TTS leadership is actively developing the TTS Transplantation Leadership Series with the generous support of Sanofi. More than 80 applicants from throughout the world applied for this inaugural series. Twenty-five individuals were chosen for the initial group. We plan a series of webinars covering topics including transplantation ethics, partnership development, basic accounting, conflict management, industry relations, data analysis, grants and publishing.
Participants are tasked with developing a project to be achieved over the course of the series under the mentorship of TTS leaders. We hope that this effort represents the first of many years of activity to help develop the next generation of leaders in transplantation.
By now, you will have received issues of our new weekly newsletter called Tribune Pulse. As we are all increasingly bombarded with a deluge of emails, some of our members have complained that they cannot keep up and, in many cases, either automatically delete our emails or their institution’s server does it systemically. So we wanted a vehicle that consolidates communication to our members, rebuilds some trust in TTS communications and establishes a frequency that is both acceptable (once a week) and predictable (every Wednesday).
In addition to the weekly mail-out, we will have this material in a news section of tts.org for easy reference. We think this approach will provide a better integration and consolidation of news in a timely fashion, but we look forward to your feedback in the coming months. We are also proud to have four Senior Editors and a number of guest editors who have volunteered to assist with the development and vetting of content. They will be identified in each of the issues.
|March 1, 2017
1ST ISSUE OF PULSE
|March 8, 2017
|March 15, 2017
VACCINATION AND SOLID ORGAN TRANSPLANTATION
Armelle Pérez-Cortés Villalobos
|March 22, 2017||VIEW|
|March 29, 2017||VIEW|
|APRIL 5, 2017
LIVER, PANCREAS AND KIDNEY TRANSPLANTATION OUTCOMES
As the issues in anesthesia and critical care as well as heart and lung transplantation are becoming more and more complex, we have decided to create separate TTS Committees to address these issues and ensure focus and direction for all TTS members in this area. A list of members of these and other committees can be found at www.tts.org/about-tts-5/committees.
Efforts are underway for the planning of the 2018 TTS Congress in conjunction with the Sociedad Madrilena de Trasplante and the Sociedad Espanola de Trasplante. Dr. José Maria Morales is serving with me as the Congress Vice-Chair and Valentin Cuervas-Mons as Finance Co-Chair. We have also brought together a high-profile Scientific Program Committee under the Chairmanship of Philip O’Connell to develop an exciting agenda with a wide range of topics to interest everyone. Since Spain has set the bar for organ procurement, it is a most fitting
site for the 27th International Congress of The Transplantation Society.
n a final note, Dr. Francis Delmonico, in his role as a member of the Pontifical Academy of Sciences was instrumental in organizing a global summit concerning Organ Trafficking and Transplant Tourism in the Vatican City in February 2017. The purpose of this meeting is to raise awareness of this global problem and bring a group of stakeholders together to address the underlying issues. A report of this summit follows in this issue of the Tribune, and the full statement of the summit and the participant list can be found on the TTS website.
Two committees have been added to the existing pool of 12 committees, making way for TTS to empower its global leadership activity in a strategic and mindful approach. All committees submit a specific action plan detailing objectives and end goals for their two-year term. With 100+ active members in these committees, they report through their committee chairs and co-chairs to the Executive between Council meetings and provide full details of their progress during the annual meeting of the Council. The current TTS committees are:
For a complete list of committee members, please visit the TTS Committee page on our website at www.tts.org/about-tts-5/committees
By the direction of Pope Francis, the Pontifical Academy of Sciences (PAS) convened a Summit on Organ Trafficking and Transplant Tourism on February 7-8, under the leadership of its Chancellor Marcelo Sánchez Sorondo and convened by Past TTS President Francis Delmonico as Academician of the PAS. The objectives of the Summit were to describe the widespread problem of transplant tourism and organ trafficking (testimony given by attendees from countries currently with transplant services throughout the world); to prepare a Statement referable to the Pontifical Academy Summit that would be signed by the participants and distributed worldwide; to engage a group of stakeholders (government officials, prosecutors, investigators, justices, and journalists) who can be influential in the long term in combatting organ trafficking in an alliance with transplant professionals.
