ASTS NewsBrief
Feb. 9, 2015

Timing of kidney transplants doesn't affect pregnancy chances
Pregnancy outcomes are similar for women who received a kidney transplant whether they were a child or an adult when they got their transplant, a new study says. Researchers reviewed data on women in Australia and New Zealand who received a new kidney and got pregnant at least once between 1963 and 2012.More

CMS QAPI Webinar Series for 2015
ASTS, AST, and representatives from the CMS Survey and Certification Group are pleased to announce a series of webinars on various Quality Assessment and Performance Improvement (QAPI) topics throughout 2015. More

2015 Winter Symposium highlights video
Check out some of the highlights of this year's ASTS State of the Art Winter Symposium!More

New policies added to policy library
New policies have been added to the ASTS Transplant Center Policy Library! The library is available for purchase as an annual subscription service. More

Evaluation of the effect of tofacitinib exposure on outcomes in kidney transplant patients
American Journal of Transplantation (login required)
Tofacitinib fixed-dose regimens attained better kidney function and comparable efficacy to cyclosporine (CsA) in kidney transplant patients, albeit with increased risks of certain adverse events. This post-hoc analysis evaluated whether a patient subgroup with an acceptable risk-benefit profile could be identified. Tofacitinib exposure was a statistically significant predictor of serious infection rate. One-hundred and eighty six kidney transplant patients were re-categorized to above-median (AME) or below-median (BME) exposure groups. More

Trends in kidney transplant outcomes in older adults
In 2011, there were more than 230,000 older adults (aged ≥65) with end-stage renal disease (ESRD), a substantial rise from approximately 50,000 in 1990. The incidence of ESRD is highest in older adults, and individuals with ESRD are living longer, further increasing the prevalence of ESRD in older adults disproportionately to the incidence, but few older adults undergo kidney transplantation (KT) relative to the burden of ESRD in this population. It has previously been identified that 76 percent of older adults with ESRD estimated to be excellent candidates for KT (in the highest quintile of KT outcomes, with predicted 3-year post-KT survival exceeding 87 percent) lack access to transplantation.More

Baseline donor chronic renal injury confers the same transplant survival disadvantage for DCD and DBD kidneys
American Journal of Transplantation (login required)
Histological assessment of baseline chronic kidney injury may discriminate kidneys that are suitable for transplantation, but has not been validated for appraisal of donation after circulatory death (DCD) kidneys. 'Time-zero' biopsies for 371 consecutive, solitary, deceased-donor kidneys transplanted at our center between 2006 and 2010 (65.5 percent DCD, 34.5 percent donation after brain death [DBD]) were reviewed and baseline chronic degenerative injury scored using Remuzzi's classification.More

Solid organ transplantation saved more than 2 million life-years since 1987
In a new retrospective analysis, solid organ transplantation saved more than 2 million life-years, including more than 400,000 among liver transplant recipients, during a 25-year period, according to new study data published in JAMA Surgery. "The 2.3 million life-years saved to date is a stellar accomplishment," the researchers wrote. "These life-years saved are in patients with end-organ failure, who are among the sickest patients." More

National survey of adult transplant hepatologists on the pediatric-to-adult care transition after liver transplantation
Liver Transplantation
Adult transplant hepatologists face challenges in providing care to young adults who received liver transplants during childhood. Because prior studies have focused mainly on pediatric providers, understanding these issues from the perspective of the adult hepatologist may provide novel insights and identify key barriers to care in this population. We conducted a national survey of adult transplant hepatologists to assess factors that may affect the transition of recipients from pediatric care to adult care.More

Lung transplant patients do worse with lungs from heavy drinkers
Medical Xpress
Lung transplant patients who receive lungs from heavy drinkers are nearly nine times more likely to experience a life-threatening complication called primary graft dysfunction, a Loyola University Medical Center study has found. Lungs transplanted from heavy alcohol users also displayed poorer gas-exchange, and transplant recipients spent more time on ventilators, lead author Erin Lowery, M.D., and colleagues report in the journal Alcoholism: Clinical and Experimental Research. More

High-risk age window for mortality in children with cystic fibrosis after lung transplantation
Pediatric Transplantation
LTx in children with CF remains controversial. The UNOS database was queried from 1987 to 2013 for CF patients less than 18 years of age at time of transplant. PCHR model was used to quantify hazard of mortality. Four hundred and eighty-nine recipients were included in the survival analysis. The hazard function of post-transplant mortality was plotted over attained age to identify age window of highest risk, which was 16-20 years. More

Novel drug therapy lowers antibodies in kidney transplant patients
By Lynn Hetzler
A new preoperative drug therapy may reduce antibodies in kidney patients better than using traditional methods, according to a three-year clinical trial led by University of Cincinnati transplant researchers. The novel approach may increase patients' candidacy for kidney transplantation and decrease the chances of rejection. The study, entitled "Prospective Iterative Trial of Proteasome Inhibitor-Based Desensitization" and published in the latest issue of American Journal of Transplantation, shows promise.More