Submitted by Dr. Marian G. Michaels, IPTA ID CARE Committee Chair; Dr. Daniel Dulek, IPTA ID CARE Committee Vice-Chair; Dr. Hayley Gans, IPTA Council Liaison ID CARE Committee.

The return of measles should be a wake-up call to protect our pediatric solid organ transplant (SOT) recipients against vaccine preventable infections

The IPTA ID CARE team look forward to a wonderful in-person IPTA 2025 Berlin meeting. As people get ready to travel to learn from colleagues, it is important to remember that the SARS CoV-2 pandemic had many repercussions from which we are still trying to recover.

During the SARS-CoV-2 Pandemic many children, worldwide, fell behind on their childhood immunizations and vaccination rates have yet to come back to their pre-pandemic levels in many countries [1]. This perhaps is no more evident than with measles. While many countries were considered measles free prior to the pandemic, there has sadly been a global increase in measles cases as vaccination rates decline. The World Health Organization noted over 10.3 million cases worldwide in 2023, a 20% increase from 2022 [2]. As WHO appropriately reminds us “transmission of the virus across borders and continents occurs regularly, and outbreaks of this highly infectious disease will occur wherever the virus finds pockets of un-or-under-vaccinated people, particularly children” [3]. Since live attenuated vaccines are often contradicted in our pediatric SOT recipients, they are a particularly vulnerable group.

IPTA members have long been at the forefront of strategizing on protecting our patients from measles along with other vaccine preventable infections. In 2018 Upton Allen led an IPTA-sponsored consensus conference on the use of live vaccines in SOT recipients [https://doi.org/10.1111/petr.13571] and Klara Posfay-Barbe led an IPTA survey of IPTA members real-life practices of managing varicella and measles in their centers [https://doi.org/10.1111/petr.13830].

For our current newsletter we would like to highlight the JAMA Pediatrics April 2025 article “Postvaccination Immunogenicity Among Pediatric Solid Organ Transplant Recipients” by Feldman AG et al [https://jamanetwork.com/journals/jamapediatrics/article-abstract/2830706]. Dr. Feldman and colleagues evaluated the immune response of 383 pediatric SOT recipients at 1-3 months after live virus vaccination and again after one year. Immune responses were found in most children early on (Varicella 71%; measles 84%; mumps 82.9%; and rubella 97.3%). For those with an initial response it remained strong at one year (varicella 77.9%; measles 91.8%; mumps 72.4%; and rubella 95.9%). Strengths of this publication include its robust size, inclusion of children from 20 centers, including some children on triple drug immunosuppressants. Limitations included over 97% of the children having had a liver transplant thereby restricting generalizability to other organs. While only 5 recipients of varicella vaccine developed rash after immunization it should serve as a reminder for transplant centers to have a protocol in place for reporting and dealing with safety issues. This important paper helps remind us that select children can be vaccinated with live virus vaccines even after SOT. Meanwhile, there is no excuse for those of us caring for pediatric SOT recipients to remind our health care teams and families that immunizing the community is one of the safest and most critical ways to protect our patients.

Keep our patients safe, vaccinate whenever possible.

We are planning a summertime Virtual Infectious Diseases Open Community forum for everyone interested. So, stay tuned and we look forward to seeing everyone live in Berlin.

Submitted by Dr. Jenny Prufe, IPTA AHNP Committee Co-Chair

The past months have been thrilling and active ones for the IPTA AHNP committee. In November 2024 – together with the education committee and some really enthusiastic colleagues from around the world – we planned and held the first joint IPTA virtual education symposium. With more than 200 participants this was a remarkable and very multifaceted event! For instance, we covered practical topics on medication, nutrition and adherence, as well as ethical challenges on complex cases and decision making in transplantation Recordings of the session can be found here: IPTA 1st Virtual Education Symposium.

Early in 2025 – Congratulations to Debra Lefkowitz who led the publication on “a consensus-based framework for the psychosocial evaluation of paediatric candidates for cardiothoracic transplant and ventricular assist devices”. This framework had collaborations from IPTA, ISHLT, PHTS, ACTION and transplant families, and can be found here: https://www.jhltonline.org/article/S1053-2498(24)01973-9/fulltext. This paper illustrates very impressively the wide array of tasks, which AHNP staff face in transplantation and is an excellent tool to help encourage consistency across centres, while also acknowledging the complexities inherent in evaluating children and their families for cardiothoracic transplant and VAD.

Publication activities are ongoing! In joint efforts together with the ID-committee and under the lead of Jessica Brennan we prepared a paper on healthy living among adolescent solid organ recipients which is now in the stage of the final edits before submission. This will cover topics such as recreational risks, body modification, and returning to school — all viewed through the lens of minimizing infections and complications.

Furthermore, we are embarking on a scoping review to explore roles and effectiveness of interventions delivered by allied health and nursing as part of paediatric solid organ transplant multidisciplinary teams. This will serve to identify the current published information on this topic and provide a foundation for the development of a framework for implementing and supporting the ideal team composition.

Proudly, we can announce that AHNP members are very active in planning and contributing to the IPTA 2025 Congress in Berlin. So, do join us on Thursday September 18th, 2025 for an exciting pre-congress half-day workshop on work related stress and how to cope with it. We will also hold our annual AHNP business meeting as well as a networking lunch! The main congress highlights other AHNP content and includes sessions on gender affirming care and barriers to transplantation and how to overcome them.

Last but not least: Don’t forget to apply for the AHNP committee if you want to become part of a vibrant group that does make a difference!

Submitted by Dr. Tom Blydt-Hansen, IPTA Ethics Committee Chair

The IPTA Ethics Committee has been busy developing policy statements on behalf of the membership. A position statement draft regarding transplant eligibility with incomplete vaccination will be completed and circulated for member feedback before the end of summer. The Committee is also hosting a symposium to discuss transplant eligibility in the setting of non-adherence at the Congress in Berlin. We will also present updates on other initiatives in poster form. As always, we look forward to your engagement on these topics and your feedback!

Submitted by Dr. Tom Blydt-Hansen, IPTA Kidney Community Chair

The newly formed IPTA Kidney Community is a vibrant community of pediatric kidney transplant providers from all over the world. We are also growing community welcoming new members! We met first in the summer of 2024 and four more times since then. This group will set its own priorities, and our initial endeavours have been in developing topical literature reviews, such as treatment of antibody-mediated rejection, peri-operative thromboprophylaxis and management of proteinuria after transplant. These meetings are open to anyone interested, and if you are interested in joining the calls please contact Katie Tait (IPTA Section Manager) at katie.tait@tts.org

The IPTA Outreach Committee is delighted to announce the winners of its 2025 Outreach Fellowship. All are pediatric transplant focused and working within the framework of the Declaration of Istanbul.

For the second year running, a third Fellowship was offered, which focused on developing and sharing knowledge within underserved regions in South Asia.

The winning applications are as follows. We wish them the best of luck in their endeavours!

Our IPTA Committees are looking for new members! All IPTA members in good standing are invited to apply. The deadline to apply is July 15th.