Seventy-five participants were in attendance, including the TTS President Nancy Ascher, President-Elect Mehmet Haberal and Immediate Past President Philip O’Connell. The consensus Statement of the Pontifical Academy of Sciences Summit on Organ Trafficking and Transplant Tourism was signed by all participants.
First held in 2001, the FOCiS Annual Meeting draws the best clinician scientists from around the world to participate in the scientific program, bringing together cutting-edge science from various disease fields related to clinical immunology.
The FOCiS approach to clinical immunology is unique, concentrating on breaking down clinical barriers between specialties and focusing on the shared pathologies of diseases and conditions. At FOCiS 2017, researchers and clinicians from over 40 disease and specialty-specific societies will unite to share knowledge across traditional disease borders, and identify commonalities between treatments and therapies that are life changing for those affected with immune-mediated diseases.
With an innovative lineup of topics and presenters, this year’s program has something for everyone! Make plans today to attend FOCiS 2017 – the meeting in translational immunology that will give you a competitive edge in your career. See you in Chicago.
The Society was established as a central, multidisciplinary association to bring together all healthcare professionals involved in the Croatia’s transplant program; subsequently, the Congress was a chance to gather those professionals to present current trends in therapeutic support and to facilitate exchange of theoretical knowledge and practice (case reports) following standards within the EU. It was also a great opportunity to exchange information, experiences, and ideas, and to present the results of the National transplantation program.
Croatia is one of the leading countries in organ donation and transplantation, not only in Europe, but worldwide. In 2016, Croatia continued its record of providing highly successful results in transplant medicine, owing to the solidarity of its citizens to make the noble decision to donate organs and an exceptional organisation model. 346 people received the "gift of a new life" in 2016: 353 organs were transplanted, out of which 190 were kidneys, 121 livers, 35 hearts, and 7 pancreases.
The President of the Croatian Society of Transplantation Medicine, Dr. Branislav Kocman, emphasized that despite these remarkable results, there remains room for improvement, especially in the development of the lung transplantation program.
The Croatian Society of Transplantation Medicine recently became an Affiliated Society of TTS.
With 18 core members and 4 active Working Groups consisting of 33 individuals, the TTS Education Committee has welcomed new initiatives for the next two years. Relying on the input and guidance from representatives of 12 countries places the Education Committee in a unique position to address current needs of those involved in transplantation worldwide.
Collaboration in the past year has led the Committee to offer two Webinar series: the Advanced Renal Transplantation, which began in 2015 and concludes this year; and the Trainee Track series, which had its first presentation in March. Each interactive Trainee Track Webinar will feature new speakers and moderators with pertinent content for those starting out in the field.
Along with webinars, there is also an update on the tts.org archival and talk resources. By curating recordings of talks and panels from past meetings and Congresses, an assigned Working Group has been able to create a direct resource for key words, facilitating TTS members’ search and access to information within these archives. These new features will be part of the revamped TTS website, set to launch later this year.
Another undertaking is the joint project with the Canadian Society of Transplantation and the Dutch Transplant Foundation for Education on Organ Donation and Transplantation for Schoolchildren. This pilot program will create a teaching module for elementary and high school students to increase their awareness about organ donation and transplantation. By partnering with other societies for this project, the Committee is welcoming new teaching methods and processes to its efforts in acknowledging demands in education. In line with this objective, the Committee has also formulated an updated Needs Assessment Survey for TTS members to evaluate their current knowledge and desired topics out of more than 80 topics involving transplantation. The data collection process will be rigorous and useful to determine topic preferences among general membership for the Society’s future endeavors.
The Working Group of the TTS Ethics Committee is pleased to report on the following key findings of the international survey investigating the experience of transplant professionals with ethical issues in practice. A journal paper reporting the results in more detail is in the final stages of preparation. More complete findings will be communicated to participants who requested feedback on the study, which will ultimately be published in a future issue of Transplantation. Updated information on the exact publication date will be included an upcoming issue of the new TTS weekly newsletter, Tribune Pulse.
