect than others.

The infections were reproted to the L.A. County health department in August by a hospital where all three patients were treated. Two of the patients had developed fevers and were hospitalized. The third was treated as an outpatient. All the patients recovered.

Public health nurse L'Tanya English investigated the outbreak and reported at a San Antonio meeting of the Assn. for Professionals in Infection Control and Epidemiology that the bacteria infecting the three patients were genetically linked. All were infected with Stenotrophomonas maltophilia, a rare type of gram-negative bacteria. Two of the patients were also infected with Candida parapsilosis, a fungus that can cause sepsis in immunocompromised patients. That same fungus was found on a door handle in the room where the dialyzers were cleaned and disinfected.

Dialysis always carries a high risk of infection, English said, because blood is pumped through the dialyzers. It is especially problematic in those dialyzers that must be taken apart to be cleaned.

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Two local residents are among those who will help the National Kidney Foundation of Maryland reach new fundraising heights this week when they rappel off a building in downtown Baltimore for the foundation's third annual Rappel for Kidney Health event.

The fundraiser will take place Saturday, June 9, at the 32-story Baltimore Marriott Waterfront.

Barbara Case, of Timonium, is a pediatric nephrology nurse at Johns Hopkins Hospital, who said she put the rappelling challenge on her "to do" list last year after watching others at the event.

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"I have to admit that the thought of rappelling 32 stories terrifies me, but it's the challenge and the good cause that grabbed me," she said. "Honestly, just knowing that I am raising funds to help the children that I work with every day is so rewarding."

Also taking the challenge will be Dr. Matthew Cooper, of Cockeysville, an associate professor of surgery and director of both kidney transplantation and clinical research at the University of Maryland School of Medicine Division of Transplantation. Cooper participated in the event last year as well.

Participants must raise $1,000, and receive a fundraising web page, a rappelling time slot and undergo training on the day of the event before stepping off.

Funds raised through Rappel for Kidney Health support patient services, education and research efforts. The first two Rappel for Kidney Health events drew 135 participants and raised more than $180,000.

To support a participant, receive information about sponsorship or see videos of last year's event, go to http://www.kidneymd.org or call 410-494-8545.

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WALTHAM, Mass.—A renal allograft was removed from a 27-year-old man on post-transplantation day 14 and donated to a 66-year-old man on the waiting list after the first patient suffered persistent proteinuria, worsening hypoalbuminemia, rising creatinine, and the development of intraabdominal hematoma beginning on posttransplantation day 2.

Both patients and the hospital ethics committee and internal review board consented to the transfer. The allograft, originally donated by the younger man's sister, regained function immediately after retransplantation, with serum creatinine levels declining from 5.27 to 1.84 mg/dL and proteinuria falling from 25 g to 1.2 g per 24 hours, according to a report in the New England Journal of Medicine

Biopsies performed on days 8 and 25 after retransplantation showed a reversal of the histopathologic lesions seen developing in the first recipient. Eight months after retransplantation, the second recipient's glomerular filtration rate remained above 90 mL/min/1.73m² in the setting of mild proteinuria (0.27 g per 24 hours).

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The Monroe Carell Jr. Children's Hospital at Vanderbilt again was named among the leaders in pediatric health care, according to rankings compiled by U.S. News & World Report.

The rankings are now in their sixth year, and recognize top performers among the nation's 178 designated pediatric hospitals. The Monroe Carrell Jr. Children's Hospital has made the list each year. The hospital was recognized for 10 out of 10 specialty programs.

"We feel honored that, once again, a maximum of 10 of our pediatric specialties have achieved national ranking," said Luke Gregory, Monroe Carrell CEO. "Our physicians and staff work hard each day to offer top-notch, comprehensive expertise and care to families."

The report ranked the hospitals in the following categories: cancer; cardiology and heart surgery; diabetes and endocrinology; gastroenterology; neonatology; nephrology; neurology and neurosurgery; orthopedics; pulmonology; and urology.

The full rankings are available here.

Chris Silva covers health care, technology and venture capital for the Nashville Business Journal.

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