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Chain transplantation: Initial experience of a large multicenter program
American Journal of Transplantation (subscription required)
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The results of a large series of chain transplantations that were facilitated by a multicenter U.S. database in which 57 centers pooled incompatible donor/recipient pairs were recently reported. Chains, initiated by nondirected donors, were identified using a computer algorithm incorporating virtual cross-matches and potential to extend chains. Chain transplantation enables many recipients with immunologically incompatible donors to be transplanted with high quality grafts.
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What's new with AST's Communities of Practice?
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The AST's Communities of Practice (COPs) have been exceedingly busy since meeting at ATC 2012. Here are some important updates to take note of:
- The Infectious Disease Community of Practice (IDCOP) has been very busy; most notably going through the final stages of the review process for the ID Guidelines 3rd Edition, compiling infectious disease highlights from ATC for a webcast program, and developing new content and suggestions for the IDCOP website. For a complete update on IDCOP activities and/or information on how to become more involved, please check out their most recent September IDCOP Newsletter.
- The Transplant Pharmacy Community of Practice (TxPharm COP) is pleased to once again be offering the Organ Donation Awareness Challenge. This highly successful program aims to increase organ donation awareness by encouraging schools of pharmacy to host an awareness event. For more information on this initiative, please check future AST eNews updates!
- The Thoracic and Critical Care Community of Practice (TCC COP) is looking to encourage more cardiothoracic and critical care abstract submissions to ATC 2013. The TCC COP will be offering travel grant awards to two abstract submitters. Qualifications and criteria will be provided in the upcoming weeks. Please look for further updates on this through the AST website or eNews updates.
AST members are encouraged to join one or more communities of practice. These groups provide their members with specialized education and networking opportunities. Learn more and join.
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Identify Antibodies That May Compromise Graft Survival
- Detect Presence of Complement Fixing Antibodies
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Submit your abstracts now to AST's Cutting Edge of Transplantation
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 B Cells from Bedside to Bench to Bedside: A Comprehensive Look at B Cells and Antibodies in Transplantation
Come together to discuss the state-of-the-art in the vital area of B cells and antibodies in transplantation, including clinical management decisions from diagnosis to desensitization to therapy and the basic research questions that inform this field and create new directions for the future. View the full program and faculty list.
Sessions include:
Clinical Problems with Antibodies in Transplantation
Biology of B Cells and Plasma Cells
What is Antibody-Mediated Rejection (AMR)?
Avoiding and Treating the Problem
Features of AMR
B Cells and Antibody-mediated Allograft Injury
Controversies: Antibodies in Transplantation
ESOT-AST Joint Meeting: Transformational Therapies and Diagnostics in Transplantation
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The ESOT-AST Joint Meeting is only one week away. Register and view the program on the ESOT website, in the "Meetings" section. Faculty and attendees will critically analyze important topics such as the results of recent clinical trials using costimulation blockade, new challenges in the diagnosis and treatment of antibody mediated rejection, pharmacogenetic testing in patient management, new immunosuppressive agents in the pipeline, new interventions for delayed graft function and graft fibrosis and current immunosuppressive therapies and identify unfulfilled needs and potential new interventions. Transformational Therapies and Diagnostics in Transplantation will be held on Oct. 12-14 at Palais de la Méditerranée in Nice, France.
 
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Hypoglycemia and risk of death in critically ill patients
The New England Journal of Medicine (subscription required)
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In critically ill patients, intensive glucose control leads to moderate and severe hypoglycemia, both of which are associated with an increased risk of death. The association exhibits a dose–response relationship and is strongest for death from distributive shock. However, these data cannot prove a causal relationship.
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Increasing the recipient benefit/donor risk ratio by lowering the graft size requirement for living donor liver transplantation
Liver Transplantation (subscription required)
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A characteristic pattern of hemodynamic changes that may occur in reperfusion phase of liver transplantation (LT) is known as post-reperfusion syndrome (PRS). In this study, researchers determined the frequency of PRS and evaluated possible predictors of PRS. They concluded that both severity of liver disease and graft steatosis may increase risk for PRS in LT.
