Table of Contents

List of Contributors



Section 1 History/Introduction



0 Introduction

Allan D. Kirk and Steven B. Webber



1 A Brief History of Clinical Organ Transplantation

Sir Roy Yorke Calne



Section 2 Transplantation Biology



Immunolgy



2 Physiology of the Immune System

Heth R. Turnquist, Giorgio Raimondi, Diana Metes and Angus W.
Thomson



3 Development of HLA, cross-matching, etc.

Paul Terasaki



4 Transplant Antigen Biology

Raja Rajalingam, Qiuheng Zhang, J. Michael Cecka and Elaine F.
Reed



5 Cellular Mechanisms of Adaptive Immunology

Maria-Luisa Alegre



6 Humoral Mechanisms of Adaptive Immunology

William M. Baldwin III and Robert L. Fairchild



7 Innate Immunity

Melissa Y. Yeung, Sacha A. De Serres and Xian C. Li



8 Mechanisms of Regulation

Kathryn J. Wood, Andrew Bushell and Joanna Hester



9 The Spectrum of Alloimmunity, Heterologous Immunity, and
Relevant Autoimmunity

Mandy L. Ford, Andrew B. Adams and Christian P. Larsen



10 Fundamental Concepts Regarding Graft Injury and
Regeneration: Tissue Injury, Tissue Quality, and Recipient
Factors

Chatchai Kreepala, Konrad S. Famulski and Philip F.
Halloran



11 Mechanisms of Allograft Tolerance

Allan D. Kirk and Raul Badell



12 Xenoimmunity

Peter J. Cowan and Anthony J.F. d?Apice



Experimental Transplantation



13 In Vitro Models of Alloreactivity

Robert L. Fairchild, Charles A. Su, Anna Valujskikh and William
M. Baldwin III



14 Small Animal Models

Lakshman Gunaratnam, Anthony M. Jevnikar and Roslyn B.
Mannon



15 Large Animal Models

Douglas J. Anderson, Benjamin M. Martin, Allan D. Kirk and David
H. Sachs



16 Advancing In Silico: Studying Global Gene Expression
Using Functional Genomics for Transplantation Research

Steven Head, Sunil M. Kurian and Daniel R. Salomon



Mechanisms of Immune Modulation



17 Pathways for Immune Manipulation

Jason R. Lees, Agnes M. Azimzadeh, Yaozhong Ding, Jiangnan Xu
and Jonathan S. Bromberg



18 Future Pathways for Immune Manipulation

Allison Webber and Flavio Vincenti



Section 3 Organ Procurement



Procurement & Allocation



19 Organ Procurement & Allocation

Jennifer Porter, Lori E. Brigham and Susan Gunderson



20 Deceased donor management

John Fung, Koji Hashimoto, Bijan Eghtesad, Daniel J. Lebovitz
and Melissa Watson



Techniques for Organ Procurement



21 Donation after Brain Death

Rupert Oberhuber, Timm Heinbokel, Zain Khalpey, Sayeed Malek and
Stefan G. Tullius



