Learning Objectives

• To discuss the evaluation of kidney transplant recipients and kidney donors.
• To describe current trends in kidney transplantation and the use of deceased donor kidneys.
• To review the recent literature on the care of kidney transplant recipients
• To describe the management of kidney transplant rejection.
• To review contemporary methods of immunological monitoring of kidney transplant recipients.

It is the policy of the American Society of Nephrology (ASN) that all individuals in a position to control the content of ASN's educational activities are expected to disclose all their and their life spouse/partner's financial relationships with “ineligible companies” within the prior 24 months as well as other non-financial interests. (“Ineligible companies” are those whose primary business is producing, marketing, selling, re-selling, or distributing health care products used by or on patients.) Participants should note that the use of products outside U.S. Food and Drug Administration (FDA) approved labeling should be considered experimental and are advised to consult current prescribing information for approval indications.

The intent of this policy is not to prevent expert faculty with relevant relationship(s) with commercial interest(s) from involvement in educational activities, but rather to ensure that these activities promote quality and safety, are effective in improving medical practice, are based on valid content, and are independent of control from commercial interests and free of commercial bias. In addition, all faculty were instructed to provide balanced, scientifically rigorous, and evidence-based presentations.

ASN requires all individuals in a position to control content for this activity to complete disclosure forms on the ASN website. Responses are listed below.

Disclosures have been reviewed and assessed by ASN. All relationships with ineligible companies have been identified and all relevant financial relationships have been mitigated.

View the full ASN Conflict of Interest and Disclosure Policy: https://www.asn-online.org/education/cme/coi-disclosure.pdf.

EDITORS:

Alice M. Sheridan, MD, FASN—Employer(s): Brigham and Women’s Hospital; No additional relevant financial relationship(s) with ineligible companies to disclose.

Martina M. McGrath, MBChB, FASN—Employer(s): Brigham and Women’s Hospital; VA Boston Medical Center; Honoraria: Lexicon Pharmaceuticals.

EDITORIAL AUTHOR:

Harsimar K Ahuja, BS—Employer(s): Harvard Medical School; No relevant financial relationship(s) with ineligible companies disclosed.

Sumit Mohan, MD, MPH, FASN—Employer(s): Columbia University Irving Medical Center; Consultancy: HSAG, Sanofi, Specialist Direct, DEKA; Patents/ Royalties: Columbia University; Advisory/Leadership Role: Deputy Editor, Kidney International Reports (ISN); Chair, UNOS, Data advisory committee; Member, SRTR Review Committee; Member, ASN Quality committee; National Faculty Chair, ETCLC; Research Funding: NIH (NIDDK, NIHMD and NIBIB) and Kidney Transplant Collaborative).

Winfred W. Williams, MD—Employer(s): Harvard Medical School; Research Funding: Transplant Genomics, Inc., EuroFinns/ViraCor; Advisory/Leadership Role: NIDDK KUH STEPS trial: System Interventions to Achieve Early and Equitable Transplants (STEPS) Study; I am the Data Safety Monitoring Board chair for this NIDDK-PCORI-sponsored study.

AUTHORS:

Mariam P. Alexander, MD—Employer(s): Mayo Clinic; No relevant financial relationship(s) with ineligible companies disclosed.

Oriol Bestard, MD, PhD—Employer(s): University Hospital Vall d’Hebron; Research Funding: Sanofi, Oxford Immunotec, Hansa Biopharrma, Natera, Eurofinis; Patents/Royalties: Oxford Immunotec; Advisory/Leadership Role: Hansa Biopharma, Astellas, Sanofi, Takeda, Neovi, Bristol Myers Squib.

Vidya Fleetwood, MD—Employer(s): SSM Health Saint Louis University Hospital; No relevant financial relationship(s) with ineligible companies disclosed.

Sean Hebert, MD—Employer(s): The University of Texas Health Science Center at Houston; No relevant financial relationship(s) with ineligible companies disclosed.

Hassan N. Ibrahim, MD, DrMed, FASN—Employer(s): The University of Texas Health Science Center at Houston; No relevant financial relationship(s) with ineligible companies disclosed.

