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Kidney Transplant Education Symposium Shares Advances

In This Article

  • The Massachusetts General Hospital Transplant Center has extensive experience and leadership in kidney transplantation, including options for complex cases and innovative approaches to care
  • The inaugural Mass General Kidney Transplant Symposium will help nephrologists, surgeons, primary care physicians, dialysis staff, nurses, social workers, pharmacists, and others to better manage their patients with kidney disease
  • Faculty will share innovations in the field, including robotic surgery and bedside point-of-care ultrasound
  • Participants will learn how to maximize a patient's health while on the waiting list, tools to monitor rejection, novel approaches to achieve tolerance after transplant, and an initiative to improve care access for historically disadvantaged populations
  • The course is available both in person and virtually, and it will offer continuing education credits to participants

Massachusetts General Hospital is launching a bi-annual symposium to educate healthcare practitioners worldwide on the latest advances and approaches in kidney transplantation. The Inaugural Mass General Kidney Transplant Symposium will review best practices for managing patients with kidney disease, innovations in transplantation, ways to approach challenging cases, kidney disease recurrence, living kidney donation, and more.

"Mass General is home to the leading kidney transplant center in the region. We've been doing transplants for 60 years, and we've performed more than 4,000 kidney transplants, including patients with hundreds of complex cases. We want to share our experience and knowledge with others who care for patients with kidney disease," says Nahel Elias, MD, chair of quality improvement and surgical director of the Kidney Transplant Program at Mass General. "We hope this education and collaboration will help the broader medical community provide better care to this high-risk patient population and make it easier for patients to navigate through the process."

Dr. Elias is codirecting the symposium with Leonardo Riella, MD, PhD, the Harold and Ellen Danser Endowed chair in Transplantation and the medical director of the Kidney Transplant Program at Mass General. Presenters will include experts from Mass General's multidisciplinary kidney transplant team, who will use didactic presentations, case studies, and open discussions, including plenty of time for Q&A with attendees.

Q: Who can benefit from attending this kidney course?

The audience for this course includes anyone on the healthcare team who interacts with patients with kidney disease who may need a kidney transplant in the future, or previous kidney transplant patients. Examples include primary care providers, surgeons, nephrologists, nurse coordinators, social workers, pharmacists, and dialysis unit staff. These may also be providers who see patients and refer them to Mass General for transplant.

Even though these providers may already be familiar with the routine transplant patient, we'd like to expand their knowledge about situations where there are opportunities to diverge from the usual approach, as well as innovations in kidney transplantation.

For example, we'll discuss transplantation options for people over 70 years of age, those with significant comorbidities such as complex cardiovascular disease or cancer, and patients with certain types of kidney disease with a high risk of recurrence.

We'll share our approach to evaluating a patient: Rather than saying yes or no to a transplant—how do we get to yes? We'll review innovative ways we approach immunosuppression and our efforts to increase access to transplantation for ethnic and racial minority patients.

Q. What will attendees learn about navigating kidney transplantation?

Our multidisciplinary team of surgeons, social workers, nurse coordinators, pharmacists, and nutritionists will present on a variety of timely and exciting topics related to our daily care of patients including:

  1. Complications of immunosuppression and unsafe drug-drug interactions post-transplant
  2. Current immunosuppressive regimens used, target drug levels and specific drug indications post-transplant
  3. The risk of disease recurrence post-transplant and advances in genetics of nephrology.
  4. The advantages of living donation and donor risks
  5. Appropriate timing of referral for transplantation and appropriate indications/contraindications for transplant, including available programs for managing challenging patients such as elderly, obese and highly sensitized patients

There are a number of other learning objectives that attendees can expect to gain from this course. View all the learning objectives.

Q. What innovations in kidney transplantation will be covered?

The symposium will allow us to share some of the innovative therapies we're providing. If attendees have patients who might do better with some of these innovations, we would love for them to reach out.

One such innovation is a tolerance protocol that combines a bone marrow transplant with a kidney transplant, which allows some patients to come off immunosuppression completely. Tatsuo Kawai, MD, PhD, director of the new Legoretta Center for Clinical Transplant Tolerance, will present on how to achieve tolerance in kidney transplantation, eliminating the use of immunosuppressive medications and the evolution of this strategy after more than 30 years of research. We'll also discuss some of our post-transplant protocols, such as minimizing certain immunosuppressive medications that carry significant side effects and managing interactions with other drugs.

Other innovations we'll highlight are new diagnostic tools for immune monitoring and point-of-care ultrasound. Often, a patient is either over-immunosuppressed and has infections or other side effects, or they're under-immunosuppressed and we see a rejection. We're using noninvasive monitoring methods to identify rejection before we see a rejection.

Finally, we'll talk about the future of transplantation—xenotransplant, providing organs from animals.

Q. How will the course address equity in kidney transplantation?

Kidney disease is more common in the Black, Hispanic, and Indigenous communities, and unfortunately, these populations' transplant rates are low. Black, Hispanic, and Indigenous patients also have significantly less access to living donation than the white patient population.

Mass General is making groundbreaking efforts to address healthcare disparities through the Mass General Equity in Kidney Transplantation (EqKT) initiative, which is led by a diverse team of English- and Spanish-speaking clinicians who work closely with local providers serving historically disadvantaged patients. We offer virtual and self-referral options to increase access to this lifesaving treatment as well as access to interpreter services for Portuguese, French, and Arabic speakers.

We have also launched a monthly webinar to discuss living donation, including its benefits and highlighting practical strategies with real-life examples of how to increase patient's chance of finding a living donor.

In 2022, we performed more living donor kidney transplants on Black patients than ever before. We're now looking into some opportunities to expand access to more Native American patients as well.

Q. How will symposium attendees change their practice after attending this course?

First, we want to encourage them to start the process earlier and collaborate with us as soon as possible in the course of the patient's kidney disease. There is no such thing as too early. We're glad to see patients and get them on the list early, as this can improve outcomes and quality of life. For example, our approach to early and quick evaluation and decision-making in patients referred before dialysis can help avoid the need for dialysis. Approximately 40% of our patients on the waiting list do not need dialysis.

Second, many things are necessary to maintain a patient's candidacy for transplantation while on the waiting list. Local providers such as nephrologists, primary care physicians, and other providers taking care of these patients will learn ways to help patients maintain their candidacy and optimize their health while they wait.

Third, attendees will be able to identify patients who are candidates for innovative therapy and living donation.

Finally, we will discuss ways to optimize a patient's medication and immune health after transplant.

Register for the Inaugural Mass General Kidney Transplant Symposium

The symposium will be held October 14, 2023, from 9:00 am to 4:00 pm in Somerville, Massachusetts, and online. It will offer continuing education credits to many members of the multidisciplinary team. Breakfast and lunch will be provided.

Learn more and register.

A limited number of Mass General clinicians can receive free tuition on a first-come, first-served basis with discount code MGHDIS4859. Participants will still be responsible for the course fees.

Learn more and register for the Inaugural Mass General Kidney Transplant Symposium

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