TTS PRESIDENT PROF. MEHMET HABERAL AND TTS LEADERSHIP AT CAST 2019

The Asian Society of Transplantation (AST) was formed in 1981 and its 16th Congress was organized in New Delhi, India on 29 September – 2 October, 2019. The Congresses of the Asian Society of Transplantation (CAST) are designed to bring to the Asian transplant community an update on the state of the art of the principles and practice of organ donation and transplantation and to provide a forum for sharing best practices and innovations. This congress followed in this tradition by putting together a rich scientific programme to meet these goals. Jointly organized by the 30th Annual Conference of the Indian Society of Organ Transplantation (ISOT), the 5th Centre for Liver and Biliary Sciences (CLBS) Symposium, the Annual Meeting of Indian Society for Heart and Lung Transplantation (INSHLT), and the 16th International Congress of the International Society of Vascularized Composite Allotransplants (ISVCA), a Section of The Transplantation Society, the congress proved to be a great success, drawing 1300 participants from all corners of the world.

Prof. Haberal was invited as the guest of honor, and in addition to several lectures and a role on a deceased donation panel, he was requested to make the opening remarks at the inauguration of the Congress. During his speech, he reiterated the importance of deceased organ donation as a solution to unethical organ transplantation activity as well as the ultimate goal of giving a second chance at life for the many patients with end stage organ failure. Prof. Haberal was then presented with the First Honorary Fellowship of the Indian Society for Organ Transplantation, after which he presented 30 new members with their fellowship certificates, among whom was TTS President-Elect Dr. Marcelo Cantarovich, who also received Honorary Fellowship of ISOT. The meeting, which was endorsed by The Transplantation Society, was also attended by several members of the society’s Executive Council and the India Relations Committee who met with ISOT leadership to discuss current transplant practices in India, and important future steps.

TRANSPLANTATION - WEEK'S MOST DOWNLOADED PAPER

TTS-ILTS PAIRED TRANSPLANT CENTERS PROGRAM
DEADLINE JANUARY 1, 2020

The TTS-ILTS Paired Transplant Centers Program is a collaboration between The Transplantation Society (TTS) and the International Liver Transplantation Society (ILTS) supporting new liver transplant programs in emerging countries.

JUST RELEASED - TRANSPLANTATION - OCTOBER ISSUE

Where is the shortage of liver transplants taking us and have changes to allocation made any differences? Can we improve the organ donor supply with oxygen? Are there practical ways to lead us to xenotransplantation or organ tolerance? Should you operate on the heart while doing a lung transplant? Can we improve the utilisation of living donation through interaction with deceased donor allocation systems? There are many more questions asked and answered in this issue of Transplantation.

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TRANSPLANTATION DIRECT - OCTOBER ISSUE - NOW AVAILABLE

The October issue of Transplantation Direct is out in open-access. Several topics in kidney transplantation are included in this issue, including the promotion of living donation in elderly patients, the aspect of elevated blood pressure in living donors, dealing with monoclonal gammopathy of undetermined significance in recipients, and recommendations regarding treatment options in cases of anti-rabbit, anti-thymocyte globulin antibody development. In liver transplantation, we present articles related to making decisions on proceeding with liver transplantation alone versus waiting for a simultaneous liver-kidney transplant in patients requiring renal replacement therapy, and on using bortezomib against refractory antibody-mediated rejection after ABO incompatible living donor liver transplantation. We also publish a study on outcomes in "Milan-out criteria" liver transplant recipients. Finally, we publish a survey on perceptions of safety during travel associated with organ procurement team activity, which is especially important is this era of aggressive organ utilization due to the organ shortage. Please visit our Transplantation Direct website for full article details.

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TRANSPLANTATION - HIGHLIGHTED ARTICLE

Dr. Andrea Schlegel, Editorial Fellow, Transplantation

SURVIVAL BENEFIT OF LIVER TRANSPLANTATION FOR HEPATOCELLULAR CARCINOMA

Kanneganti M, Mahmud N, Kaplan DE, et al.
Transplantation: Publish Ahead of Print DOI: 10.1097/TP.0000000000002816

In context of an increasing number of patients with an alcoholic or non-alcoholic liver disease, a growing rate of hepatocellular carcinoma (HCC) as primary or secondary indication for liver transplantation (LT) has been described. Although the superior outcomes after liver transplantation for HCC patients is widely known, there was a lack of multifactorial analyses comparing LT, liver resection and radiofrequency ablation (RFA). Authors of this retrospective cohort study have now compared outcomes following such three treatment modalities in a large cohort of 2129 patients at 50-69years of age, between 2008 and 2016. The majority of parameters were equally distributed among the different groups and patients with a MELD score of >15 points at diagnosis were excluded. Almost one third of patients (26,7%; n=658/2129) received a LT, and 244 underwent liver resection (11.5%), while the majority received an ablation of their HCC lesion (n=1,317, 61.59%).

Expectedly, the multivariate analysis confirmed earlier reports with a higher risk of death in the resection and ablation group compared to the liver transplant group (HR: 5.42 and 5.50).

Interestingly, patients who underwent LT were identified with a limited survival benefit of 0.02-0.03 and 0.32-0.42 years, one and three years after LT respectively, with a marginal increase to 1.04-1.24 years at five years after treatment, when compared to patients with resection or ablation. Although authors confirm here earlier findings and demonstrate a benefit of LT over other treatment modalities, the benefit appears rather small due to the limited tumour risk in all three cohorts (mainly single lesions with 2-3cm diameter). Further studies are therefore awaited to link tumour risk factors with donor or graft parameters with subsequent different levels of reperfusion injury, which may expose liver recipients to a higher risk of delayed graft function with subsequent HCC recurrence.

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OCTOBER 23 - WEBINAR ANNOUNCEMENT

TITLE: PSYCHOSOCIAL ASPECTS OF VCA
WEDNESDAY, OCTOBER 23, 2019 - 10:00 AM EDT (MONTREAL TIME)

Objectives:

This webinar will highlight the psychosocial challenges that potential recipients face and the importance of the evaluation and support on outcomes of VCA.