Title: From the Author’s Desk: Innovations in Organ Recovery to Expand the Donor Pool: U.S. and Spanish Approaches to DCD and NRP

Speakers: Drs. Ángel Ruiz, MD of the Hospital Clinic Barcelona, and Jeffrey Stern, MD of NYU Langone

Moderators: Drs. Aleah Brubaker, MD, PhD of UCSD and Chloë Ballesté, MD, PhD of the DTI Foundation, Barcelona

Author: Nitin Katariya, MD, FACS

Learning Objectives:

1. Discuss how to get to a successful pancreas transplant based on donor and recipient matching
2. Emphasize why selection matters
3. Understand the donor data and risk
4. Review imaging and pancreas qualities
5. Assess anatomy, logistics, and decisions

Author: Nitin Katariya, MD, FACS

Learning Objectives:

1. Recognize, diagnose, and manage early surgical complications:
   1. Bleeding, wound infection, graft thrombosis, parenchymal leak, enteric leak, graft pancreatitis, AVF, abscess, bowel obstruction
2. Recognize, diagnose, and manage late surgical complications:
   1. Hernia, bowel obstruction, arterial pseudoaneurysm, vascular stenosis

Pancreas Transplantation

Ryan A. Helmick, MD

Learning Objectives

1. Review the history and formation of the Organ Procurement & Transplant Network (OPTN), as well as its relationship with HRSA and UNOS
2. Identify the functions of the OPTN
3. Discuss how transplant centers relate to the OPTN

A recorded webinar on the topic of simultaneous liver-kidney (SLK) vs. the safety-net approach. Hear from the opposing perspectives from presenting fellows, followed by a Q&A and discussion.

Northwestern University: Pro-SLK

• Fellow presenter: Valeria Valbuena, MD
• Faculty advisor: Vinayak Rohan, MD

University of California, San Francisco: Pro-Safety Net

• Mignote Yilma, MD
• Hillary Braun, MD

Author: Colleen Jay, MD, MSCI, FACS

Learning Objectives:

1. Review the pathophysiology and consequences of brain death.
2. Provide updated evidence-based guidelines for medical management of potential donors.
3. Touch on organ donor evaluation and allocation considerations.
4. Understand the pathophysiology of ischemia reperfusion injury and review the basics of common preservation fluids.

Unit Objectives

I. Understand the moral, ethical and legal issues and steps involved in determining brain death.
II. Understand the moral, ethical and legal issues and steps involved in live organ donation.
III. Describe the basic assessment of the medical, laboratory, and anatomic characteristics of a potential organ donor (live or deceased), the quality of a donor organ, and its suitability for a given recipient.
IV. Outline in detail the procedure to safely recover abdominal organs from deceased donors, including those for donation after cardiac death (DCD).
V. Understand the recovery processes for living donor organs and describe the steps necessary to perform relevant organ specific recovery (liver, kidney, or pancreas).
VI. Outline the basic principles and limits of organ preservation and be familiar with organ preservation techniques, including pulsatile perfusion.

Author: Kelley M.K. Hitchman, MS, PhD, F(ACHI)

Learning Objectives:

1. Review the history and evolution of diagnostic criteria for antibody mediated rejection (AMR).
2. Describe mechanisms in which mismatched donor HLA antigens can cause and contribute to AMR.
3. Explain the components and process of performing a virtual crossmatch, as well as how it is applied as a specialized immunologic risk assessment for transplant pairs.
4. Summarize different timings and manifestations of AMR.
5. Understand how HLA-DSA detection can correlate with rejection and how anti-HLA antibody testing can help inform desensitization.

Author: Kelley M.K. Hitchman, MS, PhD, F(ACHI)

Learning Objectives:

1. List key genes of the Major Histocompatibility Complex (MHC) encoding for HLA molecules and describe MHC inheritance.
2. Summarize MHC and HLA polymorphism, HLA molecule expression and HLA molecule functions.
3. Appraise the role of HLA molecules and peptides in transplantation.
4. Describe test methods utilized by clinical histocompatibility & immunogenetics laboratories for the purposes of HLA typing and anti-HLA antibody detection/identification, as well as the clinical applications of such HLA data.