Transplantation August 2022 Issue


The COVID-19 pandemic has, for many, settled into a stable routine, but for transplant recipients this is far from over. In this issue is a wonderful review of therapeutic options for transplant patients, together with more information on vaccine ineffectiveness - this time from a large single center study. Leaving COVID aside you will also find news on patients preferences in islet transplantation and results of an international survey of islet monitoring strategies. A thoughtful and timely piece on research on donors and a great overview of the science of eosinophils will catch your attention. Overviews on clinical trial endpoints and on the impact of donor recipient genetics on transplant outcome also provide current perspectives. Living liver transplantation and the many variations that perfusion preservation can bring are amongst the myriad of subjects this month.



Stefan Tullius Elected TTS Vice President (2022-2026)

We would like to congratulate Stefan Tullius on winning the TTS by-election for the position of Vice President. Stefan will be a great addition to our council bringing his vast experince in basic, clinical and translational science and medicine to go along along with his current duties as one of the Executive Editors of Transplantation.

This by-election was held due to the current Vice President (John Fung) being elected as the incoming TTS President-Elect.

Read his biographical sketch
Stefan G. Tullius, MD, PhD, FACS, is the Joseph E. Murray, MD Distinguished Chair in Transplant Surgery, Professor of Surgery, Harvard Medical School. He has roots in both Europe and the USA, and collaborations around the world. After training in Berlin, he was appointed Chief of Transplant Surgery and Director of the Transplant Surgery Research Lab at Brigham & Women’s Hospital, Boston, in 2005. Dr. Tullius has served as Councilor and Treasurer for TTS and has been on the Boards of ESOT and UNOS. He is currently a Board member of the National Kidney Registry and Vice President of the Int’l Society of Uterus Transplantation, now a section of TTS. He is an Executive Editor, Transplantation, a position he has held since 2014. He is also an Associate Editor of Transplant International (since 2004), the Korean Journal of Transplantation, and has been an Associate Editor for AJT. In addition to being an active transplant surgeon, Dr. Tullius runs a prolific NIHfunded laboratory. His international collaborations include institutions in China, India, Argentina, Japan and Germany. Dr. Tullius is proud of his many clinical and research mentees who have moved on with their own successful clinical and research careers. His own work has been recognized with several awards including the Clinical Science Investigator Award of the AST, Excellence in Transplantation Award by the National Kidney Foundation, and the Outstanding Ach ievement Award by TTS. Dr. Tullius looks forward to serving TTS advancing the society’s international clinical, scientific, and ethical mission.

Transplantation Updates

Transplantation - Highlighted Article

Shifting Clinical Trial Endpoints in Kidney Transplantation: The Rise of Composite Endpoints and Machine Learning to Refine Prognostication

Anwar, Imran J.; Srinivas, Titte R.; Gao, Qimeng; Knechtle, Stuart J.
In featuring this article we would like to take this opportunity to remind our community of the role TTS plays within the Transplantation Therapeutics Consortium (TTC):
Since 2017 TTS has been participating in the Transplantation Therapeutics Consortium (TTC), a program of the Critical Path Institute ( ).
Read More
TTC is a public-private collaboration between the transplant community, including industry, academia, professional societies, and regulatory agencies. TTC’s mission is to accelerate the pace of medical product development for transplant recipients with a focus on obtaining regulatory agency endorsement of new medical products. TTS members, Roslyn Mannon and Randy Morris have been representing TTS in this forum. TTC’s initial work has been on endorsing the iBox Scoring System (Composite Biomarker Panel) for acceptance by the US Food and Drug Administration (FDA )and the European Medicines Agency (EMA) as a surrogate endpoint to accelerate the pace of drug development in the field of kidney transplantation.

Transplantation - In The News

Kidney Transplants From Donors With Vaccine-Induced ITP and Thrombosis

July 18 - Researchers assessed the UK experience of kidney transplantations from deceased donors who had vaccine-induced immune thrombocytopenia and thrombosis (VITT), given the theoretical risk of transmission “via passenger leukocytes within the allograft.” Their report, published in Transplantation, found that favorable transplantation outcomes were possible with kidney donors with VITT.

Transplantation Direct - Week's Most Downloaded Paper

Liver Outcome in Renal Transplant Recipients Who Acquired Hepatitis C Infection From an Infected Graft: Study Based on Liver Biopsy Findings

Long-term liver outcome in hepatitis C virus (HCV)-negative kidney recipients who acquired HCV infection from viremic donors is of intense interest in the transplant community. We evaluated the incidence of fibrosis in liver biopsy specimens of recipients who were transplanted with HCV-infected grafts.


The detailed program, faculty and abstracts are now available online!

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Hotel reservations are available here - Book early as space is limited!

