Week 8 - Mary

I can't believe how quickly the past two months have gone by. This week was spent completing the final stages of data collection for the mini longitudinal study I described in earlier posts, which examines changes in kidney volume after transplant. As part of this process, we also had to exclude a number of patients who didn't have enough scans to reliably calculate a growth rate, or who had acute kidney events that would confound any trend we measured. Among the patients who did meet criteria, we identified a small number who went on to develop chronic kidney failure following transplantation, and our initial observations suggest that their kidney volumes increased after an initial period of decline and subsequent stabilization following transplantation.

It's a small but interesting signal that warrants further investigation. One leading explanation for native kidney shrinkage after transplant has been immunosuppressive drugs, since several act on the same mTOR pathway implicated in cyst growth, but studies show the rate of shrinkage doesn't actually differ by regimen. The pattern we're seeing instead looks more like compensatory hypertrophy, where kidney tissue grows to offset declining function, a well-documented response elsewhere, such as in living donors after nephrectomy. What's unique here is that those classic cases involve a healthy kidney compensating for a lost one, whereas ours are diseased, cystic kidneys responding to failure of a separate, transplanted organ, a context where this kind of response hasn't been confirmed.
 
More broadly, working backward from individual patient observations toward more fundamental research questions has given me a much wider perspective on the power of clinical research. Watching a pattern emerge in a handful of patient scans has deepened my appreciation for how translational this kind of work actually is.
 
We also had the opportunity to present our research to our peers this week, condensing an entire summer's worth of work into a four-minute talk. It was a genuine challenge, but a valuable one, as it pushed me to consolidate my thinking and identify the points that mattered most.
 
Looking back on the summer as a whole, I'm extremely grateful for the opportunity to embed myself in a hospital setting. It's an experience I could never have gotten from reading papers or watching lectures alone, and I don't think I fully understood how different the two were until going through this program myself. I'm especially grateful to Dr. Prince for his mentorship throughout the summer, and to the members of his lab for making it such a welcoming place to learn. I'm also very appreciative of Dr. Robert Min, Dr. Martin Prince, Dr. Mert Sabuncu, Dr. Kelly Gillen, and Carly Skudin for coordinating this entire experience.

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