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EHR ‘Nudge’ Linked to Fewer C. Diff Tests for Organ Transplant Recipients

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An antibiotic stewardship program led to fewer Clostridioides difficile (C. diff) tests ordered for solid organ transplant recipients without impacting the negative test rate, a retrospective study found.

Compared with a pre-intervention period, C. diff toxin test orders dropped 47% after a diagnostic stewardship program was enacted (median 18 vs 8.5 processed orders per quarter, respectively, P=0.038), reported Michael Kueht, MD, of the University of Texas Medical Branch in Galveston, and colleagues, writing in Transplantation Proceedings.
Read the full story here.

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Researchers use CareDx solutions to monitor first successful heart xenotransplantation

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CareDx Inc. announced its non-invasive organ transplant surveillance solutions were used to monitor postoperative graft health in the first successful heart xenotransplantation.

According to the press release, surgeons from the University of Maryland School of Medicine (UMSOM) are using versions of two Care-Dx surveillance solutions to monitor the genetically modified pig heart they transplanted into a patient on Jan. 7, 2022. Read more.

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Cancer, Infection Risk Higher in Transplant Patients Than Rejection

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Cancer, infection, and heart disease are greater risk factors for death in kidney transplant recipients who die with a functional graft than organ rejection, a retrospective Mayo Clinic cohort study indicates.

“It’s important to have immunosuppression to protect people from rejection but we wanted to be able to say, ‘What are the other causes of kidney failure that we might be able to identify that help improve longer-term outcomes’,” co-author Andrew Bentall, MBChB, MD, a Mayo Clinic nephrologist, told Medscape Medical News.

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Pioneering protocol could enable transplant recipients to thrive without antirejection drugs

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Performing human-organ transplants without the necessity for a lifetime regimen of immunosuppressive drugs has been an enduring goal for transplantation medicine.

Now, a new protocol being implemented at UCLA Health with select living-donor kidney-transplant patients is bringing that dream closer to reality.

“It is the Holy Grail,” says renal transplant surgeon Jeffrey Veale, MD, who has led the pioneering effort to develop the protocol. Read more.

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Diabetes After a Transplant

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What is “new-onset diabetes” after transplant?

Even if you did not have diabetes before, you may develop diabetes after an organ transplant. This type of diabetes is called “new-onset diabetes” after transplant. It is also called “NODAT” for short. New-onset diabetes can occur as a side effect of the medications that you need to prevent rejection of your new organ. Read more.

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U.S. on pace to top 40,000 transplants in a single year for first time

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“In just the first half of 2021, 21,061 organ transplants have been performed in the U.S. according to data from United Network for Organ Sharing (UNOS), which serves as the Organ Procurement and Transplantation Network under federal contract.

Organ donation from deceased donors is up 15% over last year. There were 900 more deceased donors — people who provided one or more organs to save and enhance the lives of others — between January 1 and June 30 of 2021 than there were during the same period in 2020. The drop in donors caused by the pandemic beginning in the middle of March last year was offset enough by high numbers early in the year that there were still 242 more donors in the first half of 2020 than in the first half of 2019.

Organ transplants from deceased donors are also up — by 11%. A total of 17,821 deceased donor transplants were performed in the U.S. in the first half of 2021 compared to 15,933 in the first six months of last year. 2020 marked the 10th consecutive record breaking year for organ donation from deceased donors and the 8th in a row for deceased donor transplants.”

Read more, here.

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Making transplants without a lifelong regimen of anti-rejection drugs a reality at UCLA Health

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“When he was a medical trainee, UCLA Health nephrologist Erik Lum, MD, was part of a team at Stanford University exploring how to create “tolerance” in kidney-transplant patients — a process that encourages the body to welcome the new organ without the necessity for a lifelong regimen of anti-rejection drugs.

Now, Dr. Lum is among the leaders of a multidisciplinary team making transplant tolerance a reality at UCLA Health. Two kidney transplants have been performed thus far under the advanced protocol, making UCLA Health one of only five medical centers in the world capable of the groundbreaking approach hailed as “the Holy Grail” of transplantation.

“It requires a lot of interplay between different divisions,” Dr. Lum says. “To me, it really demonstrates the strength of a place like UCLA. You can’t do this just anywhere. It’s a huge collaboration.”

The protocol brings together a broad range of specialties, including nephrology, urology, hematology, radiation oncology and others, for a series of treatments that prime the transplant recipient’s body to accept the new organ.”

Learn more, here.

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Making allocation more fair and flexible

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“The organ donation and transplantation system in the U.S. has never worked better than it does today. Deceased donor transplants have increased for 10 consecutive years, and 26% more organ transplants are performed today than five years ago. But every day, we work to continuously improve and make the system even more effective and efficient to serve all of the patients waiting for a lifesaving transplant.

As part of these efforts, the organ donation and transplant community is working together to introduce a more fair and flexible approach to allocating donated organs to get the right organ to the right patient at the right time. Our policies have always been data-driven, but this new approach applies advanced analytic techniques to create an algorithm that makes every factor in the match run comparable.

Called continuous distribution, this new framework moves organ allocation from placing and considering patients by classifications to considering multiple factors all at once using an overall score. Doing so will dissolve hard boundaries that exist in the current, category-based system and ensure that no single factor determines a patient’s priority on the waiting list.

Read more, here.

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