Chaired by Dominique Martin (Australia) and Beatriz Dominguez-Gil (Spain), an international, multidisciplinary team of Ethics Committee members worked on the study, including Katrina Bramstedt (Australia), Riadh Fadhil (Qatar), Rudolf Garcia-Gallont (Guatemala), Jacob Lavee (Israel), Richard Trompeter (UK) and Kristof Van Assche (Belgium). Sara Vogrin is the volunteer research fellow who has assisted with statistical analysis of the data.
The study aimed to identify the areas of practice in which transplant professionals may experience ethical dilemmas or concerns, and the type of issues commonly experienced. The results will help to guide further research in the ethics of donation and transplantation and the development of resources to support professionals in dealing with ethical issues in practice.
A questionnaire, available in English and Spanish, was developed and delivered in the form of an online anonymous survey hosted on Survey Monkey. TTS members were invited via email to participate and invitations were sent to other regional or national professional organizations to invite participation by any professional working in donation or transplantation. Data was collected between January and May, 2016.
Nearly a third of respondents had personally experienced an ethical dilemma or concern throughout 2014 and 2015.
Two thirds of respondents had experience with an ethical issue relating to living donation. Common themes of concern related to encouragement of living donation without pressuring relatives, psychosocial evaluation of donors and the use of young adults as living donors. Follow up care of donors and the financial risks of donation were also important concerns.
Fifty-seven percent of respondents had experienced an ethical issue relating to deceased donation. Use of expanded criteria donors, and management of cultural and/or religious objections to deceased donation were important areas of ethical concern, as was the management of intra-familial disagreement about donation. Protocols for donation after circulatory determination of death were important concerns in North America and Europe. Concerns about medical criteria for wait-listing or selection of transplant candidates and policies governing organ allocation were common.
A third of respondents had experienced ethical issues relating to organ trading, transplant tourism or the use of incentives for donation. For those who reported experience of issues relating to travel for transplantation, two thirds had experienced concerns about management of patients who returned after possibly purchasing an organ overseas. Management of patients who were considering traveling abroad to purchase an organ or foreign patients who had travelled to the respondent’s country for the purpose of donation or transplantation were also areas of ethical concern.
About a third of respondents reported experience of ethical issues relating to healthcare funding; this was more commonly reported by respondents from Africa, North America, and Asia. Experience of ethical concerns was also reported by a quarter of respondents in the context of research activities, and nearly half of respondents reported experience of concerns relating to interactions with their professional colleagues.
When asked to select issues on which TTS should prioritise action, respondents identified the allocation of deceased donor organs, follow-up care of living donors and equity in access to transplantation in developing countries as the most important topics overall.
The Ethics Committee is currently formulating a program of work informed by the results of the study, and it is anticipated that further research will be conducted in the light of the results.
The working group would like to thank everyone who participated in the study – we really appreciate your efforts! We appreciate your patience as we work to process all the data and ensure the communication of these results to the international community of professionals working in transplantation and donation.
The Working Group of the TTS Ethics Committee is pleased to report on the following key findings of the international survey investigating psychosocial evaluation of living organ donors (PELOD). A journal paper reporting the results in more detail is in the final stages of preparation. More complete findings will be communicated to participants who requested feedback on the study, which will ultimately be published in a future issue of Transplantation. Updated information on the exact publication date will be included an upcoming issue of the new TTS weekly newsletter, Tribune Pulse.
Chaired by Riadh Fadhil (Qatar) and Elizabeth Pomfret (USA), an international, multidisciplinary team of Ethics Committee members and volunteer research fellow Lucinda Wynter worked on the study, including Dominique Martin (Australia), Katrina Bramstedt (Australia), Ian Dittmer (New Zealand), Beatriz Dominguez-Gil (Spain), Rudolf Garcia-Gallont (Guatemala), Kristof Van Assche (Belgium) and Haibo Wang (China).
While the importance of psychosocial evaluation of living donors is well recognized internationally, previous research and anecdotal reports suggested that there is considerable diversity in practice, and in some regions there are major gaps in resources required to support psychosocial evaluation. The study aimed to evaluate international practices in psychosocial evaluation of living donors, and identify potential needs for development of professional guidelines or training relating to psychosocial evaluation.
A questionnaire, available in English, Spanish, Arabic and Chinese, was developed and delivered in the form of an online anonymous survey hosted on Survey Monkey. TTS members were invited via email to participate and invitations were sent to other regional or national professional organizations to invite participation by any professional involved in a living donor program.
