Joint Plenary Presents Best of the Best
From successful
in vivo differentiation of embryonic stem cells into insulin-producing
cells in the pancreas to studies that could improve organ allocation, today's Joint
Plenary session offers American Transplant Congress attendees a look at five "best
of the best" abstracts submitted to ATC 2009. The Joint Plenary will be from 8:30
– 10:00 am in the Auditorium of the Hynes Convention Center.
In what Sudhanshu P. Raikwar, DVM, PhD, calls the first
in vivo study of
its kind, the University of Iowa researcher will address "
In Vivo Differentiation
of Pdx1+CXCR4+ Definitive Endodermal Cells into Insulin Producing Cells Efficiently
Correct Hyperglycemia in Diabetic Mice" during his 8:30 am presentation. He will
describe his team's use of pancreatic transcription factor, Pdx1, to modify embryonic
stem cells into CXCR4+ cells injected into a mouse model. The goal is a promising
novel treatment for type I diabetes.
"We show for the first time that CXCR4+ cells show preferential migration to the
pancreas and specifically into the damaged islets where they spontaneously start
differentiating into insulin producing cells," said Dr. Raikwar, Assistant Research
Professor in the research group of Nicholas Zavazava, MD, PhD, at the University
of Iowa and VA Medical Center, Iowa City.
Initial results from an NIH-funded clinical trial on noninvasive blood and urine
monitoring of the risk of renal allograft injury will be presented by Donald E.
Hricik, MD, Chief of the Division of Transplantation Services at Case Western Reserve
University School of Medicine, Cleveland, Ohio. The abstract, "Early Results from
the Clinical Trials in Organ Transplantation (CTOT-01) Trial Identifying Noninvasive
Markers as Correlates of 6-Month Renal Allograft Pathology," will be presented at
8:45 am.
Transplant surgeon and researcher W. Kenneth Washburn, MD, will address "Are HCC
Candidates Advantaged in the Liver Allocation System?" at 9:00 am. Dr. Washburn,
Transplant Center Surgical Director at the University of Texas Health Science Center,
San Antonio, has examined liver transplant waiting list dropout rates to assess
equal access to organs by both HCC and non-HCC candidates. Liver cancer patients
are given an artificially high MELD (model for end-stage liver disease) score because
waiting list criteria scores HCC patients low.
"Study data suggests HCC patients do have a distinct advantage over non-cancer patients
in access to available organs, which is a situation that may need to be addressed
by the UNOS," he said.
The results of a randomized trial comparing two immunosuppressant drugs will be
presented at 9:30 am by Flavio Vincenti, MD, Professor of Nephrology at the University
of California, San Francisco, in the abstract, "Primary Outcomes from a Randomized,
Phase III Study of Belatacept vs Cyclosporine in Kidney Transplant Recipients (BENEFIT
Study)."
"The study showed that the endpoints of patient survival and graft survival were
similar with a higher numerical rejection rate for belatacept-treated patients early
in the post-transplant period," Dr. Vincenti said. "However, the important endpoint
was that the glomerular filtration rate (GFR), an indicator of renal function, was
significantly better in patients treated with belatacept than those patients treated
with cyclosporine."
The abstract, "Impact of Regional and Center Volume Variation in Pancreatic Allograft
Utilization as Assessed by the Pancreas Risk Index," to be presented at 9:45 am,
shows significant variation in the use of pancreas grafts nationwide. Some regions
appear significantly more aggressive in their use of higher risk organs, said David
Axelrod, MD, MBA, Section Chief of Solid Organ Transplant Surgery with Dartmouth-Hitchcock
Medical Center in Lebanon, N.H.
"We also found that when used in average risk patients, higher risk organs have
better results if you use them with a kidney in a combination transplant," Dr. Axelrod
said.
The study also shows that the more pancreas transplants a center performs, the more
likely the center is to successfully use higher risk organs, he said.