TID 2022 Virtual - 14th International Transplant Disease Conference

Open to all Transplant Professionals!


Compiled by: Enver Akalin and Jeremy Chapman
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.

Can We Use Eplets (or Molecular) Mismatch Load Analysis to Improve Organ Allocation? The Hope and the Hype

Tambur AR and Das R.
Transplantation. 2022 Sep 27. doi: 10.1097/TP.0000000000004307. PMID: 36163639
This review article discusses the use of epitope matching (later changed to eplet matching) in deceased-donor allocation, pre and posttransplant immunological risk stratification. The article provides a critical review of HLAMatchmaker software. This review highlights the multiple reasons why molecular mismatch load (MML) analysis is not suitable to guide organ allocation algorithms. Although MML is likely to support risk stratification posttransplantation, the authors strongly recommend combining its implementation only as part of a holistic, 1-y posttransplant patient evaluation before changes in immunosuppression management decisions.

Recipient and Graft Outcomes in Simultaneous Kidney and Pancreas Transplantation With Steroid Avoidance in the United States

Cerise A et al.
Transplantation. 2022 Sep 30. doi: 10.1097/TP.0000000000004295. PMID: 36195029
This study reviewed SRTR data of simultaneous pancreas-kidney recipients (n=5683) between 2000-2020, who received antithymocyte globulin induction and were discharged alive with functioning grafts on tacrolimus and mycophenolate ± steroid maintenance. Recipients were grouped according to steroid use into 2 groups: steroid maintenance (n = 4191) and steroid avoidance (n = 1492). One-year acute rejection rates by steroid avoidance were comparable for kidney (8.6% versus 9%, P = 0.783); however, the pancreas rejection rate was lower in the steroid avoidance group (7.9% versus 10%; P = 0.035). After adjustment, steroid avoidance did not influence recipient survival (lower level of confidence interval, adjusted hazard ratio, upper level of confidence interval: 0.94, 1.15, 1.39), pancreas (0.75, 0.93, 1.16), or kidney (0.95, 1.18, 1.45) death-censored survival, compared with steroid maintenance.

Antibody-mediated Rejection Without Detectable Donor-specific Antibody Releases Donor-derived Cell-free DNA: Results From the Trifecta Study

Halloran PF et al. for Trifecta Investigators
Transplantation. 2022 Oct 3. doi: 10.1097/TP.0000000000004324. PMID: 36190186
This is a is a prospective trial investigating relationships between donor-derived cell-free DNA (dd-cfDNA), donor-specific antibody (DSA), and molecular findings in kidney transplant biopsies. Interestingly, DSA was frequently negative in both molecular (56%) and histologic (51%) AMR. DSA-negative antibody-mediated rejection (AMR) had slightly less molecular AMR activity and histologic peritubular capillaritis than DSA-positive AMR. However, all AMRs-DSA-positive or -negative-showed elevated %dd-cfDNA. In AMR, %dd-cfDNA ≥1.0 was more frequent (75%) than DSA positivity (44%). In logistic regression, dd-cfDNA percent (area under the curve [AUC] 0.85) or quantity (AUC 0.86) predicted molecular AMR better than DSA (AUC 0.66). However, the best predictions incorporated both dd-cfDNA and DSA, plus time posttransplant (AUC 0.88).

C-Path - Transplant Therapeutics Consortium (TTC) Press Release

C-Path’s Transplant Therapeutics Consortium Receives
EMA Draft Qualification Opinion for iBox Scoring System

The draft EMA qualification opinion is available for public consultation until November 17, 2022.
Secondary endpoint prognostic for allograft loss to catalyze development of novel therapies intended to improve long-term outcomes for kidney transplant recipients.
TUCSON, Ariz., Oct. 13, 2022Critical Path Institute (C-Path) announced today that its Transplant Therapeutics Consortium (TTC) received a draft qualification opinion for the iBox Scoring System as a novel secondary efficacy endpoint for kidney transplant trials. This was achieved through the European Medicines Agency’s (EMA) qualification of novel methodologies for drug development. After the draft qualification opinion undergoes the public consultation stage through Nov. 17, 2022, the iBox Scoring System will represent the first qualified endpoint for any transplant indication. This novel secondary endpoint supports the evaluation of novel immunosuppressive therapy (IST) applications with EMA.

About TTS and the Transplantation Therapeutics Consortium (TTC)

Since 2017 TTS has been participating in the Transplantation Therapeutics Consortium (TTC), a program of the Critical Path Institute (https://c-path.org/programs/ttc/).

