Bennett  

Transplantation: Medical and Immunosuppressive Management

(William Bennett, MD. ASN Board Review, 2006). What is the basis for the standard immunosuppression protocols in use currently? When do we use lymphocyte depleting agents or anti-IL2 monoclonal antibodies? How do we assess immunologic and non-immunologic risk and tailor immunosuppression accordingly? Which is better, cyclosporin or tacrolimus, and how is each drug best monitored? What is the basis for chronic allograft nephropathy, and how can we prevent and treat this? What is the state of knowledge regarding steroid avoidance or reduction regiments? When is it appropriate to reduce or eliminate calcineurin inhibitors from the mix? What are indications for expanded criteria donor kidneys? What are the transplant complications relating to osteoporosis, uric acid, and electrolyte disorders? How do we prevent or lower the risk for anemia and cancer? How do we approach fever in the transplant recipient? How do we treat polyomavirus nephropathy? What are the drug interactions among immunosuppressive medications?
(more...)



Murphy  

Rigatto  

Mannon  

Transplantation: Key Issues for the General Nephrologist     

Rigatto: How does cardiovascular disease manifest in transplant patients and how should we manage it? What are the BP targets, lipid, and HbA1c goals, and indications for beta-blockers, ASA, and statins? What did the ALERT trial show re fluvastatin? What is the impact of pre-emptive transplantation on CVD? Murphy: What is the epidemiology of chronic allograft nephropathy? What are the management options in terms of prevention protocols? With calcineurin withdrawal protocols, what are results using MMF or alternatively, sirolimus? What are the data using belatacept? Campath (alemtuzumab)? Mannon: What are our choices for maintenance immunosuppression agents? Induction agents? What are some of the standard regimens? What are mechanisms of actions of the major drug classes? What are common drug interactions? Side effects? Toxicities? What approaches can we use to achieve calcineurin-free immunosuppression? Steroid-free immunosuppresssion? What are the newer agents on the horizon? (2.0 CME credits)
(more...)

key Try Dr. Abbott's MATCHING quiz: Transplant Med Side Effects. This two-part matching quiz covers common side effects of drugs used to prevent allograft rejection. Make sure you click on the link at the bottom of the first page to also take Part Two.


Updated: July 22, 2008 (J22)
J22 Vagal nerve stimulation suppresses spleen production of TNF: A brain to immune system connection?
J21 Advance lowers risk of rejection of animal tissues.
J21 Singapore mulls legal kidney trading.
J18 Donor nephrectomy via umbilical incision shortens donor post-op recovery time.
J17 FDA retracts Salmonella-related warning against eating raw tomatoes. Peppers still a potential risk factor.
J17 Peptidoglycans from gut bacteria may induce C. albicans to transform into infectious variant.
J17 NEJM study shows that IVIG plus rituximab increases transplant success rates in HLA-sensitized patients.
J16 Has the Achilles heel of the HIV virus been located?
J16 Cyclosporine increases expression of VEGF. Is this a mechanism for post-transplant cancer risk?
J15 Are kidney transplants performed at night less successful? A small European study suggests this possibility.
J14 Track the 2008 U.S. Transplant Games
J13 Histone deacetylase (HDAC) inhibitor SAHA found to have anti-immune effects in graft vs. host disease.
J11 FDA lists May 2008 labeling changes: Aranesp (tumor progression) and CellCept (lymphoma and PML risk)
J10 Histone deactylase (HDAC) inhibitors protect ischemic tissue from injury.
J10 Computational biology approach leads to better understanding of immune response to presented antigen.
Industry Advances Emphasis
archive
ASTS 7th Annual Winter Symposium ASTS; 01-07
Transplantation: Medical and Immunosuppressive Management ASN Board Review 2006
Chronic Allograft Nephropathy: The Tough Questions Remain (Halloran, Colvin, Meier-Kriesche, Becker, Chapman) AST 2006
How We Reject a Graft: The Balance Between Acceptance and Rejection (Rothstein, Sayegh, Halloran, Bromberg, Najafian, Valujskikh, Murphy) AST Pre-Meeting Immunobiology Symposium 2006
Post-Transplant Infections: Updating the General Nephrologist (Rubin, Pescovitz, Ramos) ASN Renal Week 2005
Transplantation: Key Issues for the General Nephrologist (Murphy, Rigatto, Mannon) ASN Renal Week 2005
State-of-the-Art Lecture : Tipping the Immune Balance Toward Tolerance (Strom) ASN Renal Week 2005 (audiofiles)
The Spectrum of Sensitization Before and After Transplantation: Management Issues (Tinckam, Akalin, Watschinger, Jordan) ASN Renal Week 2005 (audiofiles)
The High Risk Transplant Patient (Kiberd, Wali, Adey, Chapman, Chandraker) ASN Renal Week 2005 (audiofiles)
State-of-the-Art Lecture : Tipping the Immune Balance Toward Tolerance (Strom) ASN Renal Week 2005 (audiofiles)
Managing the Transplant Patient: What the General Nephrologist Needs to Know (Helderman, Blumberg, Kasiske, Abbott) ASN Renal Week 2005 (audiofiles)
New Immunosuppressive Agents in Renal Transplantation (Steinberg, Grinyo, Knechtle) ASN Renal Week 2005 (audiofiles)
Highlights from the 2005 American Transplant Congress: Renal Transplantation (Gallon, Vanrenterghem, Mannon) ASN Renal Week 2005 (audiofiles)
Transplantation: What the General Nephrologist Must Know (Parts 1 and 2) (Norman, Tinckam, Danovitch, Chandraker, Nast, Davis; Kasiske, Pavlakis, Brennan, Josephson, Davis) ASN Renal Week 2005 (audiofiles)
Transplantation: What the General Nephrologist Must Know (Parts 3 and 4) (Heeger, Hricik, Danovitch, Chapman, Bunnapradist, Gabardi; Akalin, Chandraker, Martin, Cohen, Thomas) ASN Renal Week 2005 (audiofiles)
Donor / Recipient Evaluation (Davis) ASN 2004
B Cell and the Humoral Alloimmune Response (Denton) ASN 2004
Chronic Allograft Nephropathy and Recurrent Disease (Nankivell) ASN 2004
Immunosuppression: Induction and Maintenance (Vincenti) ASN 2004
Infectious Diseases After Immunosuppression in the Non-Transplant Kidney Patient Population (Brennan) ASN 2004
New Infectious Timeline (Davis) ASN 2004
Infections and Renal Complications of Immunosuppression: An Update (Roth) ASN 2004
CMV infection and management (Brennan) ASN Renal Week
Polyoma virus (Hirsch) ASN Renal Week
New viral infection: HHV-6, west nile virus (Limaye) ASN Renal Week
Hepatitis and the renal transplant recipient (Pereira) ASN Renal Week
Evaluation and management of the hepatitis C virus infected pretransplant candidate (Roth) ASN Renal Week
Post-transplant diabetes mellitus (Weir) ASN Renal Week

