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Transplantation Direct - March Issue

The March 2021 issue of Transplantation Direct is ready for viewing. A wide variety of areas in transplantation are covered in this issue. Starting with heart transplantation, the value of timely referrals amidst organ shortages is examined, as well as the ethical and surgical feasibility of ex situ heart perfusion in cases of heart donation after euthanasia. In kidney transplantation, an innovative peer mentoring program for transplant candidates is proposed, and an overview of current knowledge to optimize cell-free DNA diagnostics is covered. Under liver transplantation, a randomized pilot study on using telehealth lifestyle interventions within 12 weeks post-transplant is presented, and an “optimal" peri-operative strategy to rescue recipients with acute catastrophic liver failure is advocated; we also have a report on the feasibility and utility of hypothermic oxygenated machine perfusion for split liver transplantation. Lung transplant researchers examined whether invasive aspergillosis during the 1st year post-transplant affects development of chronic lung allograft dysfunction. Regarding other organs, there are reports on assessing motivations and impact of selection criteria for donation in uterine transplantation, and on the effectiveness and consequences of preemptive artery embolization in managing blood loss in multi-visceral transplantation with portomesenteric thrombosis; the use of lumen-apposing metal stents is studied in pancreas transplantation. In general, a new approach to assess geographical and spatial relationships related to organ transplantation and OPO performance is presented. We also have reports on the use of a cumulative deficits model to create a frailty index for organ transplant recipients, and on an international survey related to continuation of transplantation in the COVID-19 era. Please visit our open access Transplantation Direct website for complete details to these articles.

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The editors of this journal are pleased to offer electronic publication of accepted papers prior to print publication. These papers can be cited using the date of access and the unique DOI number. Any final changes in manuscripts will be made at the time of print publication and will be reflected in the final electronic version of the issue.

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TSANZ 2021 - March 14-16, 2021 • VIRTUAL - Starts Next Week!

39th Annual Scientific Meeting (ASM) of the Transplantation Society of Australia and New Zealand (TSANZ)

www.tsanzasm.com.au

Upcoming Webinars

New Date!
ISN-TTS JOINT WEBINAR
Donor/Recipient Pair:
RISKS VS. GAINS - KIDNEY FUNCTION

March 23, 2021
2:00 PM CET / 9:00 AM EDT (MONTREAL TIME)

Open to all healthcare professionals

Speaker: Marcelo Cantarovich, TTS President
Moderator: Jean Tchervenkov, Montreal, Canada

Click for details

Free to attend

Wednesday, April 7, 2021
2:00PM - 6:00PM (İstanbul Time Zone)

The Middle East Society For Organ Transplantation (MESOT) invites you to a new webinar on How to Increase Organ Donation and Transplantation in Our Region during the Covid-19 Pandemic Period.

With COVID-19 pandemic spreading across the globe since last year, it had the immediate effect of severely reducing living and deceased organ donation and transplantation activity worldwide.

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LATEST VIDEO - March 1 COVID & Vaccines Webinar is now available!

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Hot off the Press

«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 Drs. Enver Akalin and Millie Samaniego.

Baricitinib plus Remdesivir for Hospitalized Adults with Covid-19

Andre C. Kalil et al.
N Engl J Med. 2021; 384:795-807. 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 to 1.32; 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.

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Effect of Ivermectin on Time to Resolution of Symptoms Among Adults With Mild COVID-19: A Randomized Clinical Trial

Eduardo Lopez-Medina, et al.
JAMA. Published online March 4, 2021. doi:10.1001/jama.2021.3071

Patients were randomized to receive ivermectin, 300 μg/kg of body weight per day for 5 days (n = 200) or placebo (n = 200). The median time to resolution of symptoms was 10 days (IQR, 9-13) in the ivermectin group compared with 12 days (IQR, 9-13) in the placebo group (hazard ratio for resolution of symptoms, 1.07 [95%CI, 0.87 to 1.32]; P = .53 by log-rank test). By day 21, 82% in the ivermectin group and 79% in the placebo group had resolved symptoms. The findings do not support the use of ivermectin for treatment of mild COVID-19.

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Single-cell meta-analysis of SARS-CoV-2 entry genes across tissues and demographics

Christoph Muus et al.
Nat Med. 2021 Mar 2. doi: 10.1038/s41591-020-01227-z.

Angiotensin-converting enzyme 2 (ACE2) and accessory proteases (TMPRSS2 and CTSL) are needed for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cellular entry, and their expression may shed light on viral tropism and impact across the body. This study performed a meta-analysis of 31 lung single-cell RNA-sequencing studies with 1,320,896 cells from 377 nasal, airway and lung parenchyma samples from 228 individuals. This revealed cell-type-specific associations of age, sex and smoking with expression levels of ACE2, TMPRSS2 and CTSL. Expression of entry factors increased with age and in males, including in airway secretory cells and alveolar type 2 cells. Expression programs shared by ACE2+TMPRSS2+ cells in nasal, lung and gut tissues included genes that may mediate viral entry, key immune functions and epithelial-macrophage cross-talk, such as genes involved in the interleukin-6, interleukin-1, tumor necrosis factor and complement pathways.

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