<em>Decision-IQ:</em> How to Manage a Highly Sensitized Kidney Transplant Candidate

Decision-IQ: How to Manage a Highly Sensitized Kidney Transplant Candidate

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Developed in collaboration
Med-IQ      Duke Medicine

Online Course | Specialties: Nephrology, Transplant (Clinical and Surgical)
Released: 3/22/2022
Expires: 3/21/2023
Max Credits: 0.25
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Annette M. Jackson, PhD, F(ACHI)
Associate Professor, Departments of Surgery & Immunology
Chief, Clinical Transplantation Immunology Research
Director, Clinical Transplantation Immunology Laboratory
Duke University Medical Center
Durham, NC

Stuart J. Knechtle, MD
William R. Kenan, Jr. Professor of Surgery
Kidney/Pancreas Transplant Surgeon
Duke University Medical Center
Durham, NC
Activity Planners
Amy Burdette, PhD
Manager, Educational Strategy & Content
Baltimore, MD

Kerry Kennedy, ELS
Editorial Manager
Baltimore, MD

Laura Rafferty, ELS
Senior Editorial Manager
Baltimore, MD

Samantha Gordon, MS
Accreditation Manager
Baltimore, MD

Amy Sison
Director of CME
Baltimore, MD
Learning Objective
Upon completion, participants should be able to:

  • Integrate the latest clinical evidence to optimally manage a highly sensitized kidney transplant candidate

Target Audience
This activity is intended for nephrologists, transplant surgeons, and nephrology-related nurse practitioners, physician assistants, and nurses.
Statement of Need
Survival and quality-of-life outcomes for patients with end-stage renal disease are better in those who undergo kidney transplants compared with those who undergo dialysis. However, human leukocyte antigen (HLA) sensitization is a major barrier to kidney transplantation. As such, highly sensitized candidates, who represent approximately 35% of those on kidney transplant wait lists in the United States, have longer wait times and remain on dialysis longer than nonsensitized candidates. However, evidence-based immunosuppressive regimens exist to increase the likelihood of transplant success in sensitized candidates. Another common complication of transplantation is cytomegalovirus (CMV) infection, which can lead to death or substantial morbidity. Reducing the risk of CMV disease is critical, particularly for high-risk kidney transplant recipients. Therefore, clinicians require expert insight regarding risk assessment for a highly sensitized kidney transplant candidate, as well as strategies to increase transplant success and manage common transplant infections.

Collaboration Statement
This activity was developed by Med-IQ in collaboration with Duke Health.

Accreditation/Designation Statements
Med-IQ is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Med-IQ designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Medium/Method of Participation
This CME activity consists of a 0.25-credit online publication. To receive credit, read the introductory CME material, read the publication, and complete the evaluation, attestation, and post-test, answering at least 70% of the post-test questions correctly.  
Initial Release Date: March 22, 2022
Expiration Date: March 21, 2023
Estimated Time to Complete This Activity: 15 minutes

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Med-IQ requires any person in a position to control the content of an educational activity to disclose all financial relationships with any ineligible company over the past 24 months. The ACCME deems financial relationships as relevant if the educational content an individual can control is related to the business lines or products of the ineligible company. Individuals who refuse to disclose will not be permitted to contribute to this CME activity in any way. Med-IQ has policies in place that will identify and mitigate COIs prior to this educational activity. Med-IQ also requires faculty to disclose discussions of investigational products or unlabeled/unapproved uses of drugs or devices regulated by the US Food and Drug Administration.

Drug/Product Usage by Faculty
Off-label/unapproved drug uses or products are mentioned within this activity.

Disclosure Statement
The content of this activity has been peer reviewed and has been approved for compliance. The faculty and contributors have indicated the following financial relationships, which have been mitigated through an established COI mitigation process, and have stated that these reported relationships will not have any impact on their ability to give an unbiased presentation.

Annette M. Jackson, PhD, F(ACHI)
Consulting fees/advisory boards: Hansa Biopharma, Novartis Pharmaceuticals Corporation
Contracted research: CareDx

Stuart J. Knechtle, MD, has indicated no real or apparent conflicts.

The peer reviewers and activity planners have no financial relationships to disclose. 
Statement of Evidence-Based Content
Educational activities that assist physicians in carrying out their professional responsibilities more effectively and efficiently are consistent with the ACCME definition of continuing medical education (CME). As an ACCME-accredited provider of CME, Med-IQ has a policy to review and ensure that all the content and any recommendations, treatments, and manners of practicing medicine in CME activities are scientifically based, valid, and relevant to the practice of medicine. Med-IQ is responsible for validating the content of the CME activities it provides. Specifically, (1) all recommendations addressing the medical care of patients must be based on evidence that is scientifically sound and recognized as such within the profession; (2) all scientific research referred to, reported, or used in CME in support or justification of a patient care recommendation must conform to generally accepted standards of experimental design, data collection, and analysis.
Med-IQ is not liable for any decision made or action taken in reliance upon the information provided through this activity.
Contact Information        
For questions or comments about this activity, please contact Med-IQ. Call (toll-free) 866 858 7434 or email

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Complimentary CME
This activity is available free of charge to participants.

© 2022 Duke University Health System


Here are the key takeaways from this activity. Deeper insights and evidence, plus an opportunity to receive credit, are available at the "Continue" button below.

  • HLA sensitization is a major barrier to kidney transplantation
  • Evidence-based immunosuppressive regimens can increase the chances for successful transplantation in sensitized patients
  • CMV infection is a common complication of transplants and can lead to death or substantial morbidity
  • Reducing the risk of CMV infection is critical, particularly for high-risk kidney transplant recipients

View reference list.

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