Dr. Jeremy R. Chapman, Editor-in-Chief, Transplantation
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.
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.
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.
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.
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.
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.
The Transplantation Society (TTS) and our journal Transplantation have developed online resources to keep you informed on the Coronavirus (COVID-19) outbreak.
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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.
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 firstname.lastname@example.org for inclusion on our resources page.
Dec. 9 - TTS Past-President Dr. Nancy Ascher is one of four remarkable doctors featured in a new Netflix special, "The Surgeon's Cut."
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.
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.
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.
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.
Dec. 12 - A radical procedure restores touch and grasping in former amputees.