TTS Pulse Podcast

In this episode of Behind the Paper, Macey Levan, Social Media Editor for the Transplantation journals, speaks with Babak J. Orandi, MD, about the article:

Antiobesity Interventions in Living Organ Donor Candidates: Ethical and Policy Considerations

The discussion focuses on the ethical and policy questions raised by antiobesity interventions for living organ donor candidates. Dr. Orandi explains how obesity can affect donor eligibility and why weight management should be approached as long-term care rather than simply meeting a temporary BMI threshold to enable donation.

The episode explores the four major principles of bioethics — autonomy, beneficence, non-maleficence, and justice — and how they apply to living donor evaluation. Dr. Orandi also discusses the growing role of GLP-1 medications, access to treatment, donor safety, and legal and ethical concerns related to funding weight-loss interventions before donation.

The conversation highlights the importance of sustainable obesity management, better long-term follow-up data, and updated guidance from transplant societies as antiobesity therapies become more widely used.

Read the article:

https://journals.lww.com/transplantjournal/abstract/10.1097/tp.0000000000005719~antiobesity-interventions-in-living-organ-donor-candidates?redirectionsource=fulltextview

Presented by Transplantation and the Transplantation Journals.

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#Transplantation #LivingDonation #ObesityMedicine

In this episode of Behind the Paper, Macey Levan, Social Media Editor for the Transplantation journals, speaks with Rohit Gaurav, FRCS, about his article:

Sequential In Situ Normothermic Regional Perfusion and Ex Situ Normothermic Machine Perfusion in Controlled Donation After Circulatory Death Liver Transplantation: A Retrospective Single-center Experience

The discussion focuses on the use of sequential normothermic regional perfusion, or NRP, and normothermic machine perfusion, or NMP, in controlled donation after circulatory death liver transplantation.

Dr. Gaurav explains how DCD livers have historically presented challenges due to hypoxia, ischemia, and biliary complications, and how NRP and NMP can help transplant teams assess organ function and improve liver utilization.

The episode explores lactate clearance, liver enzyme assessment, post-reperfusion outcomes, biliary complications, and the role of machine perfusion in expanding the safe use of DCD organs. Dr. Gaurav also discusses how implementation of these techniques has increased DCD liver utilization at his center and how this approach is shaping broader practice in the United Kingdom.

Read the article:

https://journals.lww.com/transplantjournal/abstract/10.1097/tp.0000000000005659~sequential-in-situ-normothermic-regional-perfusion-and-ex?redirectionsource=fulltextview

Presented by Transplantation and the Transplantation Journals.

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#Transplantation #LiverTransplantation #DCD

In this episode of Behind the Paper, Macey Levan, Social Media Editor for the Transplantation journals, speaks with Gabriel E. Gondolesi, Marti Manyalich, and Steven Potter about their article:

Clarifying the Donation After Circulatory Death Process: Addressing Misunderstandings, Correcting Misinformation, and Building Trust Through Education

The discussion focuses on donation after circulatory death, or DCD, and why clear communication, standardized protocols, and professional education are essential to maintaining public trust in organ donation and transplantation.

The episode explores how misinformation and media narratives can affect donation rates, the importance of separating end-of-life care decisions from organ procurement, the role of the no-touch period, and why ICU clinicians need consistent training around DCD processes.

The authors also discuss international experience with DCD programs, including lessons from Spain, and emphasize that DCD should be understood as a safe, ethical, and established part of modern deceased organ donation.

Read the article:

https://doi.org/10.1097/TP.0000000000005754

Presented by Transplantation and the Transplantation Journals.

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#Transplantation #OrganDonation #DCD

In this Behind the Paper episode, Macey Levan, Social Media Editor for the *Transplantation* journals, interviews Dimitrios Morris, MD about the key insights from:

📄 **Transplant Surgery: Sustaining a Workforce at a Critical Juncture**

Commentary

Published in *Transplantation* (July 2026)

This commentary examines the growing challenges facing the transplant surgery workforce at a time when the field continues to evolve through innovation, increasing clinical complexity, and expanding expectations. The conversation explores why workforce sustainability is not only a matter of surgeon well-being, but also essential to maintaining organ utilization, equity, and public trust.

The episode highlights:

🔹 Why transplant surgery is facing declining interest among general surgery residents

🔹 How unpredictable schedules and high-acuity care contribute to workforce strain

🔹 Why fellowship training must better reflect the realities of modern transplant practice

🔹 How academic promotion pathways can better recognize transplant surgeons’ contributions

🔹 The importance of clinical excellence, applied scholarship, and systems leadership

🔹 Why attracting ambitious, idealistic, and resilient future leaders is critical to the field’s future

Dr. Morris emphasizes that sustaining the transplant surgery workforce will require structural reform, not simply individual resilience. The discussion also highlights reasons for optimism, including continued innovation in machine perfusion, expanding surgical techniques, and the field’s growing ability to treat more complex disease processes.

