The mTOR You Know

What does an elevated dd-cfDNA actually mean—and what doesn’t it mean? In this episode of mTOR You Know, Lauren Schumacher and Kimberly Leale sit down with Dr. Adele Shields and Dr. James Fleming to get into the practical side of using donor-derived cell-free DNA in solid organ transplantation. We talk through how to interpret results, when dd-cfDNA is most useful, common pitfalls and things we might be tempted to over-interpret, how it fits alongside other tools for assessing allograft injury, and what we still need to learn. Plus, we dig into where pharmacists fit into all of this and where the field might be headed next.

Currently approved dd-cfDNA tests:

CareDx (AlloSure) :

• Kidney + SPK: AlloSure Kidney

• Heart: AlloSure Heart
• Lung: AlloSure Lung

Natera (Prospera):

• Kidney: Prospera Kidney
• Heart: Prospera Heart with DQS – dd-cfDNA combined with Donor Quantity Score (DQS)
• Lung: Prospera Lung
• Liver: Prospera Liver

Transplant Genomics/Eurofins

• Kidney: TRAC
• Liver: OmniGraf – dd-cfDNA combined with gene expression

Not to be confused with rejection gene expression assays:

• Kidney: TruGraf – Transplant Genomics
• Liver: OmniGraf – Transplant Gemonics
• Heart: AlloMap - CareDx

What does it actually look like to transition from a specialized clinical role in transplantation to a career in the pharmaceutical industry? In part 2 of this "couch session" episode, host Aileen Chi sits down with industry veterans Drs. John Lyons, Simon Tremblay, and Tim Horwedel will examine the learnings in their career transitions. Tune in for an engaging and candid discussion on how to leverage clinical expertise to make a broader impact on patient care through the pharmaceutical industry.

Join Lauren Richey, PGY2 Solid Organ Transplant Pharmacy Resident at UCSF, as she reviews CMV prevention strategies in high-risk liver transplant recipients. This episode highlights the CAPSAL trial comparing antiviral prophylaxis and preemptive therapy in CMV D+/R− recipients, reviews key updates from the 2025 International CMV Consensus Guidelines, and discusses practical implications for transplant pharmacy practice.

After a long day of "left brain" science and analytics, how do you let your "right brain" take over and unleash your creativity? Transplant pharmacists Alicia Lichvar and Stacy Fredrick join hosts Lauren Schumacher, Kimberly Leale, and Brooke Aston to discuss their awesome artistic passions. From yarn crafts, to cooking, to photography, and more, we discuss how these creative activities inspire them both outside and inside the hospital. Wondering how to get started in an artistic hobby or the first steps of turning your hobby into a side hustle? Our panelists and hosts have some great advice, so tune in and find out!

Check out our panelists' art and give them a follow below!

Alicia Lichvar

• Instagram: @al_on.film

Stacy Fredrick

• Instagram: @forgetmeknotsroc
• Esty: ForgetMeKnotsROC

PGY2 SOT Gillian Stiger joins us from the Hospital of the University of Pennsylvania to discuss “Clazakizumab in the treatment of chronic active antibody-mediated kidney transplant rejection: Results from the IMAGINE phase 3, randomized, double-blind, placebo-controlled study”, as well as a discussion on her residency experience with belatacept rapid conversion for a patient with thrombotic microangiopathy associated with tacrolimus.

PGY2 Solid Organ Transplant Resident Laura Ramirez joins us from UAB Medicine to discuss “Impact of kidney function on 200 days of antiviral prophylaxis for cytomegalovirus disease in cytomegalovirus- seronegative recipients of cytomegalovirus-seropositive donor kidneys: Post hoc analysis of a randomized, phase 3 trial of letermovir vs valganciclovir prophylaxis”

Leah Georgiades, a current PGY2 SOT at UPMC Presbyterian, discusses “The association between glucagon-like peptide 1 receptor agonists therapy and outcomes after heart transplant” as well as her investigation into drug-drug interactions between letermovir and azole antifungals.

What does it actually look like to transition from a specialized clinical role in transplantation to a career in the pharmaceutical industry? In this "couch session" episode, host Aileen Chi sits down with industry veterans Drs. John Lyons, Simon Tremblay, and Tim Horwedel to pull back the curtain on the journey from the clinic to the corporate world. Tune in for an engaging and candid discussion on how to leverage clinical expertise to make a broader impact on patient care through the pharmaceutical industry.

Meet the award-winning pharmacists advancing transplant care. In this episode, we explore the innovation and clinical excellence recognized by the ACCP Transplant PRN and ACCP Foundation.

00:42 – Annual Meeting Travel Award (Resident): Eleni Pikounis

08:04 – Annual Meeting Travel Award (Pharmacist): Dawn Pluckrose

13:20 – Innovative Fund Award: William Baker

19:05 – Research Award: Abbie Leino

28:45 – Foundation Grant Award: Nicole Wilson

PGY2 Solid Organ Transplant resident Caroline Simko joins us from the University of Colorado Hospital to discuss “Low-Dose Valganciclovir for Primary Cytomegalovirus Prophylaxis After Heart Transplant: A 10-Year Experience,” along with reflections on her clinical experience counseling identical twins undergoing living donor transplantation without maintenance immunosuppression.