The long-term acceptance of living donor transplantation has been based on a combination of excellent recipient outcomes and belief that in actuarial terms, there is no increased risk of living with one kidney. However, recent studies have raised controversy and concerns regarding the long-term risks of CKD in kidney donors. How do we interpret these findings? How do we evaluate and when do we clear donors with pre-existing medical conditions like hypertension, obesity, kidney stones, etc., and convey divergent opinions to patients? Comprehensive donor consent remains at the core of this process. Though perceived as challenging existing assumptions, the disclosure of new data will enable a better understanding of the risks so that potential living donors can make a more meaningful, informed decision.

Objectives:

• Distinguish between “low risk donors” and medically complex living donors.
• Evaluate the meanings of new studies regarding donor risk.
• Refine the current informed consent process in light of the evolving data.

The diagnosis of chronic hepatitis C has been considered a relative or absolute contraindication for non-liver transplantation in the past, due to concerns of liver disease progression post-transplantation and a lack of safe and effective therapies. The recent availability of interferon-free, all-oral, antiviral drug combinations to treat of chronic hepatitis C provides an opportunity to revise management algorithms to optimize the care of non-liver transplant candidates and recipients.

Objectives:

• Describe the components of the new HCV all-oral combinations, the role of ribavirin, and anticipated rates of HCV eradication with treatment
• Summarize the safety data of new HCV therapies as it pertains to non-liver transplant candidates and recipients, including key drug-drug interactions (HCV antivirals and immunosuppressive drugs)
• Evaluate the pros and cons of HCV treatment pre versus post-transplantation, including considerations related to use of anti-HCV positive donors

The goal of this webinar is to describe the available data on pre- and post-transplant immune monitoring and how incorporating specific tests may help us diagnose, predict, and better treat our transplant recipients.

Objectives:

• Summarize the current most promising and best tested urine and peripheral blood, molecular, and cellular assays available for risk assessment following transplantation
• Detail the utility, pitfalls and limitations of currently available assays
• Propose future directions and trial designs required to develop and validate immune monitoring tools for clinical use

Dr. Kotton will describe the importance of prevention, and the various methods of preventing CMV, including; universal prophylaxis, preemptive therapy, and a hybrid approach, along with the merits and downfalls of each approach. Dr. Razonable will review the current recommendations for the treatment of cytomegalovirus infection and disease in transplant recipients, and discuss antiviral drugs in the pipeline that may be useful for the treatment of drug-resistant infections. Dr. Humar will explain how measurements of host immune response to CMV can be used to predict the risk of CMV reactivation in different settings, and how prevention and treatment strategies might be refined with the use of immune monitoring tools.

Objectives:

• Discuss the importance of CMV prevention, along with the various approaches used for optimal prevention
• Explain the standard treatment for CMV infection and disease in transplant recipients and discuss novel antiviral drugs
• Describe the potential for using immune monitoring tools to refine and improve prevention and treatment strategies

This webinar is designed to focus on emerging therapies for HCV in transplant patients with specific attention to drug-drug interactions and limitations in patients with renal disease.

Objectives:

• Define current strategies for HCV treatment in the post transplant recipient
• Describe the limitations of current drug therapy in patients with renal disease
• Explain relevant drug-drug interactions of antiviral therapies with transplant medications

Moderator: Robert Brown, MD

Optimal immunosuppression in organ transplantation is a balance between under immunosuppression, which is associated with graft rejection, and over immunosuppression, which is associated with infection and malignancy. Initial immunosuppression is designed to strike this balance. But how should one adjust immunosuppression when this balance is perturbed and there is an acute infectious complication or malignancy?

After participating in this webinar, the learner will be able to:

• Identify risks for development of acute infectious complications and malignancy in renal transplant recipients.
• Design rational immunosuppression strategies to manage acute infectious complications in renal transplant recipients.
• Design rational immunosuppression strategies to manage malignancy in renal transplant recipients.

Moderator: Harini Chakkera, MD

After participating in this webinar, the learner will be able to:

• Define the components of a successful living donor kidney program to evaluate an efficient number of FTE’s and assistant personnel as well as developing and cultivating a culture within that personnel to best support living donors, their support staff, and their needs.
  
• Appraise the current resource allocation of their current living donor program and analyze where investments might be best undertaken to begin process improvements.
• Evaluate current living donor program metrics beyond number of potential donors and number of organs transplanted to work towards a more critical evaluation of measuring success in personnel activities as well as patient safety and program quality.

AST's Cutting Edge of Transplantation welcomed a record number of attendees to Phoenix February 25 - 27. During nearly 30 hours of sessions over three days, transplant professionals explored the history behind the organ shortage, what we are doing now to address the issues, and the direction we should take going forward. If you missed the meeting, this is your chance to understand the key highlights from CEOT. Dr. Formica will present the major takeaways, covering topics from allocation to organ utilization to policy to incentives/disincentives. This is a truly multidisciplinary webinar which will be useful to all transplant organ specialties. You may have missed CEOT but don't miss this highlights webinar.

Moderator: Nicole Turgeon, MD

The Kidney Allocation System (KAS) was markedly revised on December 4, 2014, resulting in a major early alteration in national kidney distribution. Since a major objective was to provide equity in access to challenged candidates while not compromising vulnerable populations, and allowing for the bolus effects, this presentation will examine first year outcomes and assess the success in meeting the projected KAS goals.

After participating in this webinar, the learner will be able to:

1. Identify the changes in kidney transplant distribution across recipient categories
2. Distinguish the changes which will be maintained at a new level following the resolution of the initial bolus effect
3. Begin to formulate potential modifications to KAS which would further achieve equity in allocation