As we anticipated, the results revealed variation in psychosocial evaluation practices between and within countries.
Approximately 80% of respondents told us that psychosocial evaluation is always performed for living kidney and liver donors. However, the features of the evaluation process varied between respondents. Most respondents reported that a trained mental health worker or psychiatrist was involved in the evaluation. Nearly two thirds reported a transplant coordinator or nurse was involved, and about a third reported that nephrologists, hepatologists or transplant surgeons were involved. About a quarter of respondents reported social worker involvement, and 9% reported ethicists involvement.
The type of information collected during psychosocial evaluation also varied. While some items were commonly checked, such as psychiatric history or marital status, others were not. For example, about half of respondents reported collecting information about a prospective donor’s financial burdens or debts.
When asked about the goals of psychosocial evaluation at their transplant centre, nearly all respondents agreed that goals included minimising the risk of psychosocial harm and ensuring a voluntary decision. About two thirds agreed that goals included ensuring donors did not receive a financial reward or minimising the risk of economic harm to donors.
About 80% of respondents reported that years or lifelong follow-up of the physical health of living donors was provided at their centre, only half reported providing long term follow-up for mental health, and less than a quarter reported long term follow-up of financial wellbeing.
Respondents expressed the need for more staff trained in psychological evaluation of donors (60%) and in social and economic evaluation of donors (50%); access to a living donor review committee (50%); guidelines for performing psychosocial evaluation (57%); and access to experts for ethical evaluation of complex cases (48%).
The Ethics Committee has also been collecting guidelines and policies currently in use across the world in the hope of making a formal review of these so that international experiences can be shared. The Committee is now exploring the possibility of more work on this topic, in particular the development of guidelines and tools for the psychosocial evaluation of living donors that could be adapted for use in the context of local conditions.
The working group would like to thank everyone who took the time to participate in the study. Your contribution has been invaluable!
The 15th Transplantation Science Symposium (TSS) is fast approaching with many highlights of what will be a full and exciting transplantation science program. The Symposium Chairs Megan Levings and Lori West, together with the Transplantation Science Committee, have put together a fantastic program that includes Plenary and Keynote Symposia as well as Oral sessions selected from submitted abstracts. The meeting will cover the breadth and depth of what’s hot and breaking news in transplantation science in 2017.
A particular highlight will be a Keynote Lecture on “Cell Death in Immunity” by Professor Doug Green. Professor Green holds the Peter Doherty Endowed Chair of Immunology in St. Jude Children's Research Hospital and is best known for his work in uncovering the molecular basis for cell death (apoptosis), particularly relating to activation induced cell death in T cells.
A second highlight will be a presentation by Niobe Thompson and the screening of a film documentary on life-saving organ transplants called "The Nature of Things - Vital Bonds”. Niobe Thompson is a Canadian anthropologist and documentary filmmaker. This film takes us inside one of Canada’s busiest organ transplant hospitals and follows one family’s personal journey with organ transplantation.
In addition to these highlights, the meeting topics include tolerance, tailored immunosuppression, stem cells and genome engineering, tissue repair and wound healing, and sessions on the microbiome and transplantation, as well as big data and the role of sugars in transplantation.
Through the Transplantation Science Committee and the support of regional societies, TTS will once again be supporting attendance by young basic research fellows together with their mentors with the Mentee-Mentor Awards. The winners have been selected from the most highly scored abstracts and the Awards will be presented at a special networking event.
This year TSS will be preceded by the Virtual Global Transplant Lab (vGTL) Workshop, which will focus on Biomarker Validation and Implementation. The Symposium itself will be held from May 24-26 in the city of Victoria, the capital of the province of British Columbia, Canada. With abundant parkland and well known for outdoor activities and wildlife, Victoria sits on the craggy southern end of Vancouver Island on the Straits of Yuan de Fuca separating Canada from the USA. For those wishing for more information on registration and up to date information for what will be an outstanding program, please visit the Syposium website at www.tss2017.org.
The Transplantation Group has started a new initiative to involve younger clinicians and scientists in editing scientific publications. We were flooded with excellent applicants and have appointed four Transplantation Journals’ Fellows to internships with the editorial team.
