Dr. Jeremy R. Chapman, Editor-in-Chief, Transplantation
Gómez-Gavara C, Herraiz AM, Hervás D, et al.
Transplantation: October 8, 2020 - Volume Online First
N-acetylcystine (NAC) has had many advocates over the years for many different purposes in protecting the kidney and the liver. This report provides the largest randomised controlled trial of protection of the liver during procurement from early allograft dysfunction as a primary endpoint, as well as markers of oxidative stress as secondary outcomes. NAC was tested in 113 and standard protocol in 101 patients. The definitive answers from this trial provide no support for its use to improve primary allograft dysfunction, but with cold ischemia greater than 6 hours there were impacts on Alanine Aminotransferase levels.
Women in Transplantation is proud to partner with FOCIS on this very important and relevant session Diversity, Sex and Gender in the COVID Era presented by Stanford's Senior Associate Dean for Faculty Development and Diversity, Yvonne Maldonado, MD.
In this presentation, Dr. Maldonado will reflect upon her own career journey and discuss research on gender, its intersection with other marginalized social identities, and its role in the academic workplace. She will expand upon her research as an infectious disease epidemiologist as well as research and personal experiences during today’s COVID-19 era.
The session will be moderated by Dr. Megan Sykes, Michael J. Friedlander Professor of Medicine and Professor of Microbiology & Immunology and Surgical Sciences (in Surgery) and Director, Columbia Center for Translational Immunology, ex WIT Co-Chair and President-Elect of FOCIS.
Join us on Friday October 30th at 11:15am by registering at this link below:
Registration details will be sent on to all registered closer to the time.
John H. Stone et al.
NEJM October 21, 2020
This is a randomized, double-blind, placebo-controlled trial involving patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, hyperinflammatory states, and at least two of the following signs: fever (body temperature >38°C), pulmonary infiltrates, or the need for supplemental oxygen in order to maintain an oxygen saturation greater than 92%. Patients were randomly assigned in a 2:1 ratio to receive standard care plus a single dose of either tocilizumab (8 mg per kilogram of body weight) or placebo. 243 patients were enrolled; 141 (58%) were men, and 102 (42%) were women. The median age was 59.8 years (range, 21.7 to 85.4), and 45% of the patients were Hispanic or Latino. The hazard ratio for intubation or death in the tocilizumab group as compared with the placebo group was 0.83 (95% confidence interval [CI], 0.38 to 1.81; P=0.64), and the hazard ratio for disease worsening was 1.11 (95% CI, 0.59 to 2.10; P=0.73). At 14 days, 18.0% of the patients in the tocilizumab group and 14.9% of the patients in the placebo group had had worsening of disease. The median time to discontinuation of supplemental oxygen was 5.0 days (95% CI, 3.8 to 7.6) in the tocilizumab group and 4.9 days (95% CI, 3.8 to 7.8) in the placebo group (P=0.69). At 14 days, 24.6% of the patients in the tocilizumab group and 21.2% of the patients in the placebo group were still receiving supplemental oxygen. In conclusion, Tocilizumab was not effective for preventing intubation or death in moderately ill hospitalized patients with Covid-19.
Carlo Salvarani et al.
JAMA Intern Med. Published online October 20, 2020.
This is a prospective, open-label, randomized clinical trial that randomized patients hospitalized between March 31 and June 11, 2020, with COVID-19 pneumonia to receive tocilizumab or standard of care in 24 hospitals in Italy. A total of 126 patients were randomized (60 to the tocilizumab group; 66 to the control group). The median (interquartile range) age was 60.0 (53.0-72.0) years, and the majority of patients were male (77 of 126, 61.1%). Seventeen patients of 60 (28.3%) in the tocilizumab arm and 17 of 63 (27.0%) in the standard care group showed clinical worsening within 14 days since randomization (rate ratio, 1.05; 95% CI, 0.59-1.86). Two patients in the experimental group and 1 in the control group died before 30 days from randomization, and 6 and 5 patients were intubated in the 2 groups, respectively. The trial was prematurely interrupted after an interim analysis for futility.
Wan Yang et al.
