TRANSPLANTATION I—PHYSIOLOGIC, HISTOLOGIC, AND PHARMACOLOGIC MARKERS OF GRAFT FUNCTION

Background

Graft survival for all solid organ transplantation procedures is restricted by acute and chronic rejections. The solution to this problem is induction of a state of donor-specific tolerance in the patient so rejections will not occur. Current methods of diagnosing allograft dysfunction are inadequate in that significant organ damage occurs prior to the establishment of a clinical diagnosis. Clinical tolerance remains an elusive goal despite success in animal models. One of the main hurdles in developing tolerance strategies is the lack of a clinical biomarker or a "tolerance assay." The development of assays or novel technologies that will enable detection of allograft dysfunction/rejection, monitor responses to therapy, and predict long-term outcomes is vital for the success of transplantation clinical trials.

Objectives

• Assess graft dysfunction for renal, hepatic, and cardiac allografts by histological criteria and identify newer methods to quantitatively assess the degree of dysfunction
• Define physiological and pharmacological criteria for graft dysfunction and validate the techniques
• Identify areas in need of further diagnostic tool refinement

Agenda

Introduction
Stephen M. Rose, Ph.D., National Institute of Allergy and Infectious Diseases

Physiologic, Histologic, and Pharmacologic Markers of Graft Function
M. Roy First, M.D., University of Cincinnati Medical Center

Markers of Hepatic Function/Rejection
John R. Lake, M.D., University of Minnesota

Use of Surrogate Endpoints in Cardiac Transplantation
Leslie W. Miller, M.D., University of Minnesota

Break

Pharmacokinetic and Pharmacodynamic Surrogates in Transplantation
Barry D. Kahan, Ph.D., M.D., University of Texas Medical School, Houston

Optimal Pharmacological Monitoring of Antirejection Drugs
Giuseppe Remuzzi, M.D., Negri Bergamo Laboratories, Italy

Prediction of Long-Term Renal Allograft Outcome Using Image Analysis of Sirius Red Staining in Protocol Biopsies
Paul C. Grimm, M.D., University of California, San Diego

Immune Parameters Correlating Hyporepsonsiveness
Ronald H. Kerman, Ph.D., University of Texas Medical School

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