Congratulations to Dr. Joel Adler, Dr. Karen Keung, Dr. Peri Kocabayoglu, and Dr. Andrea Schlegel, all of whom will work with the editorial team to bring new ideas and new energies to the journal. Our thanks to all who applied and we look forward to incorporating new directions and improvements for both Transplantation and Transplantation Direct.
Joel is currently a chief resident in general surgery at Massachusetts General Hospital (Boston, USA). He will begin a fellowship in abdominal organ transplantation at the University of Wisconsin (Madison, USA) in August 2017. His research involves organ allocation policy, long-term outcomes after living kidney and liver donation, and the role of geography and economics in access to transplant care. He is also interested in the role of social media in disseminating research and policy and can be found on Twitter @joeladler.
Karen developed a strong interest in transplant medicine during her clinical nephrology training at Westmead Hospital in Sydney, Australia. Clinical patient care is her passion, but her curiosity towards science in transplantation spurred her onto a full time PhD after she completed her fellowship in 2015, under the supervision of Philip O’Connell and Germaine Wong. Recently she spent a year in New York collaborating with Barbara Murphy’s team at Mount Sinai Hospital. Her current focus is on molecules identified from large scale transcriptome expression profiling studies and their role in causing/ predicting allograft injury.
Peri graduated magna cum laude as a medical doctor from the University of Duisburg-Essen Medical School, Germany, in 2007, after which she commenced her surgical training at the Department of General, Visceral and Transplantation Surgery at the University Hospital Essen. She was awarded a research fellowship by the German Research Foundation (DFG) and completed her postdoctoral training from 2010-2013 at the Icahn School of Medicine at Mount Sinai Hospital in New York, USA, investigating the role of Hepatic Stellate Cells during liver regeneration and cancer. Her main areas of research are organ preservation through machine perfusion as well as the contribution of non-parenchymal cells to tumor recurrence following liver transplantation.
Following her medical degree, Andrea obtained training from the surgical Department of Prof. Pierre-Alain Clavien at University Hospital Zurich. Here her personal commitment to an academic career in the field of transplantation surgery emerged. Her research focus is on organ allocation and the development of new preservation techniques. Since 2016, she has been working as a Senior Clinical Fellow in liver transplantation and HPB surgery at Queen Elizabeth Hospital in Birmingham, UK.
IPITA started the year with a joint Key Opinion Leader workshop, held together with EPITA (the European Pancreas and Islet Transplant Association) at the end of January in city of Igls, located in the Austrian Alps. The workshop was organized and co-chaired by Mike Rickels and Peter Stock from the IPITA side. The aims of the workshop were to develop consensus definitions for success versus failure, and for graft function assessment, that could be applied to pancreas and islet transplants. At the end of an intense meeting, with tight and lively discussions, the group came with a proposal that will be conveyed to the various stakeholders in the field (transplant centers, learned societies, regulatory authorities,...) in consensus papers published simultaneously in the journals of TTS and ESOT and in communications in scientific meetings. A session of the upcoming IPITA Congress will be dedicated to this important achievement. This is clearly a work in progress, and both parties have agreed to reconvene within 3 years for an update of the “Igls Classification”.
Preparations for the 16th IPITA International Congress are progressing well. The meeting is being held in Oxford, UK on June 20-22, and is being run by a team chaired by Paul Johnson and Peter Friend. Congress Themes include the integration of whole pancreas and islet transplantation, and the development of the next generation of scientists and clinicians in beta-cell replacement. The Scientific Programme is taking shape nicely. It includes an all-day Pre-Congress Symposium on ‘Hypoxia and Ischemia in Beta-Cell Replacement’; a strong series of Plenary Talks; Oral and Poster Prize Sessions for Young Investigators. We have received a large number of abstracts and the review panels are currently scoring these. Authors will be notified of the outcome in March.