22 Donation after Cardiac Death

Chandrasekar Santhanakrishnan and Anthony M.
D?Alessandro



23 Living Donor: Kidney

Ken Newell



24 Living Donor: Liver

Koji Hashimoto, Cristiano Quintini and Charles M. Miller



Preservation and Resuscitation



25 Organ Preservation and Resuscitation: Abdominal Organs

Henri G.D. Leuvenink and Rutger J. Ploeg



26 Organ Preservation and Resuscitation: Thoracic Organs

Jonathan C. Yeung, Marcelo Cypel, John M. Craig and Shaf
Keshavjee



27 Kidney Paired Donation Networks

Adam W. Bingaman and Cathi L. Murphey



Section 4 Pre-operative Management

Patient Selection and Indications for Organ
Transplantation



28 Patient Selection and Indications for Organ Transplantation:
Kidney

Jeremy Goodman and Robert S. Gaston



29 Patient Selection and Indications for Organ Transplantation:
Liver

Kimberly A. Brown and Marwan Kazimi



30 Patient Selection and Indications for Organ Transplantation:
Heart

Andrew L. Smith and Daniel B. Sims



31 Patient Selection and Indications for Organ Transplantation:
Lung

Edward R. Garrity, Jr. and Julia B. Becker



32 Patient Selection and Indications for Organ Transplantation:
Pancreas & Islet

Alexandra Turner and Nicole A. Turgeon



33 Patient Selection and Indications for Organ Transplantation:
Intestinal & Multivisceral

Douglas G. Farmer and Robert S. Venick



34 Role of Primary Care Provider in Care of Abdominal Organ
Transplant Patients

Peggy B. Hasley, Kristine S. Schonder and Ron Shapiro



35 Role of Primary Care Provider in Care of Thoracic Organ
Transplant Patients

Remzi Bag, Arvind Bhimaraj and Sireesha Garikipati



The Histocompatibility Lab



36 Alloantibodies, Sensitization and Virtual
Crossmatching

Robert Bray and Howard Gebel



Waiting List Management


37 Waiting List Management: Kidney

Phuong-Thu T. Pham, Phunong-Chi T. Pham and Gabriel M.
Danovitch


38 Waiting List Management: Liver

John G. O?Grady



39 Waiting List Management: Heart

Howard J. Eisen



40 Waiting List Management: Lung

E. Clinton Lawrence and David Neujahr



41 Waiting List Management: Pancreas and Islet

Jon S. Odorico


42 Waiting List Management: Intestinal and Multi-visceral

Kareem M. Abu-Elmagd and Guilherme Costa



Intensive Care in End Organ Failure



43 Intensive Care in End Organ Failure: Liver

Ram Subramanian and Jenny Han



44 Intensive Care in End Organ Failure: Heart

Maryl R. Johnson, Josef Stehlik, Deborah Budge and Michael S.
Kiernan


45 Intensive Care in End Organ Failure: Lung

John Adam Reich and R. Eliot Fagley


46 Dialysis

Myriam Farah and John S. Gill


47 Artificial Liver, In Vivo Tissue Engineering, and Organ
Printing ? Solutions for Organ Scarcity

Peter Neuhaus, Igor M. Sauer and Nathanael Raschzok


48 Ventricular Assist Devices

O.H. Frazier and Steven M. Parnis


49 Artificial Heart

Hannah Copeland, Jennifer Berumen, Richard G. Smith and Jack G.
Copeland


50 The Development and Use of Artificial Lungs in Lung
Transplantation

A. Claire Watkins and Bartley P. Griffith



51 Totally Artificial Pancreas

Desmond Barry Keenan and Garry M. Steil


52 Tissue & Organ Bioengineering

Tracy C. Grikscheit and Erik R. Barthel



Organ Acceptance and Risk Management Assessment



53 Standard and Extended Criteria Donors

Stephen T. Bartlett and Matthew Cooper



54 Donation after Cardiac Death

Silke Niederhaus and Anthony M. D?Alessandro



Section 5 Transplant Procedure & Surgical
Technique



55 Kidney Transplantation Procedure & Surgical
Technique

Paul L. Tso and Thomas C. Pearson



56 Liver Transplantation Procedure & Surgical
Technique

Joseph F. Magliocca, Steven I. Hanish, Eugenia K. Page and
Stuart J. Knechtle


57 Living Donor Liver Transplantation Procedure & Surgical
Technique

Sung-Gyu Lee, Deok-Bog Moon and Chung-Man Namgoong


58 Heart Transplantation Procedure & Surgical
Technique

John M. Craig, Soyoung Lee, Gus J. Vlahakes and Joren C.
Madsen


59 Lung Transplantation Procedure & Surgical Technique

R. Duane Davis


60 Pancreas Transplantation Procedure & Surgical
Technique

Jon S. Odorico, Hans Sollinger and Dixon Kaufman



61 Islet Cell Transplantation Procedure & Surgical
Technique

A.M. James Shapiro and Camillo Ricordi



62 Intestinal Transplantation Procedure & Surgical
Technique

Thomas Fishbein


63 Multi-visceral Transplantation

Alan Langnas and Lokesh Bathla


64 Vascularized Composite Allograft (VCA) Transplantation
Procedure & Surgical Technique

Gerald Brandacher, Jaimie T. Shores, Chad R. Gordon, Damon S.
Cooney and W.P. Andrew Lee