Goni Katz-Greenberg, MD, MSc—Employer(s): Duke University School of Medicine; Research Funding: 1R01DK136286-01 The RaDIANT Health Systems Intervention for Equity in Kidney Transplantation; PI Rachel Patzer, PhD; I am site PI for Duke; Other Interests: AST member; Member of the controversies conference oversight committee; ASN member; Editorial fellow at kidney360.

Delphine Kervella, PhD, MD—Employer(s): University Hospital Vall d’Hebron; No relevant financial relationship(s) with ineligible companies disclosed.

Pascale Khairallah, MD, MS, FASN—Employer(s): University of California at San Francisco; Advisory/Leadership Role: Editorial board of American Journal of Kidney Diseases.

Ngan Lam, MD, MSc—Employer(s): University of Calgary; No relevant financial relationship(s) with ineligible companies disclosed.

Krista L. Lentine, MD, PhD, FASN—Employer(s): SSM Health Saint Louis University Hospital; Consultancy: CareDx, Inc.;Maze Therapeutics; Speakers Bureau: Sanofi; and Other Interests or Relationships: UpToDate, Author.

Lisa M. McElroy, MD, MS—Employer(s): Duke University School of Medicine; Research Funding: National Institute on Minority Health and Health Disparities under Award Number 1 K08 MD017632-01; Robert Wood Johnson Foundation Harold Amos Medical Faculty Development Award; American Surgical Association Foundation Award; Advisory or Leadership Role: editorial board, clinical transplantation, American journal of surgery American journal of transplantation and annals of surgery open.

Chethan M. Puttarajappa, MD, MS—Employer(s): University of Pittsburgh Medical Center; Consultancy: Replimune; and Research Funding: Spouse is a site Primary Investigator for contracted clinical research with the following companies: Regenxbio, Denali, Shire and Abeona/Ultragenyx.

Carrie A. Schinstock, MD—Employer(s): Mayo Clinic; Consultancy: CSL Bering; Research Funding: CSL Bering; Hi Bio; Honoraria: CSL Bering; Hansa; Hi Bio.

Puneet Sood, MD, MPH—Employer(s): University of California at San Francisco; Research Funding: Participated in multicenter trials by Amplyx and CAREDX.

ASN STAFF:

Suzanne P. Armstrong, MA—Employer(s): American Society of Nephrology; No relevant financial relationship(s) with ineligible companies to disclose.

Lisa Netha Xayavong, MA—Employer(s): American Society of Nephrology; No relevant financial relationship(s) with ineligible companies to disclose.

Commercial Support

There is no commercial support for this issue.

The nephSAP editorial team and the KSAP editorial board extend their sincere appreciation to the following reviewers. Their efforts and insights help improve the quality of these postgraduate education offerings. 

