The Medawar Prize is widely recognized as the most prestigious award in the field of transplantation. This year's award was supported by Baskent University.
This month Transplantation Direct offers new findings on a variety of topics. In kidney transplantation, a new pharmacodynamics assay meant to adjust tacrolimus levels is tested involving an NFAT-dependent cytokine assay. Two studies involve pediatric kidney transplantation; an interesting analysis of the impact of HLA mismatching is presented, and a European survey on the management of transition from pediatric to adult care is evaluated – including adherence to 2011 ISN/IPNA guidelines. For liver, a valuable base of information is provided regarding the use of different immunosuppressive regimens in the US, and cardiac MRI T2* in liver transplant candidates is evaluated as a supplemental diagnostic tool for predicting posttransplant cardiac complications. In the area of VCA, the frequency of kidney dysfunction related to immunosuppression is evaluated. The issue also contains 2 articles related to organ donation and procurement; a study from Norway presents a protocol for controlled DCD using normothermic regional perfusion, and a Canadian group explores via survey, frontline intensive care unit professionals' and organ donor coordinators' perceptions and beliefs related to key factors in the process of donation after circulatory determination death. In the basic sciences, a study is presented on the potential for the small molecule tyrosine kinase inhibitor Nintedanib to reduce allograft vasculopathy in a murine aortic graft model. We hope that this issue touches some aspect of your interests in the field of transplantation.
Sister Centers Programs link renal and transplant centers in low-and-middle income countries with centers of excellence in the developed world. There are now 65 active Sister Centers partnership and 13 of them are focused on transplantation.
The deadline to apply for the ISN Sister Renal Centers Program and the ISN-TTS Sister Transplant Centers Program is set for October 1st, 2018.
Learn to make your application stand out and register for a special webinar to be broadcast on July 12, 2018 between 2PM and 3PM CEST.
Peter Kerr, Chair of the Sister Renal Centers Program, and Philip J. O'Connell, Past-President of The Transplantation Society and Director of Transplantation, will guide you through each step of the application process. They will share some handy tips on how to prepare a successful application and answer any questions you may have.
Submitted by Dr Peri Kocabayoglu, Editorial Fellow, Transplantation.
Differences in Proinflammatory Cytokines and Monocyte Subtypes in Older as Compared With Younger Kidney Transplant Recipients
Liang EC, Rossetti M, Sidwell T, et al.
Transplant Direct. 2018;4:e348.
The proportion of elderly patients with End Stage Renal Disease has increased dramatically over the last 2 decades. Moreover, elderly kidney transplant recipients do not only have higher rates, but also an increased risk of death due to infection. On the other hand, older transplant recipients are less likely of experiencing acute rejections. However, if developing rejections, elderly transplant recipients are less likely to respond favorably to treatment. Overall, immune dysfunctions are critically important in these elderly kidney transplant recipients. Among other immune deficiencies, decreased NK cell cytokine production and cytotoxicity, in addition to impaired phagocytosis and reactive oxygen species production by monocytes/macrophages have been noted. Other aspects of age-related immune dysfunctions include decreased TLR4 expression on Dendritic and other innate immune cells.
Here, Liang and coworkers address aspects of age-associated differences in plasma cytokine levels and monocyte subtypes of 60 kidney transplant recipients. By 3 months after transplantation, innate immune phenotypes were evaluated in 22 patients ≥ 60 years, and 38 patients < 60 years. Older patients displayed significantly decreased frequencies of intermediate monocytes (CD14++CD16+) (1.2% vs. 3.3%, p=0.007), and increased levels of proinflammatory classical monocytes (CD14++CD16-). Moreover, levels of IFN-γ were increased in recipients older than 60 years.
Age-dependent differences in monocyte subtypes may represent a mechanism explaining the compromised response to infections in the elderly. Moreover, augmented levels of proinflammatory cytokines may explain the persistence of nonspecific inflammation in the presence of immunosuppression.
Results of this pilot study will need to be confirmed in larger cohorts to fully address the scope of inflammatory cytokine changes and monocyte subtype levels and their impact on transplant outcome in elderly transplant recipients.
July 5 - Spurred into action by the death of a 12-year-old girl awaiting a heart transplant, Argentina is about to make everyone an organ donor. The lower house of Congress unanimously passed a bill late Wednesday that makes all citizens in the nation of 44 million donors unless they explicitly express otherwise. Only 287 citizens had elected to donate their organs this year, according to government statistics.
June 26 - The increasing demand for organ transplantation has led many researchers to look for innovative ways to replace the need for human donors. Research in organoids, which are stem cell derived miniature mimics of organs typically grown in a dish, has significantly improved our understanding of organ development and structural organization.
July 6 - Researchers have for the first time succeeded in converting human skin cells into pluripotent stem cells by activating the cell's own genes.
July 10 - As virtual reality (VR) software becomes more sophisticated, users are able to interact with the environment through multiple senses. Our brains and bodies begin to experience the virtual environment as real.
July 9 - Currently, people receiving organ transplants must take drugs to suppress the inflammatory immune response that leads to rejection. Even so, almost all recipients eventually lose their transplant. A new approach, which maintains a population of immune cells that naturally temper immune responses, known as Tregs, could greatly enhance people's long-term tolerance for transplants.