Section 6 Post-transplant Management



Immunosuppressive Therapy



65 Induction Therapy

Ali H. Charafeddine and Allan D. Kirk



66 Maintenance Therapy

Karen L. Hardinger, Daniel C. Brennan and Christina L.M.
Klein


67 Rescue Therapy: Approaches to the Treatment of Acute and
Chronic Allograft Injury

Mark D. Stegall and Patrick G. Dean


68 Desensitization Protocols

Carmen Lefaucheur and Denis Glotz



Clinical Allograft Rejection Syndromes: Diagnosis &
Management


69 Clinical Allograft Rejection Syndromes: Kidney

Brian J. Nankivell



70 Clinical Allograft Rejection Syndromes: Liver

Sandy Feng and Matthew H. Levine


71 Clinical Allograft Rejection Syndromes: Heart

Keyur B. Shah, Joren C. Madsen and Mandeep R. Mehra


72 Clinical Allograft Rejection Syndromes: Lung

David C. Neujahr


73 Clinical Allograft Rejection Syndromes: Pancreas and
Islet

Parsia A. Vagefi and Peter G. Stock


74 Clinical Allograft Rejection Syndromes: Intestinal

Gennaro Selvaggi, Andreas Tzakis, Akin Tekin, Jennifer Garcia,
Ji Fan and Philip Ruiz, Jr.


75 Clinical Allograft Rejection Syndromes: VCA

Stefan Schneeberger and Gerald Brandacher


76 Clinical Transplantation Tolerance

Tatsuo Kawai, David H. Sachs and A. Benedict Cosimi


Clinical Recurrent Disease: Diagnosis and Management


77 Post-transplant Recurrent Disease: Kidney and Pancreas

Philip J. O?Connell and Lorna K. Henderson


78 Post-transplant Recurrent Disease: Liver

Samir Parekh and James R. Spivey


79 Post-transplant Recurrent Disease: Heart

Jignesh K. Patel and Jon A. Kobashigawa


80 Post-transplant Recurrent Disease: Lung

Todd L. Astor


Histopathological Syndromes of Graft Rejection and Recurrent
Disease


81 Histopathological Syndromes of Graft Rejection and Recurrent
Disease: Kidney

Alton B. Farris and Michael H. Mengel


82 Histopathological Syndromes of Graft Rejection and Recurrent
Disease: Liver

Anthony J. Demetris, Marta I. Minervini, Michael A. Nalesnik,
Erin Rubin, Parmjeet Randhawa and Eizaburo Sasatomi


83 Histopathological Syndromes of Graft Rejection and Recurrent
Disease: Heart

E. Rene Rodriguez and Carmela D. Tan


84 Histopathological Syndromes of Graft Rejection and Recurrent
Disease: Lung

Carol Farver and W. Dean Wallace


85 Histopathological Syndromes of Graft Rejection and Recurrent
Disease: Pancreas and Islet

Cinthia B. Drachenberg and John C. Papadimitriou


86 Histopathological Syndromes of Graft Rejection and Recurrent
Disease: Intestinal

Phillip Ruiz Jr., Jennifer Garcia, Akin Tekin, Seigo Nishida and
Andreas Tzakis


87 Histopathological Syndromes of Graft Rejection and Recurrent
Disease: VCA

Alexandra P. Turner, Alton B. Farris, III, Alessandrina M.
Freitas and Linda C. Cendales


