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TRANSPLANTATION - HIGHLIGHTED ARTICLE

Dr. Jeremy R. Chapman, Editor-in-Chief, Transplantation

Imlifidase desensitization in crossmatch-positive, highly-sensitized kidney transplant recipients: Results of an international phase 2 trial (Highdes)

Jordan SC, Legendre C, Desai NM, et al.
Transplantation: October 21, 2020 - Volume Online First

This report is of the use of imlifidase in an open-label, single arm, phase 2 trial use in highly sensitised kidney recipients conducted at five transplant centers. Imlifidase is a cysteine protease that cleaves IgG leading to a rapid decrease in antibody level and is shown to convert a positive crossmatch test to negative, thus allowing highly sensitized patients to be transplanted with a living or deceased donor kidney. 90% of the transplanted patients demonstrated conversion of their positive crossmatch to negative within 24 hours of imlifidase, but with rebound within 3-14 days and serum IgG levels normalizing 3 to 7 days after the transplant. Despite this, 2 patients had primary graft failure and about 40% had an early biopsy proven antibody mediated rejection. The drug was well tolerated and may provide a good way forward for the most difficult to transplant group of our patients.

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TRANSPLANTATION - WEEK'S MOST DOWNLOADED PAPER


«HOT OFF THE PRESS»
RECENT PUBLICATIONS IDENTIFIED BY TTS EDUCATION COMMITTEE ON COVID-19

Selected Publications by TTS Education Committee. This week's selection made by Enver Akalin, Medhat Askar, Millie Samaniego and Marlies Reinders.

Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine

Fernando P. Polack et al.
NEJM. December 10, 2020. DOI: 10.1056/NEJMoa2034577

This is a multinational, placebo-controlled, observer-blinded, pivotal efficacy trial. 16 years of age or older people were randomized in a 1:1 ratio to receive two doses, 21 days apart, of either placebo or the BNT162b2 vaccine candidate (30 μg per dose). BNT162b2 is a lipid nanoparticle–formulated, nucleoside-modified RNA vaccine that encodes a prefusion stabilized, membrane-anchored SARS-CoV-2 full-length spike protein. A total of 43,548 participants underwent randomization, of whom 43,448 received injections: 21,720 with BNT162b2 and 21,728 with placebo. There were 8 cases of Covid-19 with onset at least 7 days after the second dose among participants assigned to receive BNT162b2 and 162 cases among those assigned to placebo; BNT162b2 was 95% effective in preventing Covid-19 (95% credible interval, 90.3 to 97.6). Similar vaccine efficacy (generally 90 to 100%) was observed across subgroups defined by age, sex, race, ethnicity, baseline body-mass index, and the presence of coexisting conditions. Among 10 cases of severe Covid-19 with onset after the first dose, 9 occurred in placebo recipients and 1 in a BNT162b2 recipient. The safety profile of BNT162b2 was characterized by short-term, mild-to-moderate pain at the injection site, fatigue, and headache. The incidence of serious adverse events was low and was similar in the vaccine and placebo groups.

Genetic mechanisms of critical illness in Covid-19

Erola Pairo-Castineira et al.
Nature. https://doi.org/10.1038/s41586-020-03065-y

This article reports the results of the GenOMICC (Genetics Of Mortality In Critical Care) genome-wide association study (GWAS) in 2244 critically ill Covid-19 patients from 208 UK intensive care units. The authors identified and replicated novel genome-wide significant associations, on chr12q24.13 (rs10735079, p=1.65 × 10-8) in a gene cluster encoding antiviral restriction enzyme activators (OAS1, OAS2, OAS3), on chr19p13.2 (rs2109069, p=2.3 × 10-12) near the gene encoding tyrosine kinase 2 (TYK2), on chr19p13.3 (rs2109069, p=3.98 × 10-12) within the gene encoding dipeptidyl peptidase 9 (DPP9), and on chr21q22.1 (rs2236757, p=4.99 ×× 10-8) in the interferon receptor gene IFNAR2. This study supports of a causal link from low expression of IFNAR2, and high expression of TYK2, to life-threatening disease; transcriptome-wide association in lung tissue revealed that high expression of the monocyte/macrophage chemotactic receptor CCR2 is associated with severe Covid-19.

Baricitinib plus Remdesivir for Hospitalized Adults with Covid-19

A.C. Kalil et al.
NEJM
. December 11, 2020. DOI: 10.1056/NEJMoa2031994

This is a double-blind, randomized, placebo-controlled trial evaluating baricitinib plus remdesivir in hospitalized adults with Covid-19. All the patients received remdesivir (≤10 days) and either baricitinib (≤14 days) or placebo (control). A total of 1033 patients underwent randomization (with 515 assigned to combination treatment and 518 to control). Patients receiving baricitinib had a median time to recovery of 7 days (95% confidence interval [CI], 6 to 8), as compared with 8 days (95% CI, 7 to 9) with control (rate ratio for recovery, 1.16; 95% CI, 1.01 to1.32; P = 0.03), and a 30% higher odds of improvement in clinical status at day 15 (odds ratio, 1.3; 95% CI, 1.0 to 1.6). Patients receiving high-flow oxygen or noninvasive ventilation at enrollment had a time to recovery of 10 days with combination treatment and 18 days with control (rate ratio for recovery, 1.51; 95% CI, 1.10 to 2.08). The 28-day mortality was 5.1% in the combination group and 7.8% in the control group (hazard ratio for death, 0.65; 95% CI, 0.39 to 1.09. In summary, baricitinib plus remdesivir was superior to remdesivir alone in reducing recovery time and accelerating improvement in clinical status among patients with Covid-19, notably among those receiving high-flow oxygen or noninvasive ventilation.

