Journal Updates

Transplantation Direct - April 2021 - Vol. 7, No.

The complete Transplantation Direct issue for April is now online. In the area of kidney transplantation, studies are presented on how to improve blood pressure control in recipients, and on caution that should be taken when using dd-cfDNA measurements to rule out kidney injury; another article examines perspectives from transplant candidates regarding concerns of receiving an organ during the COVID-19 epidemic. For the liver transplant community, this issue contains articles on critical factors determining the success of transplantation in cases of cholangiocarcinoma and on how pre-transplant hepatitis C treatment affects access to high quality organs. There are also a number of articles on lung transplantation, including studies looking at carfilzomib treatment on antibody-mediated rejection, and examining the effects of ATG treatment on chronic lung allograft dysfunction; also, the association of intragraft hyaluronan levels with acute rejection is examined, and an experimental study in rats is presented testing whether ex vivo perfusion with methylprednisolone protects against brain death-induced injury. In other reports, a study from Asia examines long-term cancer development after pediatric kidney transplantation, and a clinical trial protocol is presented for a randomized trial that seeks to test whether an educational intervention can improve kidney transplantation among waitlisted Blacks. For more details on these articles, please visit our open access Transplantation Direct website.

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Highlighted News

New Initiative Puts At-Home Testing to Work in the Fight Against COVID-19

The Say Yes! COVID Test initiative is an important next step in informing the best testing strategies in communities all over the country to end this and future pandemics. The initiative will also help to determine how readily people accept such testing when it’s made available to them. If the foundational data looks promising, the hope is that rapid at-home tests will help to encourage people to protect themselves and others by following the three W’s (Wear a mask. Wash your hands. Watch your distance), getting vaccinated, and saying “Yes” to the COVID-19 test.

The Lancet - Early outcomes after lung transplantation for severe COVID-19: a series of the first consecutive cases from four countries

Woman Gets New Windpipe In Groundbreaking Transplant Surgery

A medical team in New York City says it has performed the first complete surgical transplant of a windpipe.

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 Dr. Enver Akalin..

Seroprevalence and humoral immune durability of anti-SARS-CoV-2 antibodies in Wuhan, China: a longitudinal, population-level, cross-sectional study

Lancet Volume 397, Issue 10279, 20–26 March 2021, Pages 1075-1084
This study analyzed blood samples from more than 9,500 people in some 3,500 randomly selected households in Wuhan, China at three separate times over the course of 2020: once in April, after the city’s lockdown lifted; once in June; and again between October and December. The researchers found that only 7% of the population had been infected with the virus, of whom more than 80% had had no symptoms. Around 40% of the infected people produced neutralizing antibodies that could be detected for the entire study period. The researchers conclude that most people in Wuhan are still susceptible to SARS-CoV-2 infection, and that a mass vaccination campaign is needed to achieve herd immunity.

SARS-CoV-2-specific serological and functional T-cell Immune responses during acute and early COVID-19 convalescence in Solid Organ Transplant patients

Alexandre Fava et al. Am J Transplant2021; doi:10.1111/AJT.16570
Cytokine-producing T-cell responses such as IFN-γ, IL-2, IFN-γ/IL-2, IL-6, IL-21 and IL-5 against main immunogenic SARS-CoV-2 antigens and IgM/IgG serological immunity were tracked in solid organ transplant recipients (n=28) during acute infection and at 2 consecutive time-points over the following 40 days of convalescence and were compared to matched IC (n=16) patients admitted with similar moderate/severe COVID-19. Although the development of a robust serological and functional T-cell immune responses against SARS-CoV-2 among solid organ transplant patients, similarly to immunocompetent patients during early convalescence. However, at the infection onset, SOT displayed lower IgG seroconversion rates (77% vs 100%; p=0.044).

COVID-19 in solid organ transplant recipients: A national cohort study from Sweden

John Mackay Søfteland et al. Am J Transplant. 2021 Apr 3. doi: 10.1111/ajt.16596.
This is a retrospective study of all known Swedish solid organ transplant recipients with RT-PCR confirmed COVID-19 between March 1st and November 20th, 2020 and analyzed patient characteristics, management, and outcome. 230 patients with a median age of 54.0 years (13.2), who were predominantly male (64%) were identified. Most patients were hospitalized (64%), but 36% remained outpatients. Thirty-day all-cause mortality was 9.6% (15.0% for inpatients), increased with age and BMI, and was higher in men. Renal function decreased during COVID-19 but recovered in most patients. SARS-CoV-2 antibodies were identified in 78% of patients at 1-2 months post-infection. Nucleocapsid-specific antibodies decreased to 38% after 6-7 months, while spike-specific antibody responses were more durable. Seroprevalence in 559 asymptomatic patients was 1.4%.

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