ASTS NewsBrief
Feb. 13, 2012

Penny wise, pound foolish? Coverage limits on immunosuppression after kidney transplantation
The New England Journal of Medicine
As a treatment for end-stage renal disease (ESRD), kidney transplantation is superior to dialysis for improving patient survival rates and quality of life. Its long-term success, however, requires ongoing treatment with immunosuppressive drugs. Ironically, although many of the pivotal discoveries related to immunosuppression have been made in the United States, U.S. kidney-transplant recipients do not benefit from a coherent funding policy for these drugs, and thousands of such patients are therefore at risk for allograft failure and premature death. Ensuring lifetime access to these medications for all Americans with kidney transplants would save lives as well as reduce the total cost of treating patients with ESRD.More

Immunosuppressive drug coverage — act now!
ASTS
Earlier this month an article was published in the New England Journal of Medicine by Drs. John Gill and Marcello Tonelli titled "Penny Wise, Pound Foolish? Coverage Limits on Immunosuppression after Kidney Transplantation." The article reports that the United States is the only industrialized nation that offers transplantation without full coverage of immunosuppressive medications. This recent article gives renewed interest and strength to achieve passage of immunosuppressive drug coverage in the upcoming legislative session. This week, Congressmen Michael Burgess, MD (R-TX) and Ron Kind (D-WI) sent a letter to their colleagues highlighting the recent article. ASTS encourages all its members to contact their legislators and urge their support in helping to ensure that all transplant recipients have access to immunosuppressive drug coverage. Learn how to contact your legislators today and help gain their support!More

ASTS call for committee nominations
ASTS
This year, we are making the process easier for committee appointments! We have set up an easy, automated system for members to indicate their interest in serving on a committee. You can also put forth nominations for your colleagues. Click here to submit your nomination. Be sure you include the nominee information, the committees he/she would like to serve and why he/she would be a valuable member to the committee(s). Nominees must be members in good standing and be willing to serve as outlined in the bylaws. Nominations must be submitted by March 18, 2012. More

Hawaii secures new organ transplant center
KITV4-TV
VideoBrief The closures of Hawaii Medical Centers east and west facilities shut down the states only organ transplant center, increasing fears faced by more than 400 Hawaii patients waiting for life-saving transplants. However with Governor Neil Abercrombie signing HB 608 into law, the law secures hope for the patients and their families.More

Kidney donors not at higher risk of needing acute dialysis
Renal & Urology News
Living kidney donors are at no higher risk for requiring acute dialysis than non-donors, according to a study conducted in Canada and the United States. Investigators led by Amit X. Garg, MD, of the University of Western Ontario in London, compared 2,027 living kidney donors with 20,270 matched non-donors. After a median follow-up period of 6.6 years, only one donor received acute dialysis, which translated into 6.5 events per 100,000 person-years, according to an online report in Nephrology Dialysis Transplantation. More

Muscle mass loss in cirrhosis patients linked to higher death rate
Medical News Today
Medical researchers at the University of Alberta reviewed the medical records of more than 100 patients who had a liver scarring condition and discovered those who were losing muscle were more apt to die while waiting for a liver transplant. These cirrhosis patients were placed at a lower spot on the transplant list because they had a higher functioning liver and were seemingly less sick than others with the same condition, based on scoring systems physicians commonly use today. More

African-American kidneys may worsen transplant outcomes
Renal & Urology News
Recipients of kidneys from African Americans (AA) are at increased risk of all-cause and cardiovascular mortality compared with patients who receive kidneys from non-AA donors, investigators reported. Non-AA recipients of AA kidneys also are at increased risk of death-censored graft failure.More

Decreased risk of graft failure with maternal liver transplantation in patients with biliary atresia
American Journal of Transplantation via Wiley Online Library (paid subscription required)
The authors evaluate a national database of pediatric liver transplants as well as their own institutional data and find that there is a decreased risk of graft failure/retransplantation and decreased risk of refractory rejection in biliary atresia patients who receive a maternal liver compared to a paternal one.More

Post-liver transplantation survival outcomes — cardiopulmonary exercise testing helps predict
Medical News Today
According to a study in the February edition of Liver Transplantation, a journal published by Wiley-Blackwell on behalf of the American Association for the Study of Liver Diseases, preoperative cardiopulmonary exercise testing (CPET) is a specific predictor of 90-day survival after liver transplantation. The findings reveal that the CPET measurement, the anaerobic threshold or fitness level, is an important predictor of mortality in patients following transplantation. More

Pharmacokinetics and pharmacodynamics of mycophenolate sodium co-administered with cyclosporine in the early-phase post-kidney transplantation
Clinical Transplantation via Wiley Online Library (paid subscription required)
Mycophenolate drug levels are decreased by co-administration of cyclosporine. However, mycophenolate levels may be associated with insufficient immunosuppression. We investigated the pharmacokinetics of 720 mg mycophenolate sodium and inosine monophosphate dehydrogenase activity under co-medication with cyclosporine and steroids within the first 30 days after kidney transplantation.More

Retained surgical items — prevention system created
Medical News Today
In order to avoid leaving surgical items, such as needles, sponges, retractors, blades and other items used during operations, in the body, surgical teams have relied on counting and recounting the items for decades. However, a new system using innovative technologies has been developed by the University of Michigan Health System. The new system reduces potentially serious medical errors, by ensuring that no foreign objects are accidently left in the patient's body during surgery. More