📖 Read the full article:

https://journals.lww.com/transplantjournal/fulltext/2026/07000/transplant_surgery__sustaining_a_workforce_at_a.5.aspx

In this Behind the Paper episode, Macey Levan, Social Media Editor for the *Transplantation* journals, interviews Bethany Foster, MD, a pediatric nephrologist and professor at McGill University, about the key insights from:

📄 Sex Disparities in Transplantation Access and Outcomes: An Overview

Review Article

Published in *Transplantation* (April 2026)

This review explores how sex disparities affect access to and outcomes after solid organ transplantation, including kidney, heart, liver, and lung transplantation. The conversation examines the barriers women may face throughout the transplant journey, from referral and waitlisting to transplantation and post-transplant outcomes.

The episode highlights:

🔹 How women may experience reduced access to transplant evaluation, waitlisting, and transplantation

🔹 Why sex disparities appear more pronounced in older age groups

🔹 How unconscious or conscious bias may influence clinical decision-making

🔹 The role of perceived frailty, obesity, and risk assessment in transplant access

🔹 How biologic differences and gendered behaviors may affect outcomes after transplant

🔹 Why more objective referral criteria and allocation systems are important for improving equity

Dr. Foster emphasizes that women benefit significantly from transplantation, but that achieving equitable access and outcomes requires a better understanding of both systemic and biologic factors. The discussion underscores the need for continued research, policy updates, and a shared commitment from transplant professionals to reduce disparities across the transplant pathway.

📖 Read the full article:

https://journals.lww.com/transplantjournal/abstract/2026/04000/sex_disparities_in_transplantation_access_and.18.aspx

In this Behind the Paper episode, Macey Levan, Social Media Editor for the Transplantation journals, interviews Robert Rolfe, MD about the key insights from:

📄 **Travel After Transplant: Demographics, Travel Trends, and Vaccination Practices of US Immunocompromised Travelers**

Original Clinical Science—General

Published in *Transplantation* (April 2026)

This study describes the largest reported cohort of immunocompromised post-transplant travelers to date, drawing on data from **17 US clinical sites** collected between **2009 and 2023**. The conversation explores how international travel is evolving among transplant recipients and why pretravel preparation is especially important for this higher-risk population.

The episode highlights:

🔹 How travel patterns differ for immunocompromised post-transplant travelers compared with other travelers

🔹 Why visiting friends and relatives and cruise travel were more commonly reported in this group

🔹 The added complexity of pretravel counseling for transplant recipients

🔹 How immunocompromise influences vaccine decision-making before international travel

🔹 Why understanding travel trends in this population is essential to improving preparation, prevention, and outcomes

This discussion offers an important look at a growing area of transplant medicine, where individualized risk assessment, practical guidance, and preventive care can make travel safer for immunocompromised patients.

📖 Read the full article:

https://journals.lww.com/transplantjournal/abstract/2026/04000/travel_after_transplant__demographics,_travel.28.aspx

In this Behind the Paper episode, Macey Levan, MD and Leonardo V. Riella, MD discuss the key insights from:

📄 Advancing Hope Through Science: The Inaugural Richard Slayman International Workshop on Xenotransplantation

Meeting Report – Published in *Transplantation* (February 2026)

This landmark workshop brought together more than 140 participants from North America, Europe, and Asia to examine the latest advances—and the remaining challenges—in translating xenotransplantation from bench to bedside.

Framed by the legacy of Richard Slayman, the first living recipient of a genetically edited pig kidney, this conversation explores how patient courage, scientific collaboration, and careful clinical design are helping move the field from possibility toward reality.

The episode highlights:

🔹 Why patient selection is critical in early xenotransplantation trials

🔹 How genetic editing is helping overcome immune incompatibility

🔹 The evolving role of immunosuppression, including complement inhibition and CD154 blockade

🔹 New molecular tools for immune and infectious surveillance

🔹 The importance of transparency, ethics, and global collaboration

🔹 What the next 5–10 years may look like for kidney xenotransplantation

This discussion offers an important look at one of the most promising and complex frontiers in transplantation—where innovation, safety, and patient-centered care must advance together.