We are particularly keen to encourage Allied Health Professionals and Young Investigators to attend the meeting; there will be specific AHP Pre-Congress Symposium and there are reduced AHP registration fees for the main Congress. In addition to learning about the latest scientific and clinical developments in our field, the Congress is an ideal opportunity to catch up with old friends and to network with new ones.
friends and to network with new ones. We have planned an exciting Social Programme during the Congress, including a Welcome Reception at the Natural History Museum; a Networking Event for Young Investigators / Trainees on the River Thames; and the Congress Formal Dinner at Balliol College, University of Oxford. The Board of IPITA looks forward to seeing you in Oxford.
The International Pediatric Transplant Association will be holding its 9th Congress in Barcelona, Spain, from May 27-30, 2017. Come and join us in the cradle of Catalan culture! Founded as a Roman City in the Middle Ages and particularly renowned for the architectural works of Antoni Gaudí and Lluís Domènech i Montaner, Barcelona has a rich heritage and is an important cultural centre and major tourist destination. The IPTA scientific sessions will take place overlooking the blue waters of the Mediterranean Sea at the World Trade Center Barcelona, centrally located on Barcelona’s most well connected main road and just a few steps away from an extensive range of amenities, shops and services.
Join us for six exciting and topical plenary sessions ranging from Sensitization and the Importance of Alloantibodies, Clinical Tolerance Protocols, and an update on the CTOT-C clinical trials to Ethical Issues in pediatric transplantation. We are honored to have five cutting edge State-of-the-Art lectures being delivered by leaders in their fields including Dr. Benedict Cosimi (The Holy Grail: From Mouse to Man), Dr. John O’Shea (New Strategies for Immunosuppression), and Dr. Paolo de Coppi (Growing Organs – the Future of Transplantation). Merge all of this with the fourteen expert-led Interactive Workshops, four open poster sessions with opportunity for discussion, and two vibrant pre-symposia (one in Spanish!), and you will find something for everyone involved in the field of pediatric transplantation!
Join us as we recognize colleagues in the field with IPTA and TTS Awards and also announce the first IPTA Pioneer in Transplantation Award to a well deserving pioneer in our field. Network with old friends and colleagues and meet new ones from around the world at the Opening Ceremony and reception and the congress social evening showcasing the history of medicine in Spain at the Hospital San Pau.
We look forward to seeing you all in Barcelona!
The Intestinal Transplant Association (ITA) is one of the smaller Sections of TTS. In a near-unanimous vote, at the 14th International Small Bowel Transplant Symposium (ISBTS) in Argentina in 2015, the Council of the ITA voted to rename the association, the Intestinal Rehabilitation and Transplant Association (IRTA). Thus it is that ISBTS 2017 became CIRTA 2017 (Congress of the IRTA). The change in name of the association, and of the biennial symposium is an acknowledgement of the strong presence that non-transplant care of intestinal failure has had in the content of past meetings of the ITA.
CIRTA 2017will be hosted jointly by TTS, along with the Mount Sinai Medical Center and the Columbia Presbyterian Medical Center serving as local hosts in New York. Taking place from June 28–July 1 at the historic Roosevelt Hotel, the Congress will be chaired by Dr. Kishore Iyer, MBBS, FRCS, Director of theIntestinal Rehabilitation and Transplantation Program at Mount Sinai Medical Center; and co-chaired by IRTA President Dr. Debra Sudan, MD, Chief of Abdominal Transplantation at Duke University Medical Center.
CIRTA 2017 will kick off with a state-of-the-art 1-day workshop with parallel sessions for physicans/surgeons as well as allied health professionals, featuring invited lectures and panel discussions with world leaders in intestinal transplantation and rehabilitation. A workshop on the hot-topic of the role of DSA in intestinal transplantation under the auspices of the IRTA will cap the first day, wrapping up with a cocktail reception.
The main Congress will feature plenary speakers, Dr. Megan Sykes, USA; Dr. Robert Lookstein, USA; Dr. Palle Jeppesen, Denmark; and, Dr. Paul Wales, Canada. Abstract sessions will include premier, oral, min-oral and rapid-fire sessions as well as poster sessions. The meeting wraps up with International Registry data as well as regional overviews from North America, Europe, Asia and Latin America. A grand gala banquet taking place a few feet from the Hudson River in Battery Park, and the myriad attractions of the ‘City That Never Sleeps’, promises that CIRTA 2017 will be a memorable meeting.
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