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AST educational document on liver redistricting
AST applauds the efforts of UNOS to explore ways of increasing equity in access to transplantation by examining the issue of liver redistricting. In response to these efforts, AST has created a workgroup to closely follow the work of the UNOS liver committee. This workgroup has produced a document that summarizes the issues and outlines key considerations, so that you can better understand the implications of any proposal that might be put forth. Click here to read more.
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Watch webinars online, anytime
AST has a variety of recorded webinars available for viewing online 24/7. The most recent archived webinars include WTC 2014 highlights, Kidney Allocation System changes, and vaccine updates; all are available at

Visit to choose from more than 30 webinars on topics ranging from Hepatitis C management to living donor advocacy to infectious disease guidelines.

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COP contribution contest
The AST Board presents a COP Contribution Contest to all AST members who participate in one or more Communities of Practice. The board will award a prize to the COP with the highest percentage of contributing members during this time: $2,000 towards a COP initiative in 2015 (must be approved by the AST Board of Directors).

For more details, click here.

To improve our external fundraising efforts, we must first improve our internal philanthropy. We encourage all AST members to donate to the AST before the end of 2014. The amount is not crucial, but achieving high participation rates are of paramount importance:

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You care about your transplant patients. And so do we. That’s why we’re introducing Astellas Cares—a new program that offers you customized tools, educational resources, and comprehensive support to help your patients care for their health. To register, visit today.

Time for a change: The new kidney allocation system
In the latest post on the president’s blog, AST Board Member Dr. Rich Formica discusses the factors that led to the design and implementation of the new kidney allocation system and highlights some of the major changes that the system introduces. Click here to read more.
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Deeply discounted early registration rates end soon
The Cutting Edge of Transplantation
Immunity and Inflammation: Engineering Cell, Gene, and Drug Therapies

Feb. 5-7, 2015
Sheraton Wild Horse Pass – Chandler, Arizona

Time is running out to take advantage of deep discounts on registration for CEOT. Register by November 30 to enjoy heavily discounted rates. These early registration rates are the lowest rates that will be available for this meeting. Make plans to attend this high-energy, intimate meeting where expert clinicians, leading diagnosticians, and world class scientists will address the field’s cutting edge challenges together with an engaged audience.

This year’s CEOT will feature talks on:
  • Tregs: What is the Promise of Cell Therapy Today?
  • Promising New Drugs in Other Fields: Best in Rheumatology, Inflammatory Bowel Disease & Cancer Immunology
  • Adding Value: The Approach to Repurposing Drugs
  • Novel Approaches to Modifying the Genome
  • Genetic Manipulation to "Supercharge" T Cells
  • Novel Therapeutic Strategies for Regenerative Medicine
  • Differentiation of Stem Cells in 3-D
Click here to register for CEOT 2015 and take advantage of early registration discounted rates! Or, learn more about this engaging meeting and view the preliminary program here.