Post-operative Monitoring


88 Cardiovascular Disease and Preventive Healthcare

Steve Pastan and Divya Gupta


89 Post-Transplant Monitoring for HLA Antibody

Robert A. Bray and Howard M. Gebel


90 Biomarkers and Alloimmune Monitoring

Oriol Bestard, Birgit Sawitzki and Alberto
Sánchez-Fueyo


91 Protective Immune Competence

Aneesh Mehta


Transplant Infectious Diseases


92 Donor-derived Infections

Marissa B. Wilck and Emily A. Blumberg


93 Peri-operative Infectious Disease

Daniel Kaul and Michael Green


94 Post-Transplant Infections

Jay A. Fishman and Robin K. Avery



Malignancy in Transplantation


95 General Malignancy

Oriol Bestard, Josep M. Cruzado and Josep M. Grinyó


96 Post-Transplant Lymphoproliferative Disorders

Steven B. Webber and Michael Green


Pregnancy and Contraception in Transplantation


97 Pregnancy and Contraception in Transplantation

Serban Constantinescu, Veronica Gomez-Lobo, John M. Davison,
Michael J. Moritz, and Vincent T. Armenti


The Transplant Pharmacopeia


98 Drugs Specifically Approved for Transplant Indications

Winston A. Ally and Avinash Agarwal


99 Infectious Disease Prophylaxis

G. Marshall Lyon III


100 Metabolic and Endocrine Management

Naim Issa, Scott A. Reule and Aleksandra Kukla



101 Off-Label Use of Immunosuppressive Agents in Solid Organ
Transplantation

Jill C. Krisl, Rita R. Alloway, and E. Steve Woodle


102 Drug Interactions

William D. Simmons, Pamala A. Jacobson and Karen L.
Hardinger


Section 7 Long-term Transplant Outcomes


103 Long-term Outcomes of Renal Transplant Recipients

Sundus A. Lodhi and Neema Stephens


104 Factors Influencing Long-Term Survival after Liver
Transplantation

Heidi Yeh, Paulo Martins and James F. Markmann


105 Long-term Transplant Outcomes: Heart Transplantation

Michelle M. Kittleson and Jon A. Kobashigawa


106 Long-term Transplant Outcomes: Lung and Heart-Lung
Transplantation

Toshihiro Okamoto, David Wheeler, and Kenneth R. McCurry


107 Long-term Transplant Outcomes: Pancreas
Transplantation

Philip Y. Wai and Hans W. Sollinger


108 Long-term Transplant Outcomes: Islet Transplantation

A.M. James Shapiro and Camillo Ricordi


109 Long-term Transplant Outcomes: Intestinal and Multi-visceral
Transplantation

Jennifer Garcia, Gennaro Selvaggi, Akin Tekin, Philip Ruiz Jr.
and Andreas Tzakis


110 Long-term Transplant Outcomes: Vascularized Composite
Allograft (VCA) Transplantation

Alessandrina M. Freitas and Linda C. Cendales


Section 8 Pediatric Transplant


111 An Introduction to Pediatric Organ Transplantation

Allan D. Kirk and Steven B. Webber


112 Develomental Immunology: From Birth to Adult

Simon Urschel and Lori J. West


113 Pediatric Transplant: Kidney

Bill Harmon


114 Pediatric Transplant: Liver

John C. Bucuvalas and Sandy Feng


115 Pediatric Transplant: Heart

Steven B. Webber


116 Pediatric Transplant: Lung

Stuart C. Sweet and Albert Faro


117 Pediatric Transplant: Intestinal and Multivisceral
Transplant

Douglas G. Farmer


Special Pediatric Considerations


118 Growth and Development After Organ Transplantation

Franz Schaefer


119 Cognitive Development and Functional Outcomes

Estella M. Alonso, Saeed Mohammad and Lisa G. Sorensen


120 Nonadherence, Psychosocial Adaptation and Its Effects in
Pediatric Transplantation

Robert Ettenger and Margaret L. Stuber


121 Management of the Recipient in the Transition from Pediatric
to Adult Care

Sandi Amaral and Lorraine E. Bell


Section 9 Transplant Administration


122 Transplant Coordination

Dianne LaPointe Rudow


123 The Transplant Pharmacy

Christin C. Rogers, Nicole A. Pilch, Eric M. Tichy, Lonnie D.
Smith, David J. Taber and Rita R. Alloway


