Johnson, Jonathan

ABSTRACT IPTA created the SMARTER Initiative to address persistent gaps in pediatric transplant education worldwide. Through webinars, podcasts, case discussions, and interactive resources, SMARTER provides trainees and allied professionals with accessible, peer‐reviewed content across all major organ systems. The program is designed for global reach, with downloadable modules, mobile compatibility, and recorded sessions to accommodate different regions and time zones. Since its launch, SMARTER has shown strong engagement, with fellows reporting that the platform helps them prepare for board exams, improve clinical decision‐making, and connect learning directly to patient care. Survey feedback highlights high satisfaction and identifies opportunities for further growth, such as expanded case‐based modules, procedural videos, and simulation exercises. By reducing disparities in transplant training and supporting collaboration, SMARTER is positioned to strengthen existing curricula and promote a better‐prepared, more globally connected transplant workforce.

ABSTRACTBackgroundPediatric organ transplantation is the primary treatment for end‐organ failure. Improving medication adherence and healthcare compliance can decrease healthcare burdens, graft rejection, morbidity, and mortality. Adolescents commonly struggle with non‐adherence, necessitating a smooth transition to adult care. This systematic review aims to assess and evaluate the effectiveness of existing transition tools and models used in the care of pediatric solid organ transplant recipients (pSOTR).MethodsA systematic literature review of studies in electronic databases (PubMed, Google Scholar, and Mendeley) on interventions improving transition in pediatric solid organ transplant recipients (pSOTR) from 2000 to 2022 was conducted. Included studies involved pSOTR before the age of 12 years transitioning to adult care.ResultsA lower proportion of graft acute rejection was observed among pSOTR with more than two transition interventions (10.088%, 95% CI: 0.901%–27.441%, I2 = 85.95%, p < 0.0001, random effects, five studies, n = 155) compared to those with two or fewer interventions (13.892%, 95% CI: 4.588%–27.142%, I2 = 74.73%, p = 0.0014, random effects, six studies, n = 140). Additionally, a significant association was found between transition protocols and lower rejection rates (χ2 = 10.57, p = 0.0011), with multiple protocols showing better outcomes (χ2 = 5.091, p = 0.024). Although adherence scores differed significantly with and without transition protocols (χ2 = 8.75, p = 0.0126), no significant difference was found between single and multiple protocol groups (χ2 = 4.8, p = 0.091).ConclusionThis review identifies various transition models and their impact on adherence and graft rejection, which correlate with morbidity and mortality and influence transplant outcomes. The heterogeneity of data within the current literature necessitates further research to establish causality and develop a standardized transition program aimed at improving patient outcomes.

Evidence from medicine and other fields has shown that gender diversity results in better decision making and outcomes. The incoming workforce of congenital heart specialists (especially in pediatric cardiology) appears to be more gender balanced, but past studies have shown many inequities. Gender‐associated differences in leadership positions, opportunities presented for academic advancement, and recognition for academic contributions to the field persist. In addition, compensation packages remain disparate if evaluated based on gender with equivalent experience and expertise. This review explores these inequities and has suggested individual and institutional changes that could be made to recruit and retain women, monitor the climate of the institution, and identify and eliminate bias in areas like salary and promotions.

AbstractBackgroundThe SARS‐CoV‐2 pandemic and corresponding acute respiratory syndrome have affected all populations and led to millions of deaths worldwide. The pandemic disproportionately affected immunocompromised and immunosuppressed adult patients who had received solid organ transplants (SOTs). With the onset of the pandemic, transplant societies across the world recommended reducing SOT activities to avoid exposing immunosuppressed recipients. Due to the risk of COVID‐19‐related outcomes, SOT providers adapted the way they deliver care to their patients, leading to a reliance on telehealth. Telehealth has helped organ transplant programs continue treatment regimens while protecting patients and physicians from COVID‐19 transmission. This review highlights the adverse effects of COVID‐19 on transplant activities and summarizes the increased role of telehealth in the management of solid organ transplant recipients (SOTRs) in both pediatric and adult populations.MethodsA comprehensive systematic review and meta‐analysis were conducted to accentuate the outcomes of COVID‐19 and analyze the efficacy of telehealth on transplant activities. This in‐depth examination summarizes extensive data on the clinical detriments of COVID‐19 in transplant recipients, advantages, disadvantages, patient/physician perspectives, and effectiveness in transplant treatment plans via telehealth.ResultsCOVID‐19 has caused an increase in mortality, morbidity, hospitalization, and ICU admission in SOTRs. Telehealth efficacy and benefits to both patients and physicians have increasingly been reported.ConclusionsDeveloping effective systems of telehealth delivery has become a top priority for healthcare providers during the COVID‐19 pandemic. Further research is necessary to validate the effectiveness of telehealth in other settings.

Abstract Despite increasing legalization and use of marijuana, there is no consensus among pediatric heart transplant institutions or providers regarding users' eligibility for cardiac transplant. We sent a survey to pediatric and ACHD transplant providers (physicians, surgeons, transplant coordinators, and pharmacists) assessing their current institution's policies and their personal opinions about marijuana use in patients being considered for heart transplantation. Of the respondents, 84% practice in the United States and Canada. Most providers (80%) care for both pediatric and ACHD patients. Respondents included cardiologists (77%) and surgeons (11%), with the remaining being coordinators and pharmacists. Most providers (73%) reported their institution had no policy regarding marijuana use in heart transplant candidates. Only 20% of respondents' institutions consider mode of consumption, with 87% and 53% approving of oral and transdermal routes, respectively, and only 7% approving of vaporized or smoked routes. While 73% of providers would consider illegal marijuana use an absolute/relative contraindication to heart transplant listing, the number decreases to 57% for legal recreational users and 21% for legal medical users. Most providers personally believe marijuana to be physically and mentally/emotionally harmful to pediatric patients (67% and 72%, respectively). Many institutions lack a policy regarding marijuana use in pediatric and ACHD heart transplant candidates, and there is considerable disagreement among providers on the best practice. With increasing legalization and use of marijuana, each institution will have to address this issue thoughtfully to continue to provide high‐quality, consistent, and equitable care for pediatric and ACHD heart transplant candidates.