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Live webinars in March—free to AST members
Register now for these upcoming webinars:
  • March 18 at 2 p.m. EST: Hepatitis C Eradication: Liver Transplant Patients and Beyond by Dr. Jacqueline O'Leary, Ph.D. (free to AST members, $25 for non-members)
  • March 20 at 4 p.m. EST: Translational Research Webinar for Fellows by Dr. Peter Heeger (free to everyone)
Click here for all upcoming and on demand webinars, including an update on the new kidney allocation policy, new UNOS living donor care policies and more!

Thank you to our past webinar presenters and moderators: Mark Aeder, Yolanda Becker, Naima Carter-Monroe, John Friedewald, Nitika Gupta, Mark Haas, Rebecca Hays, Seth Heldenbrand, Camille Kotton, Murli Krishna, Deepali Kumar, Michael Mengel, Jennifer Mitlon, Lorraine Racusen, Rene Rodriguez, Peter Stock, Jennifer Trofe-Clark, Nicole Turgeon and David Wojciechowski.

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  UCLA Immunogenetics Center

The UCLA Immunogenetics Center (UIC) provides comprehensive testing for organ and tissue transplantation. Transplant testing has a long history at UCLA. HLA typing was pioneered here in the 1960's. The development of the microcytoxicity test in 1964 marked the beginning of international testing and standardization of HLA typing. The UCLA Immunogenetics Center has retained its leadership position in HLA research, and in the development of accompanying diagnostic testing. MORE

Recognize transplant nurses with the ITNS Transplant Nurses Day Essay Contest
The Transplant Nurses Day Essay Contest allows patients to nominate an ITNS transplant nurse who has made a difference in their lives. The winning essay will be featured in a future issue of the ITNS Insider newsletter. In addition, the winning nurse will receive a recognition award, a letter will be sent to his or her supervisor and he or she will be acknowledged on the ITNS website and in an ITNS E-Updates membership email. Entries are due March 14, 2014. Click here for full contest rules and details.
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A novel organ donor facility: a decade of experience with liver donors
American Journal of Transplantation (login required)
Transplant surgeons have historically traveled to donor hospitals, performing complex, time-sensitive procedures with unfamiliar personnel. This often involves air travel, significant delays and frequently occurs overnight. In 2001, the nation's first organ recovery center was established. The goal was to increase efficiency, reduce costs and reduce surgeon travel. Liver donors and recipients, donor costs, surgeon hours and travel time, from April 1, 2001 through Dec. 31, 2011 were analyzed.
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A multicenter study of primary graft failure after infant heart transplantation: Impact of extracorporeal membrane oxygenation on outcomes
Pediatric Transplantation
Primary graft failure is the major cause of mortality in infant HTx. The aim of this study was to characterize the indication and outcomes of infants requiring ECMO support due to primary graft failure after HTx. Authors performed a retrospective review of all infants who underwent Htx from three institutions.
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Glutathione s-transferase iso-enzymes in perfusate from pumped kidneys are associated with delayed graft function
American Journal of Transplantation (login required)
Accurate and reliable assessment tools are needed in transplantation. The objective of this prospective, multi-center study was to determine the associations of the alpha and pi iso-enzymes of glutathione S-transferase, measured from perfusate solution at the start and end (base and post) of kidney allograft machine perfusion, with subsequent delayed graft function.
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Hepatitis C recurrence: the Achilles heel of liver transplantation
Transplant Infectious Disease (login required)
Hepatitis C virus infection is the most common indication for liver transplantation worldwide; however, post-transplant recurrence is almost universal and follows an accelerated course. Around 30 percent of patients develop aggressive HCV recurrence, leading to rapid fibrosis progression (RFP) and culminating in liver failure and either death or retransplantation. Despite many advances in our knowledge of clinical risks for HCV RFP, we are still unable to accurately predict those most at risk of adverse outcomes, and no clear consensus exists on the best approach to management. This review presents a critical overview of clinical factors shown to influence the course of HCV recurrence post transplant, with particular focus on recent data identifying the important role of metabolic factors, such as insulin resistance, in HCV recurrence.
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T-cell migration to vascularized organ allografts
Current Opinion in Organ Transplantation
Antigen-driven migration of effector and memory T cells sheds new light on the pathogenesis of transplant rejection and predicts that interrupting the TCR-triggered 'inside-out' signaling pathway, rather than that initiated by Gαi-coupled chemokine receptors, is a key approach to preventing rejection.
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Peritransplant absolute lymphocyte count as a predictive factor for advanced recurrence of hepatitis C after liver transplantation
Lymphocytes play an active role in natural immunity against hepatitis C virus (HCV). Authors hypothesized that a lower absolute lymphocyte count (ALC) may alter HCV outcome after liver transplantation (LT). The aim of this study was to investigate the impact of peritransplant ALC on HCV recurrence following LT. A total of 289 LT patients between 2005 and 2011 were evaluated. Peritransplant ALC (pre-LT, two-week, and one-month post-LT) and immunosuppression were analyzed along with recipient and donor factors in order to determine risk factors for HCV recurrence based on METAVIR fibrosis score.
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Renal cooling beneficial in robotic kidney transplants
By Trina McMillin
Surgeons in India and Detroit recently collaborated to perform kidney transplants on 50 patients using a new technique that involves using a robot to assist with the procedure and cooling the organ throughout the procedure using sterile ice. Mani Menon, M.D., the chair of Henry Ford's Vattikuti Urology Institute in Detroit and the co-author of this study, stated that a minimally-invasive surgery decreases the patient's pain during recovery. He said it also minimizes complications when compared to conventional surgery.
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Missed last week's issue? See which articles your colleagues read most.

    Time course of pathologic changes in kidney allografts of positive crossmatch HLA-incompatible transplant recipients (Transplantation)
Antibody-mediated rejection, T cell-mediated rejection, and the injury-repair response (Kidney International)
High CTLA-4 expression on Th17 cells results in increased sensitivity to CTLA-4 coinhibition and resistance to belatacept (American Journal of Transplantation)
The renin-aldosterone axis in kidney transplant recipients and its association with allograft function and structure (Kidney International)
Histologic phenotype on 1-year posttransplantation biopsy and allograft survival in HLA-incompatible kidney transplants (Transplantation)

Don't be left behind. Click here to see what else you missed.

Banff fibrosis study: Multicenter visual assessment and computerized analysis of interstitial fibrosis in kidney biopsies
American Journal of Transplantation (login required)
Increasing interstitial fibrosis (IF) in native and kidney transplant biopsies is associated with functional decline and serves as a clinical trial end point. A Banff 2009 Conference survey revealed a range in IF assessment practices. Observers from multiple centers were asked to assess 30 renal biopsies with a range of IF and quantitate IF using two approaches on trichrome, Periodic acid-Schiff (PAS) and computer-assisted quantification of collagen III immunohistochemistry (C-IHC) slides, as well as assessing percent of cortical tubular atrophy and Banff total cortical inflammation score (ti-score).
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Impact of HLA mismatch at first kidney transplant on lifetime with graft function in young recipients
American Journal of Transplantation (login required)
As HLA matching has been progressively de-emphasized in the American deceased donor kidney allocation algorithm, concerns have been raised that poor matching at first transplant may lead to greater sensitization and more difficulty finding an acceptable donor for a second transplant should the first transplant fail. Authors compared proportion of total observed lifetime with graft function after first transplant, and waiting times for a second transplant between individuals with different levels of HLA mismatch at first transplant.
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