📖 Read the full paper:

https://journals.lww.com/transplantjournal/fulltext/9900/advancing_hope_through_science__the_inaugural.1314.aspx

In this special *Behind the Paper* panel, Cynthia Tsien, Tanjala Purnell, PhD, MPH, Nazia Selzner, MD, PhD, and Stefan G. Tullius (Editor-in-Chief, *Transplantation*) discuss the key insights from:

📄 **Global Strategies for Advancing Diversity, Equity, and Inclusion in Transplantation: Insights From the Inaugural International Congress**

Perspectives: Meeting Report – Published in *Transplantation* (February 2026)

Despite decades of progress in transplantation science, inequities persist — affecting both the transplant workforce and the patients we serve. Many professionals report challenges related to gender, race, or sexual orientation, as well as inequities in leadership opportunities, promotion, and compensation. These structural barriers contribute to work-related stress and burnout.

At the same time, disparities in access to transplantation remain evident across all organ types and throughout every stage of the transplant process — from referral to waitlisting to post-transplant outcomes.

This discussion highlights the outcomes of a landmark international conference held in Toronto, Canada (September 13–14, 2024), which convened global transplant leaders, clinicians, nurses, researchers, and patients across organ groups. Endorsed by multiple international transplant societies, the meeting identified critical workforce and patient-centered inequities — and proposed actionable strategies for systemic change.

The panel explores:

🔹 Structural inequities within transplant professional environments

🔹 Persistent disparities in patient access and outcomes

🔹 Leadership representation and pathways to advancement

🔹 Burnout, inclusion, and psychological safety in transplant teams

🔹 Global collaboration and accountability frameworks

🔹 Policy and institutional strategies to advance equity

This important conversation provides practical recommendations for institutions, societies, policymakers, and transplant professionals committed to building a more inclusive and equitable transplant ecosystem worldwide.

📊 Read the full meeting report:

https://journals.lww.com/transplantjournal/fulltext/2026/03000/global_strategies_for_advancing_diversity,_equity,.2.aspx

In this special panel, Stefan G. Tullius, MD, PhD (Editor-in-Chief, Transplantation), Friederike Martin, MD, and Beatriz Domínguez-Gil, MD, PhD discuss the findings of the landmark publication:

📄 Organ Donation and Transplantation Worldwide: The Global Observatory on Donation and Transplantation 2024 Report

Published in Transplantation (March 2026) 

In 2024, a record 173,727 solid organ transplants were performed worldwide — the highest number ever reported to the Global Observatory on Donation and Transplantation (GODT). This represents a 2% increase from 2023, largely driven by growth in deceased donation, including continued expansion of donation after circulatory determination of death (DCD), which accounted for 28% of all deceased donations.

The panel explores:

🔹 Global transplant activity trends across regions

🔹 The continued gap between supply and demand (over 668,000 patients waitlisted globally)

🔹 Geographic disparities in access to transplantation

🔹 The impact of DCD expansion and donor utilization rates

🔹 Ethical frameworks, transparency, and global benchmarking

🔹 The role of WHO and international collaboration in strengthening transplant systems

Despite record-breaking numbers, more than 31,000 patients died in 2024 while waiting for a transplant, underscoring the ongoing global organ shortage and inequities in access.

This discussion provides critical insights for clinicians, policymakers, researchers, and transplant professionals committed to expanding ethical access and strengthening donation systems worldwide.

📊 Read the full report:

https://journals.lww.com/transplantjournal/fulltext/2026/03000/organ_donation_and_transplantation_worldwide__the.25.aspx

#OrganDonation #Transplantation #GlobalHealth #WHO #GODT #DCD #HealthEquity #SolidOrganTransplant #TransplantationJournal

Federally Funded Research in Transplantation: Achievements, Strategy, and Vision

Federal investment—particularly through the National Institutes of Health—has been central to many of the most important advances in transplantation. From foundational discoveries in alloimmunity to the translation of innovative ideas into clinical practice, publicly funded research has shaped how the field looks today.

In this News and Views / Short Report discussion, Macey Levan is joined by Satish N. Nadig, author of Federally Funded Research in Transplantation: Achievements, Strategy, and Vision, along with experts Jonathan Bromberg and Anita Chong, for a conversation on the impact of federal funding in transplantation research.

Together, they reflect on:

Key scientific and clinical achievements made possible through federal support

How sustained funding enables long-term, high-impact research

Ongoing challenges and unmet needs in transplantation

Why continued investment is essential to drive future breakthroughs and improve patient outcomes

The discussion highlights how strategic, federally funded research not only advances science but also strengthens the pipeline from discovery to real-world clinical impact.

📄 Read the publication:

Federally Funded Research in Transplantation: Achievements, Strategy, and Vision

https://journals.lww.com/transplantjournal/fulltext/2026/02000/federally_funded_research_in_transplantation_.1.aspx

About the Journal

Transplantation is the official journal of The Transplantation Society. Published monthly, it is one of the most highly cited journals in the field, with more than 25,000 citations per year.

https://transplantjournal.com

The Transplantation Society

Learn more about the journal and society initiatives:

https://tts.org/journal/transplantation