nephSAP Review Panel, Volume 23, Number 5, December 2024

• Gaurav Agarwal, MD, FASN, University of Alabama at Birmingham, UNITED STATES
• Farsad Afshinnia, MD, MS, FASN, University of Michigan, UNITED STATES
• Khaled Boubes, MD, FASN, The Ohio State University, UNITED STATES
• Manohar Bairy, MD, MBBS, Tan Tock Seng Hospital, SINGAPORE
• Gopal Basu, MD, MBBS, FASN, The Alfred, AUSTRALIA
• Shirley Shwu-Shiow Chang, MD, FASN, SUNY Buffalo, UNITED STATES
• Devasmita Choudhury, MD, FASN, Salem VA Medical Center, UVA, Virginia Tech Carilion School of Medicine, UNITED STATES
• Kiran M. Goli, MD, FASN, Kidney Care Specialists, LLC, UNITED STATES
• Elvira O. Gosmanova, MD, FASN, Albany Medical College, UNITED STATES
• John S. Hammes, MD, Balboa Nephrology Medical Group, UNITED STATES
• George Jarad, MD, Washington University School of Medicine, UNITED STATES
• Poonum Khalid, II, MBBS, Nishtar medical university Multan, PAKISTAN
• Rakhi Khanna, DO, FASN, Rush University Medical Center, UNITED STATES
• Charbel C. Khoury, MD, Washington University in St Louis, UNITED STATES
• Nicolae Leca, MD, FASN, University of Washington, UNITED STATES
• Eleanor D. Lederer, MD, FASN, University of Texas Southwestern Medical Center, UNITED STATES
• Roy O. Mathew, MD, FASN, Loma Linda VA Health Care System, UNITED STATES
• Ashraf I. Mikhail, MD, NHS Wales, UNITED KINGDOM
• Kerri A. McGreal, MD, University of Kansas School of Medicine, UNITED STATES
• Cynthia C. Nast, MD, FASN, Cedars-Sinai Medical Center, UNITED STATES
• Chanigan Nilubol,MD, MedStar Georgetown University Hospital, UNITED STATES
• Anastasia Ptinopoulou, MD, PhD, General Hospital of Trikala, GREECE
• Hernan Rincon-Choles, MD, MS, FASN, Cleveland Clinic, UNITED STATES
• Jean-Sebastien Rachoin, MD, FASN, Cooper University Hospital, UNITED STATES
• Anand M. Ravindran, MD, MBBS, Toledo Clinic Nephrology, UNITED STATES
• Subodh J. Saggi, MD, MPH, SUNY Downstate Medical Center, UNITED STATES
• Mwf van den Hoogen, MD, PhD, Erasmus MC Medical Centre Rotterdam, NETHERLANDS
• Suthaharan Vimalendran, MD, Orillia Soldiers Memorial Hospital, CANADA
• Michifumi Yamashita, MD, PhD, FASN, Cedars-Sinai Medical Center, UNITED STATES
• Brian Y. Young, MD, FASN, UC Davis Medical Center, UNITED STATES

Program Mission and Objectives

nephSAP® provides a learning vehicle for physicians, scientists, advanced practitioners, nurses, pharmacists, and other health professionals working and training in the field of nephrology to renew and refresh their clinical knowledge, diagnostic, and therapeutic skills. This enduring material provides learners challenging, clinically-oriented questions based on case vignettes, detailed learning objectives, a series of articles that review recent publications, and an editorial on an important and evolving topic. This combination of materials enables learners to rigorously assess their strengths and weaknesses in the broad domain of nephrology.

Target Audience

Physicians, scientists, advanced practitioners, nurses, pharmacists, and other health professionals working and training in the field of nephrology.

Accreditation Statements

In support of improving patient care, the American Society of Nephrology is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

AMA Credit Designation Statement – Physicians: The American Society of Nephrology designates this internet activity (enduring material) for a maximum of 10.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABIM MOC Statement

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 10.0 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to Joint Accreditation for the purpose of granting ABIM MOC credit. MOC points will be applied to only those ABIM candidates who have enrolled in the MOC program. It is your responsibility to complete the ABIM MOC enrollment process.

Original Release Date: December 2024

CME/MOC Termination Date: November 30, 2026 at 11:59 pm ET

Examination Available Online: On or before December 31, 2024

Estimated Time for Completion: 10 hours 

Self-Assessment Examination

• Answers with explanations are provided with a passing score after the first and/or second attempt
• This issue will be archived December 1, 2026, and answers with explanations will be posted on the ASN website

Method of Participation

• Read the entire issue that is supplemented by original articles in the reference lists.
• Complete the online self-assessment examination.
• Each participant is allowed two attempts to pass the examination (75% correct) for CME and MOC.
• Upon completion, review your score and incorrect answers and print your certificate.

Activity Evaluation, CE, and MOC

• Go to ASN eLEARNING CENTER (education.asn-online.org)
• Select MY ACTIVITIES from the left-hand navigation.
• Select the corresponding issue.
• Read all information on the Overview screen.
• Follow the onscreen instructions to:
  • Complete the Exam (i.e., post test),
  • Complete the Evaluation,
  • Claim credit/MOC, and
  • IMPORTANT: select the credit type that corresponds with your designation, and
  • Print a Certificate

Your ASN Transcript is available on the ASN website:

• Go to the ASN website and log in to your ASN Profile page
• Select the CME/CE Transcript tab
• View credits claimed or print a certificate with continuing education information for completed learning activities