Course Director

Stanley C. Jordan, MD, FASN
Stanley C. Jordan, MD, FASN

David Geffen School of Medicine at UCLA
Cedars-Sinai Medical Center
Los Angeles, California


Alexander Wiseman
Alexander Wiseman, MD, FAST

University of Colorado School of Medicine
Aurora, Colorado

Accredited by

Medical Learning Institute, Inc.

Activity Details

Credit Types:CME
Credit Amount:1.0 Credits
Release Date:2017-May-31
Expiration Date:2018-May-30
Estimated Time for Completion:60 minutes
Registration Required:No
Cost:Free of Charge

Activity Description and Educational Objectives

Production of de novo donor-specific antibodies (dnDSAs) is a major risk factor for acute and chronic antibody-mediated rejection and graft loss after kidney transplantation, and current understanding suggests that inadequate immunosuppression is the major cause of DSA development and attendant pathology. Calcineurin inhibitors (CNIs) are the mainstay for maintenance immunosuppressive therapy in renal transplantation, with tacrolimus being the most widely used. However, CNIs have a narrow therapeutic window and a high degree of inter- and intra-patient pharmacokinetic variation, which present a challenge when trying to achieve optimal dosing. Consequently, therapeutic drug monitoring is required in order to adjust treatment in individual patients.

This activity is based on a live symposium that was held at the 2017 American Transplant Congress (ATC 2017) that examines contemporary, evidence-based strategies to minimize late renal allograft failure via optimizing immunosuppressive therapy. Our faculty experts take a closer look at DSAs as mediators of allograft injury, while providing practical guidance on what clinicians can do to achieve and maintain adequate immunosuppression in individual kidney transplant recipients.

Upon completion of this activity, participants should be better able to:
  • Describe the relationship between inadequate immunosuppression and chronic renal allograft failure, focusing on the pathophysiologic significance of donor-specific antibodies (DSAs)
  • Outline factors contributing to high inter- and intra-patient pharmacokinetic variability observed with immunosuppressive therapy, specifically calcineurin inhibitors (CNIs), after renal transplantation
  • Overcome barriers to achieving target blood concentrations of immunosuppressive therapy (ie, CNIs) in individual kidney transplant recipients, recognizing the importance of optimized dosing and medication adherence
  • Implement evidence-based strategies to minimize late allograft failure in individual kidney transplant recipients, focusing on adequate immunosuppression to prevent DSA development

Target Audience

This activity has been designed to meet the educational needs of nephrologists, transplant surgeons, and other clinicians involved in the care of kidney transplant recipients.

Requirements for Successful Completion

In order to receive credit, participants must view the activity and complete the post-test and evaluation form. A score of 70% or higher is needed to obtain CME credit. There are no pre-requisites and there is no fee to participate in this activity or to receive CME credit. Statements of Credit are awarded upon successful completion of the post-test and evaluation form.

Media: Enduring Material
Release and Expiration Dates: May 31, 2017 - May 30, 2018
Time to Complete: 60 minutes

Faculty & Disclosure / Conflict of Interest Policy

Before the activity, all faculty and anyone who is in a position to have control over the content of this activity and their spouse/life partner will disclose the existence of any financial interest and/or relationship(s) they might have with any commercial interest producing healthcare goods/services to be discussed during their presentation(s): honoraria, expenses, grants, consulting roles, speakers bureau membership, stock ownership, or other special relationships. Presenters will inform participants of any off-label discussions. All identified conflicts of interest are thoroughly vetted by Medical Learning Institute, Inc. for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

The associates of Medical Learning Institute, Inc., the accredited provider for this activity, and PVI, PeerView Institute for Medical Education do not have any financial relationships or relationships to products or devices with any commercial interest related to the content of this CME activity during the past 12 months.

Course Director and Moderator

Stanley C. Jordan, MD, FASN
Professor of Pediatrics & Medicine
David Geffen School of Medicine at UCLA
Director, Nephrology & Transplant Immunology
Medical Director, Kidney Transplant Program
Cedars-Sinai Medical Center
Los Angeles, California

Stanley C. Jordan, MD, FASN, has a financial interest/relationship or affiliation in the form of:
Consultant for Genentech, Inc.; Hansa Medical; Novartis Pharmaceuticals Corporation; and Vitaeris Inc.
Grant/Research Support from Genentech, Inc.; Hansa Medical; and Novartis Pharmaceuticals Corporation.

Stanley C. Jordan, MD, FASN, does intend to discuss either non-FDA-approved or investigational use for the following products/devices:therapeutic modalities to prevent/treat antibody-mediated rejection in kidney transplant recipients.


Alexander Wiseman, MD, FAST
Professor of Medicine, Division of Renal Diseases and Hypertension
Medical Director, Kidney and Pancreas Transplant Programs
University of Colorado School of Medicine
Aurora, Colorado

Alexander Wiseman, MD, FAST, has a financial interest/relationship or affiliation in the form of:
Grant/Research Support from Alexion Pharmaceuticals Inc.; Astellas; Bristol-Myers Squibb; Novartis Pharmaceuticals Corporation; Oxford Immunotec, Inc.; and Quark Pharmaceuticals, Inc.
Advisory Board for Veloxis Pharmaceuticals.

Alexander Wiseman, MD, FAST, does not intend to discuss any non-FDA-approved or investigational use of any products/devices.

CME Reviewer

Susan H. Bray, MD, MBE
Keystone Care
Philadelphia, Pennsylvania

Susan H. Bray, MD, MBE, has no financial interests/relationships or affiliations in relation to this activity.

Medical Director

Kathryn B. Charalambous, PhD
PVI, PeerView Institute for Medical Education

Kathryn B. Charalambous, PhD, has no financial interests/relationships or affiliations in relation to this activity.


The information provided at this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient's medical condition. Recommendations for the use of particular therapeutic agents are based on the best available scientific evidence and current clinical guidelines. No bias towards or promotion for any agent discussed in this program should be inferred.

Providership, Credit & Support

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Medical Learning Institute, Inc. and PVI, PeerView Institute for Medical Education. The Medical Learning Institute, Inc. is accredited by the ACCME to provide continuing medical education for physicians.

The Medical Learning Institute, Inc. designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


This CME activity is jointly provided by Medical Learning Institute, Inc. and PVI, PeerView Institute for Medical Education.


This activity is supported by an educational grant from Astellas.

Disclosure of Unlabeled Use

The faculty of this educational activity may include discussions of products or devices that are not currently labeled for use by the FDA. Faculty members have been advised to disclose to the audience any reference to an unlabeled or investigational use.

No endorsement of unapproved products or uses is made or implied by coverage of these products or uses in our reports. No responsibility is taken for errors or omissions in reports.

Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings.

The materials presented here are used with the permission of the authors and/or other sources. These materials do not necessarily reflect the views of PeerView Press or any of its partners, providers, and/or supporters.

Copyright © 2000-2017

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