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 Updates

Transplantation - Week's Most Downloaded Paper

Glycocalyx Damage Within Human Liver Grafts Correlates With Graft Injury and Postoperative Graft Function After Orthotopic Liver Transplantation

Destruction of the endothelial glycocalyx has been observed within lung and kidney grafts during ischemic organ preservation. We aimed to quantify glycocalyx damage within human liver grafts after organ preservation and correlate the results with graft injury and postoperative graft function in patients undergoing orthotopic liver transplantation (OLT).

Transplantation Direct - Highlighted Tweet

Challenges in the Management of Kidney Allograft Herniation With a Single-stage Pedicled Anterolateral Thigh Flap

Wound complications are the most common surgical complication after kidney allograft transplantation. Total wound rupture exposing the entire kidney is a rare and not well-described event. We present a successful treatment of this complication in a patient admitted to our unit. A single-stage procedure was performed combining debridement and reconstruction with a pedicled anterolateral thigh flap and an iliotibial band transferring. A short literature review is performed comparing the different treatment strategies and results.

Recent Quick Clip Interview

TTS 2022 - Virtual Post Congress Symposium Recording

TTS-ILTS Paired Transplant Centers Program - Apply Today!

Program Schedule

Deadline to Apply: January 1, 2023
Program Start Date: April 1, 2023

An experienced supporting transplant center (SC) in the developed world is paired with an emerging transplant center (EC) to facilitate vital multidisciplinary training and an exchange of knowledge and expertise.
The project aims to benefit both centers. The SC is involvedin global health, and promotes ethical and competent transplantation in regions of the world with limited or no current access to transplantation. The EC connects with a multidisciplinary team of experts in transplantation from a world-leading center.
The ultimate goal is for Level 3 centers to graduate and become true local centers of excellence for regional training and support.
The TTS-ILTS Paired Transplant Centers Program is bound by a limited budget which it cannot exceed. This budget is divided over all center pairs who receive a different financial allocation dependent on their level within the program.
  • Level 1 - maximum annual allocation per pair: $ 3,500 USD
  • Level 2 - maximum annual allocation per pair: $12,000 USD
  • Level 3 - maximum annual allocation per pair: $15,000 USD
Programs Launched in April 2022
Dow Universtiy Hospital, Karachi, Pakistan paired with the University of Chicago, Chicago, USA

TTS and ILTS congratulates these teams and wishes them every success in their collaborations over the next six years and beyond.

TTS-RMEI Partnership CME Activity

This activity is intended for clinicians practicing in transplantation, infectious disease, and nephrology.

This activity is meant to improve clinician’s identification of resistant/refractory cytomegalovirus (CMV) and update them on newly approved treatment strategies for resistant/refractory CMV in solid organ transplant (SOT) patients.


CMV is one of the most common opportunistic infections affecting solid organ transplant recipients (SOTRs), conveying higher risks of complications, graft loss, morbidity, and mortality. Treatment options for CMV are limited, have similar mechanisms of action, suffer from cross-resistance, and have serious toxicities. Until recently, no treatment option was available in the resistant/refractory setting. This workshop, developed in collaboration with The Transplantation Society (TTS) and Dr. Camille Kotton, MD, FIDSA, FAST, will take you through a CMV primer and then move on to discuss cases submitted by your peers from transplant centers across the United States.

Upon completion of this activity, participants should be better able to:
  • Employ evidence-based antiviral treatment strategies for cytomegalovirus (CMV) in solid organ transplant (SOT) patients
  • Utilize antiviral resistance testing to identify SOT patients with treatment refractory or drug resistant CMV
  • Implement new treatment strategies in the management of resistant or refractory CMV in SOT patients


Physicians - maximum of 0.75 AMA PRA Category 1 Credit(s)™

Nurses - 0.75 ANCC Contact Hour(s) (0 contact hours are in the area of pharmacology)

Pharmacists - 0.75 Knowledge-based ACPE (0.075 CEUs)
  • CME / CE Released: 9/15/2022 Valid for credit through: 9/14/2023


TTS Needs Assessment Survey - last chance to submit!

This survey focuses on issues encountered by physicians in day-to-day decision-making.

Your responses will aid TTS in developing strategies, programs and resources to improve access and transparency in transplantation, emphasizing increasing deceased donor organ transplantation.

The information collected will also aid the work TTS is doing as part of our World Health Organization collaboration.

All responses will be kept confidential and anonymous.

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

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The Transplantation Society
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