Lancet Infect Dis 2020 Published Online October 19, 2020
This article studied 56 waitlisted patients and 80 kidney transplant recipients diagnosed with COVID‐19 between March 13‐ May 20, 2020. Despite similar demographics and burden of comorbidities between waitlisted and transplant patients, waitlisted patients were more likely to require hospitalization (82% vs. 65%, p=0.03) and were at a higher risk of mortality (34% vs. 16%, p=0.02). Intubation was required in one‐third of hospitalized patients in each group, nd portended a very poor prognosis. The vast majority of patients who died were male (84% waitlist, 100% transplant). Multivariate analysis demonstrated waitlist status, age, and male sex were independently associated with mortality. COVID‐19 has had a dramatic impact on waitlisted patients, decreasing their opportunities for transplantation and posing significant mortality risk.
Researchers at McGill University are currently conducting a study entitled LIST-COVID-19 to study the impact of the COVID-19 pandemic on transplantation activity, volumes and immunosuppression practices on a global scale. The study will also help better understand the current and anticipated risks to transplantation during the pandemic and inform clinical practice during the “ramp-up” phase. The Transplantation Society is supporting the project, as well as several National and International Societies.
They are looking for physicians who take care of patients with a solid organ transplant to take a 10-15 minute survey on behalf of their center and program. Please note this is not a patient registry and no specific patient-level data is being collected. Please be assured they will only perform a collective analysis of the survey questions and no personal information identifying the participants will be divulged. The survey responses will be confidential. If you are interested in participating, please contact them at the emails listed below.
Investigators: Shaifali Sandal, MD and Marcelo Cantarovich, MD
The Transplantation Society (TTS) and our journal Transplantation have developed online resources to keep you informed on the Coronavirus (COVID-19) outbreak.
We are also requesting contributions and news from the transplant community to be sent to firstname.lastname@example.org for inclusion on our resources page.
In this dashboard, you will find links to TTS and other global and regional resources, as well as interactive maps, publications and webinars. We encourage you to explore this dashboard and share with your colleagues.
Editors and contributors to Transplantation have shared their thoughts on how they are dealing with the current crisis. While we understand that the information of today may be quite different tomorrow in this fast-moving pandemic, this report will open our forum of an international exchange on COVID for the transplant community.
Please send your own contributions and news to email@example.com for inclusion on our resources page.
Oct. 20 - Previous studies have examined the effects of cold and warm ischemia times on graft function following kidney transplantation. Results of those studies have suggested that extended cold ischemia time (CIT) or extended warm ischemia time (WIT) were independently adversely associated with graft survival. However, according to colleagues at the Royal London Hospital, London, United Kingdom, there are few data available on analyses of both cold and warm ischemia times.
Oct. 20 - Pediatric patients with end-stage kidney disease treated with kidney transplantation have improved quality of life and prolonged life expectancy. Aydincan Akdur, MD, and colleagues at Baskent University, Ankara, Turkey, conducted a study to examine surgical complications following pediatric kidney transplantation.
Oct. 14 - Both pancreas transplantation alone (PTA) and islet cell transplantation (ICT) have been associated with peri-operative declines in estimated glomerular filtration rate (eGFR), a decline that is less than that associated with medically managed diabetes. According to Rashikh Choudhury, MD, and colleagues in the department of surgery-division of transplantation surgery at the University of Colorado Hospital, Aurora, PTA and ICT have demonstrated long-term stabilization of chronic kidney disease (CKD) in patients with type 2 diabetes.
Oct. 22 - A team of University of Alabama at Birmingham researchers has shown a simple way to protect transplanted islets, by coating them with a thin skin of alternating layers of two biopolymers. As reported in the journal Diabetes, this coating delays allograft and autoimmune-mediated rejection in mouse models of T1D.
The International Pancreas & Islet Transplant Association (IPITA) Conference Organizing Committee is committed to bringing the community together virtually.
TTS members are invited to attend the FOCIS 2020 Virtual Annual Meeting – THE meeting in translational immunology!
The Federation of Clinical Immunology Societies exists to improve human health through immunology.
The FOCIS 2020 Virtual Annual Meeting on October 28-31, 2020, brings together an interdisciplinary group of world-renowned physicians and researchers to share the latest findings on diseases impacting the immune system.