Atherosclerotic renal artery stenosis: overtreated but underrated? J Am Soc Nephrol (Apr 2008)
Trends in organ donation and transplantation in the United States, 1997-2006 Am J Transplant (Apr 2008)
Transplant glomerulopathy Am J Transplant (Mar 2008)
A randomized, multicenter study of steroid avoidance, early steroid withdrawal or standard steroid therapy in kidney transplant recipients Am J Transplant (Feb 2008)
Rapid remission of steroid and mycophenolate mofetil-resistant minimal change nephrotic syndrome after rituximab therapy Nephrol Dial Transplant (Jan 2008)
Alemtuzumab (Campath-1H) in kidney transplantation Am J Transplant (Jan 2008)
Renal transplantation in the ANCA-associated vasculitides (Geetha et al) Am J Transplant (Dec 2007)
Evaluation of adult kidney transplant candidates (Bunnapradist et al) Am J Kidney Dis (Nov 2007)
Immunosuppression minimization in pediatric transplantation (Sarwal et al) Am J Transplant (Oct 2007)
Organ donation after cardiac death (Steinbrook) N Engl J Med (Jul 2007)
Checklist: Passport, plane ticket, organ transplant (Bramstedt et al) Am J Transplant (Jul 2007)
Conditional gene expression: a new tool for the transplantologist Am J Transplant 04-07
Report of the First World Transplant Congress (Cravdei et al) CJASN (03-2007)
Report of the First World Transplant Congress CJASN 03-07
The interleukin-12 family: new players in transplantation immunity? Am J Transplant 02-07
The interleukin-12 family: new players in transplantation immunity? (Goriely, Goldman) Am J Transplant (02-2007)
Gal knockout and beyond (Zhong) Am J Transplant 01-07
Gal knockout and beyond (Zhong) Am J Transplant (01-2007)
Pathogenesis and prevention of bone loss in patients who have kidney disease and receive long-term immunosuppression JASN (01-2007)
Recurrent glomerulonephritis after kidney transplantation (Choy, Chan, Lai) Am J Transplant 11-06
Emerging issues in hepatitis C virus-positive liver and kidney transplant recipients (Bloom and Lake). Am J Transplant 10-06
Developments in clinical islet, liver thoracic, kidney and pancreas transplantation in the last 5 years (Feng et al) Am J Transplant 07-06
TRANSPLANT LINKS
Am Soc Transplantation
Am Soc Transplant Surgeons
NAPRTCS
Renal Pathology Society
Transweb
UNOS
U.S. Transplant Reports
NKF Transplantation

CTS: List of links
HDCN Topic Pages (KEY)
Transplantation
Cyclosporine and the kidney
Hypertension in Tx Patients
CLINICAL TRIALS
Clinical Trials.gov
CONGRESSES, MEETINGS
UNOS Calendar
AST Meeting Archives
Upcoming AST meetings  (2007-2009)
INDUSTRY SPONSORED
Tx Square (Novartis)
ROTRF (Roche)
Walter Reed Army Medical Center

Dr. Kevin C. Abbott, LTC, MC
Director, Dialysis, Nephrology Service
Chief, Research and Development, Telemedicine, Walter Reed Army Medical Center, Washington, DC