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Bridge to lung transplantation with extracorporeal membrane oxygenation support
Current Opinion in Organ Transplantation (subscription required)
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Extracorporeal membrane oxygenation (ECMO) can provide pulmonary and, if needed, right heart support for patients with acute and chronic lung disease. Many patients on lung transplant lists die from acute exacerbations of their underlying chronic lung disease before they can receive a lung transplant. Transplant teams have taken advantage of these recent advances in ECLS to bridge such patients to lung transplantation (bridge to transplant, BTT).
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Inducing tolerance to pregnancy
The New England Journal of Medicine (subscription required)
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What causes recurrent miscarriage? Perhaps a paucity of regulatory T cells. A recent study showed that these cells prevent pregnant mice from mounting an immune response against the fetus.
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Surgeons develop framework to assess long-term impact of facial transplant operations
Science Codex
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Facial transplant operations are often portrayed as dramatic before-and-after stories but new research shows that the procedures' real long-term impact may sometimes be underreported, explained researchers from The Johns Hopkins Hospital, Baltimore. An analysis of patient outcomes data found that a recently developed standard scoring system called "the FACES score" — which measures a patient's ability to return to a normal life — has not been fully utilized for some patients who have already undergone facial transplants, according to reconstructive surgeons who presented study results at the 2012 American College of Surgeons Annual Clinical Congress.
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Therapeutic time window important factor for cord blood cell transplantation after stroke
Medical Xpress
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A research team from Germany has found that optimal benefit and functional improvement for ischemic stroke results when human umbilical cord blood mononuclear cells (hUCB MNCs) are transplanted into rat stroke models within 72 hours of the stroke. Their study is published in the current issue of Cell Transplantation (21:6), now freely available online.
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Artificial cornea gives hope when transplants won't work
Medical Xpress
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Blindness is often caused by corneal diseases. The established treatment is a corneal transplant, but in many cases this is not possible and donor corneas are often hard to come by. In the future, an artificial cornea could make up for this deficiency and save the vision of those affected.
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Genetic testing can be a cost-effective way to increase the number of living related donor transplants. Mutational analysis may help direct long-term treatment plans, including pre-operative screening of potential kidney transplant recipients and living related donors. more
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Current strategies and future trends in immunosuppression after heart transplantation
Current Opinion in Organ Transplantation
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The changing population of heart transplantation patients has become older and sicker. Immunosuppression strategies should be developed for each patient based on their risk for rejection and their risk for developing important complications of immunosuppressive therapy.
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Quality of recipient-caregiver relationship and psychological distress are correlates of self-care agency after lung transplantation
Clinical Transplantation (subscription required)
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Self-care behaviors are crucial for following the complex regimen after lung transplantation, yet little is known about recipients' levels of self-care agency (the capability and willingness to engage in self-care behaviors) and its correlates. Researchers examined levels of self-care agency and recipient characteristics (socio-demographics, psychological distress, quality of relationship with primary lay caregiver and health locus of control) in 111 recipients. Recipients with poorer caregiver relationships and greater psychological distress may need additional support to perform the self-care behaviors expected after lung transplantation.
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Patterns of de novo allo b cells and antibody formation in chronic cardiac allograft rejection after alemtuzumab treatment
American Journal of Transplantation (subscription required)
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Even though the etiology of chronic rejection (CR) is multifactorial, donor specific antibody (DSA) is considered to have a causal effect on CR development. Currently the antibody-mediated mechanisms during CR are poorly understood due to lack of proper animal models and tools. In a recent study, effects of T cell depletion in the development of antibody-mediated rejection were examined using human CD52 transgenic (CD52Tg) mice treated with alemtuzumab.
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Researchers harness the immune system to improve stem cell transplant outcomes
Science Codex
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A novel therapy in the early stages of development at Virginia Commonwealth University Massey Cancer Center shows promise in providing lasting protection against the progression of multiple myeloma following a stem cell transplant by making the cancer cells easier targets for the immune system.
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