Just Released - Transplantation - December Issue

This December issue of Transplantation contains informative reviews on the topics of PTLD and TMA after transplantation, pros and cons of the new US liver allocation system are discussed. In basic science, an immune atlas of T helper cells in rejection is presented, the role of exosomes in neuroinflammation is explored and mechanisms of ABO-antibody generation are dissected. Optimal surgical techniques for donor hepatectomy are presented, other studies look at the relevance of fibrosis in peadiatric liver transplantation and uses of CT for liver function monitoring. Data is presented for risk stratification of BOS. Further clinical science studies analyze fitness after heart transplant, factors associated with early and late ABMR in Ktx, cancer mortality in SOT as well as trends in referral for Ktx

Table of Contents

Around the World

Cardiac Transplantation on the Canary Islands, A European Ultraperipheral Region: Organization, Optimized Utilization of Local Donors, and Early Transplant Outcomes

Research Highlights

Research Highlights

Game Changer

Heart Transplantation From DCD Donors Enters the Mainstream

People in Transplantation

Sanjay Nagral, MB, BS, MS and Thomas F. Mueller, MD, PhD

Commentaries

Reviews

Original Basic Science

Original Clinical Science—Liver

Original Clinical Science—General

Letter to the Editor

Letter to the Editor: Immunogenicity After the Third Dose of COVID-19 Vaccine in Cardiac Transplantation

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TTS 2024 - Abstract Submission Opens December 8!

Submitting an abstract to the TTS 2024 Congress offers a platform to showcase groundbreaking research, connect with global experts, and contribute to advancements in transplantation medicine, fostering collaboration and influencing the field's future direction. Stay tuned for the official launch in next week's Tribune Pulse.

Visit Congress Website

Santander Transplant Summit - Santander Statement

In follow-up to the last two editions of the Pulse, TTS is pleased to present the Santander Statement. We encourage all to review and share with stakeholders, as TTS continues its leadership in the development and pursuit of ethics and excellence in organ donation and transplantation around the world.

On 9 and 10 November 2023, the Organización Nacional de Trasplantes (ONT), under the Spanish Presidency of the Council of the European Union, convened in Santander a Global Summit entitled “Towards Global Convergence in Transplantation: Sufficiency, Transparency and Oversight”. The Summit was coorganised by the European Directorate for the Quality of Medicines and Healthcare (EDQM) of the Council of Europe, the European Society for Organ Transplantation (ESOT), and The Transplantation Society (TTS). The Summit was co-sponsored by the World Health Organization (WHO) and supported by the International Society of Nephrology (ISN).

The Summit’s objective was to pave the way for global action in transplantation for the next decade. In particular, the Summit aimed to critically review the current state of donation and transplantation of organs, tissues, and cells, identify key challenges, and shape the future direction of transplant activities worldwide to ensure that advances in this field benefit citizens across the globe.

The Summit, attended by 183 participants from 57 countries, international organisations and professional associations, concluded with the following set of recommendations targeted to national and regional governments, though acknowledging the role of other key stakeholders, including health authorities, relevant professional associations, healthcare professionals and institutions, law enforcement agencies, academic and research institutions, and civil society organisations. The Summit also called upon international organisations, in particular the European Union, the Council of Europe, and the WHO, to provide guidance and support States in taking effective measures to implement these recommendations to ensure that no one is left behind.

Recommendations

Participants in the Global Convergence in Transplantation Summit urge governments to:

1. Improve Patient Care by...

implementing preventive strategies to reduce the burden of diseases that give rise to the need for transplantation;
integrating donation and transplantation of organs, tissues, and cells into their healthcare systems, taking into account the resources available to address the population’s health needs;
prioritising transplant therapy when that is the most cost-beneficial treatment modality for patients;
incorporating opportunities for donation of organs, tissues and cells into end-of-life care; working towards a unified concept of death, recognising that death can be defined as the permanent cessation of brain functions;
supporting low-resource countries in developing and strengthening their transplant systems;
making donation and transplant programs resilient by establishing emergency preparedness plans designed to ensure a timely and effective response to transplant needs in the event of crisis;
identifying and relieving inequities in access to donation and transplantation and to Substances of Human Origin (SoHO)-based therapies.

2. Make Progress towards sufficiency in transplantation by...

developing and expanding deceased donation to its maximum therapeutic potential, including donation after both the neurological and the circulatory determination of death;
developing living donation programs, preferably as supplements to deceased donation, that ensure informed consent, optimal care of, and long-term follow-up for donors;
removing financial disincentives for living and deceased donation, while prohibiting financial incentives, in order to ensure that donation is a financially neutral act.

3. Ensure transparency and oversight of practices by...

designating health authorities at the national or regional level that are responsible for the authorisation and monitoring of donation and transplant activities;
mandating the reporting of data on every donation and transplant procedure, as well as demographic, clinical, and outcome data of recipients and living donors to a registry established or recognized by the relevant health authority;
establishing a biovigilance system and ensuring the traceability of organs, tissues, and cells from donors to recipients and vice versa;
supporting data sharing, including by health authorities with relevant international bodies and registries, with due regard for the protection of patients’ and donors’ privacy.

4. Strengthen the prevention of human trafficking for the removal of SoHO and trafficking in SoHO by...

ensuring appropriate psychosocial evaluation of all prospective living donors;
establishing a mechanism for the mandatory reporting of suspected or confirmed cases of trafficking, while respecting professional obligations towards patients and maintaining a human rights-based approach focusing on early identification and appropriate protection of victims;
criminalising and prosecuting all illicit transplant-related activities within their jurisdiction, including by establishing extraterritorial jurisdiction over such activities of their residents in other countries;
strengthening national and international cooperation in combatting transplant-related crimes.