Plenary Spotlight

Sessions Spotlight

Hot Off the Press


Editor: Enver Akalin
TTS Educational Committee started weekly Hot Off the Press in April 2020 after COVID-19 pandemic to review important articles related to COVID-19 and transplantation. The aim was to inform the TTS members important publications as early as possible and this initiate has received good feedback. We plan to continue New Hot Off The Press to cover various other topics on a weekly basis and pick up the important manuscripts published in high impact journals.
Translational Science
Compiled by Enver Akalin

Pretransplant kidney transcriptome captures intrinsic donor organ quality and predicts 24-month outcomes

Archer KJ, et al.
Am J Transplant. 2022 Jun 22. doi: 10.1111/ajt.17127
PMID: 35730259
This study investigated the utility of pretransplant gene expression profiles of preimplantation transplant kidney biopsies by microarrays in predicting 24-month graft outcomes in 270 deceased-donor transplants. Grafts that progressed to low function at 24 months exhibited upregulated immune responses and downregulated metabolic processes at pretransplantation. Using penalized logistic regression modeling, a 55 gene model area under the receiver operating curve (AUROC) for 24-month graft function was 0.994. Gene expression for a subset of candidate genes was then measured in an independent set of pretransplant biopsies (n = 96) using quantitative polymerase chain reaction. The AUROC when using 13 genes with three donor characteristics (age, race, body mass index) was 0.821. Subsequently, a risk score was calculated using this combination for each patient in the validation cohort, demonstrating the translational feasibility of using gene markers as prognostic tools. These findings support the potential of pretransplant transcriptomic biomarkers as novel instruments for improving posttransplant outcome predictions and associated management.
Translational Science
Compiled by Enver Akalin

The phenotype of HLA-binding B cells from sensitized kidney transplant recipients correlates with clinically prognostic patterns of interferon-γ production against purified HLA proteins

Burton H et al.
Kidney Int.2022 Aug;102(2):355-369. doi: 10.1016/j.kint.2022.02.041
PMID: 35483526
This study reported the specific phenotype of HLA-binding B cells and define how they associated with patterns of anti-HLA response in interferon-gamma ELISpot.The results demonstrated that these antigen-specific B cells are found at a greater frequency in sensitized kidney transplant recipients when compared with healthy volunteers and using an indirect antigen-specific enzyme-linked immunosorbent spot assay, they uncover the complexity of B- and T-cell interactions and the influence of regulatory T cells on such interactions in vitro. HLA-binding class-switched and IgM+CD27+ memory cells associated strongly with B-dependent interferon-γ production and appeared not suppressible by endogenous Tregs. High numbers of non-HLA-binding transitional cells associated with B-suppressed interferon-γ production, especially if Tregs were present. However, high frequencies of HLA-binding marginal-zone precursors associated with B-dependent interferon-γ production that appeared suppressible by Tregs. Finally, non-HLA-binding marginal zone precursors may also suppress interferon-γ production, though this association only emerged when Tregs were absent from the ELISpot.
Compiled by Hatem Amer

Impact of different urinary tract infection phenotypes within the first-year post-transplant on renal allograft outcomes

Jakob E. Brune et. al.
Am J Transplant.2022 Jul;22(7):1823-1833. doi: 10.1111/ajt.17026.
PMID: 35286781
Using the Swiss Transplant Cohort Study (STCS) the authors defined and studied four phenotypes of urinary tract infection (UTI) occurring in 2368 adult solitary kidney transplant recipients within the first-year post-transplant and their association with short- and long-term outcomes. The patients were from all 6 Swiss transplant centers followed by similar protocols, for the most part. The four defined phenotypes were: A) no urinary tract colonization nor UTI [59%], B) Colonization (>10^5 CFU mL bacteria or fungi) without signs of symptoms of infection [15%], C) Occasional ≤2 UTI (B but with signs and or symptoms) [19%], D) Recurrent ≥3 UTI events within the first year [7%]. As expected, females were more likely to have colonization and UTI within the first year. There was no sex difference in risk of urosepsis suggesting that males may be at higher risk for progression to urosepsis when they have a UTI. E. Coli, Enterococcus species and Klebsiella species accounted for 85% or UTI cases. Enterococcus species and Coagulase negative staphylococci were more commonly identified in colonized individuals. Colonization and Occasional UTIs showed no association with graft function. Recurrent UTIs associated with lower eGFR at one year post transplant as well as lower death censored graft function long-term.

Women in Transplantation & Asian Society of Transplantation - Fellowship Grant

Women in Transplantation is delighted to announce that they will co-sponsor a research fellowship grant with the Asian Society of Transplantation.

The Asian Society of Transplantation will fund a research project that contributes to our understanding of the impact of sex and/or gender in transplantation using “Asian Society Transplant Registry-Women in transplantation-kidney transplantation (ASTREG-WIT-KT) data.”

ASTREG-WIT-KT is an online registry for data collection and analysis of gender disparity across Asia-Pacific countries. It was borne out of WIT's Pillar 2, which focuses on sex and gender research as it related to solid organ transplantation.

Any epidemiologic, clinical studies using this data will be considered for this grant.

Upcoming Webinar: TTS-Women in Nephrology - India

TTS Needs Assessment Survey

The slogan we adopted for the TTS 2022 Congress is "Committed to Access and Transparency" and as a lead-up to the Congress we have launched a new needs assessment survey which will aid TTS in developing new programs, educational material and strategies to better improve access and transparency in the field of transplantation. As a non-governmental organization in official relations with the World Health Organization (WHO) the information collected will feed into the work TTS is doing as part of our WHO collaboration.

Your support, by completing this survey, will contribute to the success of this initiative. Your answers will be kept confidential and anonymous.

The survey will take 6+ minutes and must be done from a computer or tablet.

In the News 



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