A Closer Look at the Immunology/Transplantation PRN
Overview of the PRN
The Immunology/Transplantation (IMTR) PRN, founded in 1993, is a professional home for solid organ transplant clinical practice, networking, education, and research for its members. The PRN has 508 members, including 40 residents/fellows and 51 students. The PRN engages its membership in unique learning opportunities, including CE-accredited webinars, educational programming at the ACCP Annual Meeting, social media, educational podcasts, and the creation of resources and toolkits to help individual pharmacists and organizations advance their transplant pharmacy practice. The IMTR PRN is committed to engaging its resident and new practitioner members and has resident representation on all of its committees.
Opportunities and Resources
The IMTR PRN has resident positions on all of its committees, which include the Nominations, Research, Historian and Communications, Programming, Workforce, and Social Media committees and the New Practitioner’s Council. The PRN also has a resident member who serves on its Executive Committee.
The Nominations Committee educates members regarding various national ACCP and PRN awards. This group organizes the annual PRN officer elections and formalizes the process for reviewing and nominating IMTR PRN members for ACCP Fellowship (FCCP). The Nominations Committee also annually recognizes IMTR PRN members with five PRN-specific awards.
The Research Committee is in charge of IMTR PRN Research Seed Grants and Travel Award selection, review, and notification. Each year, the PRN provides travel awards for the Annual Meeting to one or more trainee or early-career members. The PRN also proposes and organizes PRN position (opinion) papers and PRN collaboration manuscripts as needs arise.
Historian and Communications Committee
The Historian and Communications Committee provides up-to-date information and features the outstanding work of PRN members. This committee organizes and distributes the weekly SOT PGY2 Resident Blog. It also maintains an online repository of supportive practice-related documents for IMTR PRN members, including policies, protocols, procedures, and local guidelines. The committee also generates ACCP and joint newsletters with other professional pharmacy organizations and maintains the History section within the IMTR PRN website.
The Programming Committee assesses needs for educational content, including regularly scheduled webinars and CE hours that address members’ needs and interests. This committee also plans programming and solicits speakers for the ACCP Annual Meeting.
The Workforce Committee collects, analyzes, and presents detailed demographic information from the PRN membership, including, but not limited to, practice site, specialty, ongoing research endeavors, and training, to help determine the PRN’s ongoing needs. This group then works with the IMTR PRN Executive Committee chair to execute a 5-year plan to ensure the PRN’s evolving needs are met.
Social Media Committee
The Social Media Committee manages the PRN’s social media accounts, with initiatives such as #ManuscriptMonday, #TraineeTuesday, and #SquadGoals to enhance member and potential member awareness. Follow the PRN on Facebook @ACCP Immunology/Transplantation PRN, Instagram @imtr_prn, and Twitter @accpimtrprn!
New Practitioner’s Council
The New Practitioner’s Council engages the PRN’s early-career members. This group maintains the ACCP PRN Mentorship Program as well as encourages participation in the annual ACCP Virtual Poster Symposium.
Current Clinical Issue
Transplanting HCV-Positive Organs into HCV-Negative Recipients
As of August 2022, more than 105,000 people were on the waitlist in the United States to receive a solid organ transplant according to the Organ Procurement and Transplantation Network. Unfortunately, this greatly outweighs the number of transplants being performed, and about 17–22 people die each day waiting for an organ. Historically, viable organs from hepatitis C virus (HCV)-positive individuals have been discarded because of the risk of seroconversion of HCV, resulting in poor outcomes (including graft loss) if used for solid organ transplantation. Between 2014 and 2016, an estimated 1500 kidneys were declined for transplantation. Now, with the development of pangenotypic direct-acting antivirals (DAAs) that have a high cure rate against HCV, transplanting HCV-seropositive organs into HCV-seronegative recipients is revolutionizing the field of transplantation.
Obtaining DAAs, however, is no easy feat. Many obstacles may present themselves when trying to prescribe DAAs for patients, including insurance and access issues. Workflows need to be established to ensure appropriate therapy initiation and follow-up when transplanting HCV-positive organs into negative recipients, and transplant pharmacists play a major role in this process. The American Society of Transplantation even suggests that HCV viremic donor transplants should only be done in the setting of a structured clinical protocol. A dedicated transplant pharmacy team helps identify the best agent for treatment, assists with monitoring, and evaluates drug-drug interactions with DAA therapy. Financially, there is a huge need for pharmacists to submit prior authorizations and appeals to insurance companies and to obtain financial assistance for the patient (if indicated).1,2
The integration of transplant pharmacists into this process may reduce the time from DAA prescription to insurance approval, as well as the time from transplantation to initiation of DAA therapy. Prompt initiation of DAA therapy is essential to rapidly lowering the HCV viral load. In addition, transplant pharmacists can help their respective provider teams select an appropriate DAA, offer patient education, and ensure patient adherence to DAAs at routine clinic appointments.
Transplanting HCV-seropositive organs into HCV-seronegative recipients has been shown to be a safe and effective method for potentially expanding the donor pool and shortening wait times. Treatment of HCV is essential to this success, and a transplant pharmacy team member is vital to this process.
- Crona L, Berry H, Byrns J, et al. Clinical pharmacy programmatic perspectives on use of direct-acting antivirals for acquired hepatitis C infection in solid organ transplant recipients. Am J Health Syst Pharm 2020;77:1149-52.
- Bova S, Cameron A, Durand C, et al. Access to direct-acting antivirals for hepatitis C–negative transplant recipients receiving organs from hepatitis C–viremic donors. Am J Health Syst Pharm 2022;79:173-8.
Cece Wong, Pharm.D., BCTXP
Anne (Annie) K. Thorndyke, Pharm.D., BCPS, BCTXP
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