Transplantation Direct October 2021 Issue

JUST RELEASED - TRANSPLANTATION DIRECT - OCTOBER ISSUE

The October issue of Transplantation Direct is our largest issue to date, with over 25 articles offered this month. Among the many highlights of this issue is the publication of practical clinical guidelines on dealing with COVID in transplantation. We have three interesting and instructive case reports. There are several articles in heart, lung, liver and kidney transplantation that will capture your interest, including a variety of clinical issues, organ donation, organ allocation policies, patient education, financial aspects of organ transplantation and use of machine learning for optimal allograft utilization. Biliary complications in liver transplantation are of ever-increasing interest, and this is addressed in the current issue. Another hot issue covered in different articles is optimizing the use of machine perfusion methods in organ transplantation. There is also a strong representation of studies in pediatric transplantation. This is an exciting issue that offers articles across a broad spectrum of transplantation - please visit our open access Transplantation Direct website to get all the details.

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IPITA 2021

On behalf of the IPITA Council and all members of the Congress Committees, we look forward to welcoming you online next week!

The Congress will bring to you, in the comfort of your own environment, the latest clinical data and state-of-the-art advances in islet and pancreas transplant, and stem cell and regenerative medicine. Besides great scientific presentations and discussions, there will be numerous opportunities to network and engage with colleagues from all over the world.

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James Markmann, United States

IPITA President

Jon Odorico, United States

Chair, Scientific Program Committee

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Hot Off The Press

«HOT OFF THE PRESS»
RECENT PUBLICATIONS IDENTIFIED
BY TTS EDUCATION COMMITTEE ON COVID-19

Articles this week reviewed by Dr. Enver Akalin

Waning Immune Humoral Response to BNT162b2 Covid-19 Vaccine over 6 Months

Einav G. Levin et al.
New England J Med, October 6, 2021, DOI: 10.1056/NEJMoa2114583 PMID: 34614326

Despite high vaccine coverage and effectiveness, the incidence of symptomatic infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been increasing in Israel. Whether the increasing incidence of infection is due to waning immunity after the receipt of two doses of the BNT162b2 vaccine is unclear.

The study conducted a 6-month longitudinal prospective study involving 4868 vaccinated health care workers in Israel who were tested monthly for the presence of anti-spike IgG and neutralizing antibodies. The level of IgG antibodies decreased at a consistent rate, whereas the neutralizing antibody level decreased rapidly for the first 3 months with a relatively slow decrease thereafter. Although IgG antibody levels were highly correlated with neutralizing antibody titers (Spearman’s rank correlation between 0.68 and 0.75), the regression relationship between the IgG and neutralizing antibody levels depended on the time since receipt of the second vaccine dose. Six months after receipt of the second dose, neutralizing antibody titers were substantially lower among men than among women (ratio of means, 0.64; 95% confidence interval [CI], 0.55 to 0.75), lower among persons 65 years of age or older than among those 18 to less than 45 years of age (ratio of means, 0.58; 95% CI, 0.48 to 0.70), and lower among participants with immunosuppression than among those without immunosuppression (ratio of means, 0.30; 95% CI, 0.20 to 0.46).

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COVID-19-Associated Mortality among Kidney Transplant Recipients and Candidates in the United States

Sumit Mohan et al.
Clin J Am Soc Nephrol. 2021 Sep 29: doi: 10.2215/CJN.02690221. PMID: 34588178

The COVID-19 pandemic has had a profound impact on transplantation activity in the United States and globally. Several single center reports suggest higher morbidity and mortality among candidates waitlisted for a kidney transplant as well as recipients of a kidney transplant. We aim to describe 2020 mortality patterns during the COVID-19 pandemic in the United States among kidney transplant candidates and recipients.

Using national registry data for waitlisted candidates and kidney transplant recipients collected through April 23, 2021, 11% of deaths were attributed to COVID-19 among waitlisted patient deaths in 2020, and these candidates were more likely to be male, obese, and belong to a racial/ethnic minority group. Nearly 1 in 6 deaths (16%) among active transplant recipients in the United States in 2020 was attributed to COVID-19. Recipients who died of COVID-19 were younger, more likely to be obese, had lower educational attainment, and were more likely to belong to racial/ethnic minority groups than those who died of other causes in 2020 or 2019. The study found higher overall mortality in 2020 among waitlisted candidates (24%) than among kidney transplant recipients (20%) compared to 2019.

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