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Planning for uncertainty and fallbacks can increase the number of transplants in a kidney-paired donation program
American Journal of Transplantation (login required)
A kidney-paired donation (KPD) pool consists of transplant candidates and their incompatible donors, along with nondirected donors (NDDs). In a match run, exchanges are arranged among pairs in the pool via cycles, as well as chains created from NDDs. A problem of importance is how to arrange cycles and chains to optimize the number of transplants. We outline and examine, through example and by simulation, four schemes for selecting potential matches in a realistic model of a KPD system; proposed schemes take account of probabilities that chosen transplants may not be completed as well as allowing for contingency plans when the optimal solution fails.
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SOCIETY NEWS


Registration open for ASTS 2016 Winter Symposium
ASTS
As more patients suffer due to the shortage of life-saving donor organs each year, ASTS is focusing its Winter Symposium on innovative science and effective public policy to combat this crisis. Register today to join us in Miami Jan. 14-17, 2016, to learn what is being done to save lives through expanding organ transplantation — and how you can help.
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Spots still available for ASTS Leadership Development Program
ASTS
There’s still time to register for the 2015 Leadership Development Program Sept. 27-30. This course is the only one of its kind, combining specific case studies and expertise in transplantation with experts in leadership and organizational topics from Northwestern’s Kellogg School of Management.
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Claim your ATC credits by Sept. 30
ASTS
If you haven't claimed your CME credits for attending the 2015 American Transplant Congress, you have until Sept. 30, 2015, to complete your evaluation and claim credits. If you did not receive a link to claim your credits, please contact education@asts.org to ensure your email is up to date.
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TOP NEWS


When brain-dead organ donors were cooled, their kidneys worked better in transplant recipients
Los Angeles Times
Allowing brain-dead organ donors' body temperatures to fall slightly after brain death — rather than following the accepted protocol of keeping donors warmed to a normal body temperature — resulted in more successful kidney transplants in a recent clinical trial, with fewer organ recipients requiring dialysis in their first week after surgery. Once better understood and if eventually adopted, the simple intervention could improve outcomes for the 40 percent or so of kidney transplant patients who experience delayed organ function immediately after transplant and continued problems in the longer term.
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PRODUCT SHOWCASE
 
You care about your transplant patients. And so do we. That’s why we’re introducing Astellas Cares—a new program that offers you customized tools, educational resources, and comprehensive support to help your patients care for their health. To register, visit AstellasCares.com/Transplant today.
 


Gender differences in use of prescription narcotic medications among living kidney donors
Clinical Transplantation (login required)
Prescription narcotic use among living kidney donors is not well described. Using a unique database that integrates national registry identifiers for living kidney donors (1987-2007) in the United States with billing claims from a private health insurer (2000-2007), we identified pharmacy fills for prescription narcotic medications in periods 1-4 and >4 years post-donation, and estimated relative likelihoods of post-donation narcotic use by Cox regression. We also compared narcotic fill rates and medication possession ratios (MPRs, [days of medication dispensed]/[days observed], between donors and age- and sex-matched non-donors.
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1st report on the OPTN national variance: Allocation of A2/A2B deceased donor kidneys to blood group B increases minority transplantation
American Journal of Transplantation (login required)
In 2002, the Organ Procurement and Transplantation Network (OPTN) Minority Affairs Committee (MAC) implemented a national, prospective, "variance of practice" to allow deceased donor, ABO blood group incompatible, A2 antigen, kidney transplantation into blood group B recipients; outcomes of this cohort were compared to ABO compatible recipients. The goal of the variance was to increase the number of transplants to B candidates without negatively impacting survival or compromising system equity. Only B recipients with low anti-A IgG titers were eligible to receive these kidneys.
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It's time to compensate kidney donors
The New York Times
Iran shows that a kidney market need not resemble organ trafficking. Indeed, its market is closely regulated and has pre-empted the exploitative and abusive illegal markets found in many other countries. Iran's program has flaws, such as lack of follow-up for donors and limited support for poor recipients, that are typical of an underdeveloped health system.
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Post-transplantation immunoadsorption can be withheld in ABO-incompatible kidney transplant recipients
Therapeutic Apheresis and Dialysis (login required)
After ABO-incompatible kidney transplantation, postoperative plasma exchange (PE) or immunoadsorption (IA) is performed per protocol or depending on postoperative A/B-titers to prevent acute rejection. However, the need for postoperative PE or IA is not known. Since 2006, 30 consecutive patients received three standard postoperative IAs. Starting from 2009, the last 46 patients received only preoperative IA. Preoperative desensitization consisted of rituximab, tacrolimus, mycophenolate mofetil, prednisone and intravenous immunoglobulins.
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ASTS NewsBrief
Colby Horton, Vice President of Publishing, 469.420.2601
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