124 Inpatient Transplant Unit Management

Linda Ohler, Margaret J. Schaeffer, Kelly Carter and Donna B.
George


125 Transplant Clinic Management

Elizabeth A. Kallenborn, Chris Shay-Downer, Kathy Schwab and
Shelley Zomak


126 Transplant Center Management and Leadership ? A Case
for Structured Intrapreneurship

Luke Preczewski, Gwen McNatt and Michael Abecassis


127 Transplant Quality Programs

Christian Morath, Peter Schemmer and Martin G. Zeier


128 National and International Transplant Management and
Oversight

Jeremy Chapman, Virginia A. McBride, Esther-Marie Carmichael and
Linda Ohler



Transplant Education



129 Abdominal Solid Organ Transplantation Fellowship
Training

Rachel C. Forbes and Mitchell L. Henry



130 Medical Solid Organ Transplant Fellowship

Deirdre Sawinski and Roy D. Bloom



131 Transplantation in General Medical Education

Douglas J. Norman and Rowena de los Santos


Section 10 Clinical Trials & Data Management


132 Building and Sustaining a Local Data Management
Program

Regina Eady, Tim Morris, Marc J. Overcash and Jeff
Weaver


133 National Transplant Data Registries and Population
Studies

Allan Massie and Dorry L. Segev


134 Clinical Research Methods and Analysis in Organ
Transplantation

Jesse D. Schold and S. Joseph Kim


135 Comparative Effectiveness in Transplant

Edward A. Meister and Bruce Kaplan


Section 11 Transplant Policy



Transplant Ethics


136 Transplant Ethics for Clinicians

Richard N. Formica Jr. and Francis L. Delmonico



137 Organ Allocation

Richard S. Luskin and Alexandra K. Glazier


138 Living Donation

Alice Peng and Andrew Klein


139 Cultural Variations

Chris J. Callaghan and J. Andrew Bradley


Economic and Societal Impact of Transplantation and
Transplant Policy


140 Federal and Private Insurance Coverage for Transplant
Policy

Timothy L. Pruett


141 Drug Development in Solid Organ Transplantation and the
Approval Process for Transplant Immunosuppressants

Candace Wang, J. Mark Hexham, Alan Slade, Peter Heining, Ronald
Van Valen, Guido Junge and Marc I. Lorber



Index

About the Author

Allan D. Kirk is a Professor of Surgery and Pediatrics and a practicing transplant surgeon and physician at Emory University Hospital and Children's Healthcare of Atlanta. Dr. Kirk was the inaugural Chief of the NIH intramural Transplantation Branch and he has been Principal Investigator (PI) for multiple past and ongoing clinical trials. Dr. Kirk's bibliography contains over 200 peer-reviewed manuscripts and he is Editor-in-Chief of the American Journal of Transplantation.

Joren C. Madsen is the founding Director of the MGH Transplant Center, which encompasses kidney, liver, lung, heart, pancreas and small bowel transplantation and is Co-Director of the Transplantation Biology Research Center, a multi-disciplinary group of scientists translating discoveries in basic immunology into clinical protocols. Dr. Madsen has authored more than 150 publications and served on the editorial boards of Transplantation, the American Journal of Transplantation, and the Annals of Thoracic Surgery. In 2009, Dr. Madsen became the first surgeon to be elected president of the American Society of Transplantation.

Chris Larsen, MD, DPhil, became Dean of Emory University School of Medicine, Vice President for Health Center Integration for the Woodruff Health Sciences Center, and Chairman of the Board of The Emory Clinic in January 2013. An internationally recognized leader in transplant surgery and immunology, Larsen joined the Emory medical faculty in 1991 and was appointed Chair of Surgery in 2009. He became founding director of the Emory Transplant Center (ETC) in 2001, building and directing one of the foremost research and clinical transplantation programs in the world.