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ABO incompatible renal transplantation without antibody removal using conventional immunosuppression alone
American Journal of Transplantation
ABO incompatible living donor renal transplantation (ABOi) can achieve outcomes comparable to ABO compatible transplantation (ABOc). However, with the exception of blood group A2 kidneys transplanted into recipients with low titer anti-A antibody, regimens generally include antibody removal, intensified immunosuppression and splenectomy or rituximab.
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Antifungal prophylaxis in liver transplantation: A systematic review and network meta-analysis
American Journal of Transplantation
Invasive fungal infections (IFIs) cause significant morbidity and mortality in liver transplant recipients, but the need and best agent for prophylaxis is uncertain. A comprehensive literature search was performed to identify randomized controlled trials comparing regimens for antifungal prophylaxis in liver transplant recipients. Direct comparisons were made between treatments using random-effects meta-analysis and a Bayesian network meta-analysis was performed for the primary end point of proven IFI.
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New pancreas transplant policies take effect
Transplant Pro
As of Oct. 30, 2014, new policies are in place to allocate pancreas and kidney-pancreas transplants. The revisions are intended to increase access to transplantation for more than 3,000 candidates currently listed for these organs and enhance the efficiency of the allocation system. Under the new system, offers of pancreas-alone and simultaneous kidney-pancreas (SPK) transplants will be allocated separately from kidney-only offers.
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OPTN/UNOS Board of Directors approves policies regarding living donor evaluation and consent, donor disease risk assessment
Transplant Pro
The OPTN/UNOS Board of Directors, at its meeting Nov. 12-13, approved policies to ensure thorough and consistent processes are used in the medical evaluation and informed consent process for living organ donors. The policies specifically address living donation for kidney transplantation as well as segmental liver, lung, intestine and/or pancreas transplantation. 
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Evaluating the validity of MELD exception points for HCC patients with multiple nodules <2cm
Clinical Transplantation
Liver transplant allocation policy does not give MELD exception points for patients with a single hepatocellular carcinoma (HCC) less than 2 cm in size, but does give points to patients with multiple small nodules. Because standard-of-care imaging for HCC struggles to differentiate HCC from other nodules, it is possible that a subset of patients receiving liver transplant for multiple nodules <2cm in size do not have HCC. We evaluate risk of post-transplant HCC recurrence and waitlist dropout for patients with multiple small nodules using competing risks regression based on the Fine and Gray model.
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Effect of lanreotide on polycystic liver and kidneys in autosomal dominant polycystic kidney disease: An observational trial
Liver International
Several trials have demonstrated that somatostatin analogues decrease liver volume in mixed populations of patients with autosomal dominant polycystic kidney disease (ADPKD) and isolated polycystic liver disease. Chronic renal dysfunction in ADPKD may affect treatment efficacy of lanreotide and possibly enhances risk for adverse events. The aim of this open-label clinical trial (RESOLVE trial) was to assess efficacy of 6 months lanreotide treatment 120 mg subcutaneously every 4 weeks in ADPKD patients with symptomatic polycystic liver disease.
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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

Missed last week's issue? See which articles your colleagues read most.

    A complete treatment of adult living donor liver transplantation: A review of surgical technique and current challenges to expand indication of patients (American Journal of Transplantation)
Donor-specific antibodies in allograft recipients: Etiology, impact, and therapeutic approaches (Current Opinion in Organ Transplantation)
An interferon-free antiviral regimen for HCV after liver transplantation (The New England Journal of Medicine)
Actual and perceived knowledge of kidney transplantation and the pursuit of a live donor (Transplantation)

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

Effect of dialysis initiation for preemptively listed candidates in the revised kidney allocation policy
American Journal of Transplantation
The new allocation policy for deceased donor kidneys in the United States is expected to begin in late 2014. As part of this policy, prioritization to the highest quality deceased donor kidneys is dependent on candidate's estimated posttransplant survival (EPTS) score. In particular, candidates with low (≤20 percent) EPTS (indicating better estimated survival) will have greater access to donor offers. We evaluated the effect of dialysis initiation on preemptively listed candidates' EPTS score.
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Levofloxacin for BK virus prophylaxis following kidney transplantation
The Journal of the American Medical Association
BK virus infection is a significant complication of modern immunosuppression used in kidney transplantation. Viral reactivation occurs first in the urine (BK viruria) and is associated with a high risk of transplant failure. There are currently no therapies to prevent or treat BK virus infection. Quinolone antibiotics have antiviral properties against BK virus but efficacy at preventing this infection has not been shown in prospective controlled studies.
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An interferon-free antiviral regimen for HCV after liver transplantation
New England Journal of Medicine via PubMed
Hepatitis C virus (HCV) infection is the leading indication for liver transplantation worldwide, and interferon-containing regimens are associated with low response rates owing to treatment-limiting toxic effects in immunosuppressed liver-transplant recipients. We evaluated the interferon-free regimen of the NS5A inhibitor ombitasvir coformulated with the ritonavir-boosted protease inhibitor ABT-450 (ABT-450/r), the nonnucleoside NS5B polymerase inhibitor dasabuvir, and ribavirin in liver-transplant recipients with recurrent HCV genotype 1 infection.
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