5. Foster responsible innovation for the clinical use of SoHO by...

actively supporting and funding efforts to overcome the research and economic challenges in developing sustainable innovation;
mandating the demonstration of quality, safety, and effectiveness of SoHO-based therapies before permitting them to be incorporated into healthcare systems;
reinforcing the capacity of donation and transplant systems to oversee ethical conduct and clinical translation of research;
ensuring that human organs, tissues and cells do not become marketable products and that necessary fees for services relating to SoHO and benefits from SoHO-derived products are proportionate and consistent with the altruistic nature of donation;
ensuring transparency in costs, pricing, and profits from all SoHO-based therapies, and making such therapies affordable to patients;
promoting social responsibility in public-private collaboration in the development of SoHO-based therapies.

CLICK HERE TO VIEW THE SUMMIT AGENDA WITH LINKS TO PRESENTATION MATERIALS

TTS leaders contribute to Brain Death and Circulatory Death Symposium in Middle East

Pictured: Marcelo Cantarovich (Immediate Past President), Mehmet Haberal (Past President), Jeremy Chapman (Transplantation - Editor-in-Chief and Past President), John Fung (President-Elect)

With the goal of increasing deceased donation (in the Middle East, this week TTS leaders were among the international faculty present at the MESOT Brain Death and Circulatory Death conference in Ankara, Turkey. Over 150 delegates interacted on practices and perspectives from around the globe in an effort to advance deceased donation practices worldwide.

Antibody Mediated Rejection (AMR) Management: Multi-Disciplinary Team (MDT) Conference survey

The care of transplant patients is complex, requiring a collaborative and multi-disciplinary effort to address medical, behavioral, and psychosocial needs.

Despite evidence supporting the benefit of a multidisciplinary approach, very little is known regarding the actual proportion of transplant centers practicing regular, comprehensive, multidisciplinary transplant conferences.

To better understand current practice and the perceived value of multidisciplinary perspectives in the diagnosis and management of transplant patients at risk for immune-mediated injury, transplant professionals worldwide are invited to participate in a brief <10 minute survey.

Click to Access Survey

Upcoming TTS-ISN Webinar Presentation

click here for details and to register

News Spotlight

Can Bioprinted Skin Substitutes Replace Traditional Grafts for Treating Burn Injuries and Other Serious Skin Wounds?

An NIH-funded team recently showed that bioprinted skin substitutes may serve as a promising alternative to traditional skin grafts in preclinical studies reported in Science Translational Medicine.2 The approach involves a portable skin bioprinter system that deposits multiple layers of skin directly into a wound. The recent findings add to evidence that bioprinting technology can successfully regenerate human-like skin to allow healing. This latest work comes from a team led by Adam Jorgensen and Anthony Atala at Wake Forest School of Medicine’s Wake Forest Institute for Regenerative Medicine, Winston-Salem, NC.

Read the Article

Scientists create ‘cloaked’ donor cell and tissue grafts that escape rejection by the immune system

In a preclinical breakthrough that could transform cell therapies for incurable diseases, researchers at Sinai Health and the University of Toronto have developed a technology that provides promise as one avenue to one day eliminate the need for immunosuppressive drugs in transplant patients.

Read the Article

Transplantation Journal Highlights

Transplantation - Highlighted Tweets

Prognostic Value of Chest CT Findings at BOS Diagnosis in Lung Transplant Recipients

Bronchiolitis obliterans syndrome (BOS) after lung transplantation is characterized by fibrotic small airway remodeling, recognizable on high-resolution computed tomography (HRCT). We studied the prognostic value of key HRCT features at BOS diagnosis after lung transplantation.

Bioimpedance Spectroscopy in Heart Transplantation: Posttransplant Changes in Body Composition and Effects in Outcomes

Bioimpedance spectroscopy yields measurements of fat-free mass, fat mass, phase angle, and other measures. Bioimpedance spectroscopy has been validated as a preoperative assessment tool in cardiac surgical studies, in which low phase angle predicted morbidity and mortality. No studies have evaluated bioimpedance spectroscopy following heart transplantation.

Transplantation Direct - Highlighted Tweets

Assessing Kidney Transplantation Using ECMO-Supported Donors Within a KDPI-Based Allocation System

Organ donors supported by extracorporeal membrane oxygenation (ECMO) have historically been considered high-risk and are judiciously utilized. This study examines transplant outcomes using renal allografts from donors supported on ECMO for nondonation purposes.

Tough Nut to Crack: Transplant-acquired Food Allergy in an Adult Liver Recipient

Transplant-acquired food allergy (TAFA) is the phenomenon in which a de novo food allergy presents after transplantation. Although more widely reported in pediatric literature, liver TAFA remains rare in adults, with only 7 prior reported cases. The underlying pathophysiologic mechanisms, risk factors, and long-term outcomes of liver TAFA in adults are not well understood. We present a case of TAFA in a patient with no prior allergic history who received a graft from a young donor who died from a reported asthma attack.

TTS Call for Nominations

We are now accepting nominations for three (3) Officer positions and nine (9) Councilors-at-large positions representing the Regions.

Click here to see full details

TTS Seeking a New Editor-in-Chief for Transplantation and Transplantation Direct

Jeremy Chapman

Editor-in-Chief
Transplantation Journals

Professor Jeremy R. Chapman, a dedicated leader at the helm of Transplantation and Transplantation Direct, has announced his intention to retire from the role of Editor-in-Chief of The Transplantation Society’s journals at the close of 2024.