Innovations in Kidney Transplantation, Arjang Djamali, MD, and Dixon B. Kaufman, MD, PhD
Advances in identifying and understanding the immunologic barriers in kidney transplantation are enhancing our ability to preserve the lifesaving potential of solid organ transplantation. This presentation will focus on overcoming immunological barriers in kidney transplantation and the new approaches to immunosuppression minimization.
- Summarize the advantages and disadvantages of calcineurin inhibitor (CNI)-free and prednisone-free immunosuppression in kidney transplant recipients.
- Discuss the management and outcomes of kidney transplantation across ABO, human leukocyte antigen (HLA), and non-HLA barriers.
- Describe the role of desensitization in the current era of kidney transplantation.
- Recognize the need for improved long-term outcomes after transplantation across immunological barriers.
Expanding Access to Liver Transplantation for Patients with Low MELD Scores, Luis Fernandez, MD; Tricia Blum, Living-Liver Donor; and Tawny Holtz, Living-Liver-Donor Recipient
Successful liver transplantation has led to an increased demand for donors even as the organ shortage remains unchanged. And the waiting list for liver transplants is continually changing as the most severe patients are always being placed at the top of the list, resulting in patients with less-severe disease to have a significant wait time. This presentation will focus on expanding access to the donor pool for these patients with a low MELD score (Model for End-Stage Liver Disease) from underutilized resources — such as living donors and donation after cardio-circulatory determination of death (DCDD) — to provide an opportunity for these patients to be transplanted before becoming seriously ill.
- Explain the advantages of live-donor liver transplantation and associated outcomes in comparison to deceased donor transplantation.
- Discuss the rationale for expanding the pediatric-donor pool from living donors and review the long-term outcomes.
- Describe how to safely expand the donor pool using livers from DCDD.
11:15 a.m.–12:15 p.m.
Expanding the Limits of Liver Transplant Candidacy, John Rice, MD
Alcoholic liver disease (ALD) is a common cause of cirrhosis, and hepatocellular carcinoma (HCC) may complicate alcoholic cirrhosis. This presentation will focus on changes in liver-transplant-candidate-selection criteria for HCC and ALD.
- Review the strategy of “ablate and wait” in selecting patients for liver transplantation for HCC outside of traditional Milan criteria.
- Identify changes to the Model for End-Stage Liver Disease (MELD) point allocation for patients with HCC.
- Summarize the medical evidence for six-month sobriety and long-term risk of alcohol relapse after transplantation.
- Discuss the evidence supporting rescue transplantation in selected patients with alcoholic hepatitis and short-term sobriety.
New Horizons in Living-Donor Kidney Transplantation, Didier Mandelbrot, MD; Josh Mezrich, MD; and Jill Dillon, Living-Kidney Donor
The benefits of a living-donor kidney are important for all patients on a kidney transplant wait list. Currently, patients seeking a kidney transplant have more options to consider. This presentation will include living-donor transplant updates, including paired-exchange options, surgical techniques, outcomes and innovations.
- Outline current options for paired kidney exchange, including internal program exchanges, external registries and compatible share.
- Discuss current laparoscopic and robotic surgical trends in donor surgery.
- Describe current trends in kidney transplant and living-donor candidacy and outcomes.
- Summarize innovative trends in living-donor transplant patient care.
Pancreas Transplantation: Expanding Indications and Current Outcomes, Jon S. Odorico, MD, and Tom Nustad, Pancreas Recipient
Successful pancreas transplantation has demonstrated to be efficacious in significantly improving the quality of life for people with diabetes. This presentation will focus on how indications for pancreas transplantation are broadening to include type II- and surgical diabetes as results continue to improve.
- Discuss the varying expanded indications for pancreas transplantation in uremic and nonuremic situations, as well as the outcomes under these conditions.
- Describe the history of the field of pancreas transplantation.
- State current trends in pancreas transplantation.
Promising Avenues in Clinical Tolerance Induction in Kidney Transplantation, Dixon B. Kaufman, MD, PhD, and Peiman Hematti, MD
Allograft rejection is a major barrier to transplantation, therefore, a major goal in transplantation is the induction of tolerance. The possibility of one day being able to completely eliminate the need for chronic immunosuppression in kidney transplant recipients is being successfully explored in several pilot studies in the United States. This session will focus on current research and some of the early results in clinical tolerance induction in kidney transplantation.
- Discuss the methodology of inducing immunological tolerance.
- Describe the transplant-recipient populations that are appropriate candidates for tolerance induction.
- Explore the development of future multicenter trials in clinical tolerance induction for kidney transplantation.