Latest Video Content Posted

Videos from the Congress are now available to TTS Members.

SPLIT 2020 Meeting videos are now available to TTS & SPLIT Members.

Beta Cells Summit videos are now available to TTS & IPITA Members.

Nov 22 - FUNDAMENTALS TO COMPLEX DECISIONS WITH KIDNEY TRANSPLANTATION - Milagros Samaniego Picota

Click to view (TTS Members only)

Nov 19 - Tips and Tricks for Virtual Care in Pediatric Transplant - IPTA Allied Health and Nursing Professionals Webinar - Ashley Graham, Julie Guillen, Lisa Remaley, Robin Deliva, Anna Galloway, Rosa Reed-Berendt

Click to view (IPTA or TTS Members only)

TTS-ILTS Paired Transplant Centers Program
Application Deadline - January 1, 2021

The TTS-ILTS Paired Transplant Centers Program is a collaboration between The Transplantation Society (TTS) and the International Liver Transplantation Society (ILTS) supporting new liver transplant programs in emerging economies.

TTS and TTS Sections News

New Two-Year WIT Fellowship Grant Program

Letter of intent is due on March 1, 2021

Women in Transplantation (WIT) initiative of The Transplantation Society will provide funding to an Early Career Researcher to support research focusing on sex and gender issues relevant to solid organ transplantation.

This initiative was made possible with support with One Lambda, a Thermo Fisher Scientific brand, and Sanofi, with each supporting one award.

The spectrum of studies includes basic, clinical and translational. This individual should have spent two years or less performing research relevant to solid organ transplantation since obtaining their last degree (PhD, MD, MSc, PharmD, or equivalent). This work may represent a continuation of current research or a novel aspect of work. The mentor should have expertise in transplantation or immunology but need not be an investigator with known expertise in gender or sex.

Click here to read the statement

Happening Today!
Pediatric Intestinal Failure and Rehabilitation Symposium (PIFRS)

WEDNESDAY, DECEMBER 16, 2020

The Allied Health Provider Committee of the Intestinal Rehabilitation and Transplantation Association (IRTA) is pleased to collaborate with the Allied Health Provider group of the biannual Pediatric Intestinal Failure and Rehabilitation Symposium (PIFRS) to present a virtual education event that focuses on pediatric and adult intestinal rehabilitation and transplant.

Current strategies in medical, surgical, nutritional, and psychosocial care of patients with intestinal failure and transplant will be discussed. Presentations also include practical interventions for routine care and information on long-term outcomes. Opportunities for questions and discussion are also scheduled.

Plan to attend this free virtual event! There is something of interest for everyone on the transplant and intestinal failure multidisciplinary teams.

Click here to find out more and to register

WMA Statement on Measures for the Prevention and Fight against Transplant-Related Crimes

TTS fully endorses the WMA Statement on Measures for the Prevention and Fight Against Transplant-Related Crimes

CORONAVIRUS (COVID-19) UPDATES

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 covid-19@tts.org for inclusion on our resources page.

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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.

Website - www.tts.org/covid-19

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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.

Website - www.tts.org/txjcovid19

Please send your own contributions and news to covid-19@tts.org for inclusion on our resources page.


IN THE NEWS

Where is Dr. Nancy Ascher From Netflix’s The Surgeon’s Cut Now?

Dec. 9 - TTS Past-President Dr. Nancy Ascher is one of four remarkable doctors featured in a new Netflix special, "The Surgeon's Cut."

READ THE FULL ARTICLE

Donor stem cell transplant can improve survival rates for older patients with MDS, study shows

Dec. 5 - A new clinical trial offers the most compelling evidence to date that a donor stem cell transplant can improve survival rates for older patients with higher-risk myelodysplastic syndrome (MDS), Dana-Farber Cancer Institute investigators report at the virtual 62nd American Society of Hematology (ASH) Annual Meeting.

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Real-World Comparison of Costs, Outcomes of LBCL With or Without Transplantation

Dec. 9 - Karl Kilgore, PhD, Avalere Health, An Inovalon Company, Washington, DC, discusses study results comparing patient characteristics, treatments, costs, and overall survival between Medicare beneficiaries with large B-cell lymphoma (LBCL) who received stem cell transplantation versus those who did not.

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Scientists build whole functioning thymus from human cells

Dec.11 - Researchers have rebuilt a human thymus, an essential organ in the immune system, using human stem cells and a bioengineered scaffold. Their work is an important step towards being able to build artificial thymi which could be used as transplants.

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7 Incredible Health Breakthroughs Worth Celebrating in 2020

Nov. 28 - Yes, it’s been a challenging and often tragic year when it comes to health. But our hardest times often push us to our greatest achievements, and there’s a lot of progress to be excited about in 2021—like these seven advances.

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Hand Transplants Demonstrate the Nervous System’s Amazing Adaptability

Dec. 12 - A radical procedure restores touch and grasping in former amputees.

READ THE FULL ARTICLE


UPCOMING MEETINGS AND ANNOUNCEMENTS

International Symposium on Benign and Malignant Tumors in Liver With or Without Cirrhosis

24-25 June, 2021 • Kızılcahamam-Turkey

17th Congress of the Middle East Society For Organ Transplantation (MESOT 2021)

September 3-5, 2021 • AMMAN-JORDAN
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