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Introduction and objectives: The incidence of upper urinary tract tumors is currently unknown. The aim of this study is to determine the real incidence of upper tract urothelial carcinoma (UTUC) in Spain. Material and methods: A descriptive, prospective and multicenter epidemiological study was conducted in 31 Spanish facilities by means of the Platform for Multicenter Studies of the Spanish Association of Urology. Recruitment was opened from May 1st, 2017 to April 30th, 2018. The original database was exported directly from the electronic Data Collection Logbook on December 15th, 2018, with a total of 404 cases registered (402 valid cases after depuration). Statistical analysis was performed using IBM SPSS software v 23 and EPIDAT v 3.4. Results: The incidence adjusted to Spanish population from raw data was 3.27 cases per 100.000 inhabitants per year (2.93 – 3.61 95% CI) and 3,3 cases per 100.000 inhabitants per year (2.96-3.66 95%CI) when adjusted to European population by age. The mean age at diagnosis was 70 years, and 77% of patients were male. Thirty-four percent of patients had an incidental diagnosis. Tumors were most commonly located in the pyelocalyceal system (54%), followed by the distal ureter (22%). Prior ureteroscopy was performed in 114 patients: this technique modified the subsequent treatment indication in 58% of cases. Radical nephroureterectomy was performed in 311 patients. Kidney-sparing surgery was the elected treatment in 76 patients (20%). Complications were found in 69% of cases, most of them classified as Clavien 1 and 2 (86% of all complications). Postoperative mortality rate was 1.7%. Conclusions: UTUC adjusted incidence rate in Spain is 3.27 and 3.3 in Europe. Prior URS modified the treatment indication in 18% of patients. We found a 69% complication rate and a 1.7% mortality rate.

Purpose Along with infections, rejection and graft vasculopathy, malignancies comprise a major complication after heart transplant, with a rate of occurrence of over 30% in 10 years. Skin cancers and posttransplant lymphoproliferative disorder are more common in adults. The risk factors for development of a malignancy after heart transplant are the same as for the nontransplant population. Identification of biomarkers that assess post-transplant risk is needed to improve long-term outcomes following heart transplantation. Methods We performed a single center, cohort study of 281 heart transplant recipients followed for a mean time of 9.5 years (2-19 years post-transplant). Mean age was 54.5, male 71.5%. The primary endpoint was development of neoplasia (27.2%). 8.2% developed metastasis. We serially measured funcionally distinct lymphocyte subsets in peripheral blood. We correlated assay results with the outcomes of neoplasia and development of metastasis. Lymphocyte subsets were assessed by four-colour flow-cytometry before transplantation at the time of inclusion in waiting list, at day 7 and 30 after heart transplantation. Results Clinical risk factors of cancer were age, smoking, obesity, ischemic etiology and post-transplant infections. We observed the following abnormalities in heart recipients who developed cancer: lower percentages of naive B-cells and lower mean fluorescence intensity (MFI) of toll like receptor (TLR) 4 on B-cells before transplantation (p=0.01 and p=0.049, respectively); lower non switched memory B-cell percentages and lower MFI of TLR4 on B-cells at 7 days after transplantation (p Conclusion Immunological abnormalities of B-cells and of TLR4 expression on B-cells and CD8 T-cells were observed in heart recipients who developed cancer after heart transplantation. These results suggest a role of these abnormalities in the predisposition to cancer that warrants further evaluation.

Purpose The identification of pre-transplant biomarkers to assess the risk of post transplant infections in lung transplantation is of interest. The anti-inflammatory cytokine interleukin-10 (IL-10) was investigated in this study. Higher IL-10 plasma levels have been associated with prolonged CMV clearance in lung recipients. In other clinical setings higher IL-10 levels have been found to be a predictor of clinical outcome in sepsis. In this study we evaluated the relationship between pre-transplant IL-10 serum concentration and the development of infections occurring after lung transplantation. Methods In a prospective follow-up multicenter study, 87 patients in 5 centers were included to identify potential biomarkers of risk for development of post transplant infections. 82 patients were transplanted. 41 patients (50%) developed at least one infection episode that required intravenous drug therapy during the first 6 months after transplantation. Pre-transplant IL-10 was measured with an enzyme-linked immunosorbent assay in blood. IL-10 levels were then correlated with the prevalence of infections. Results The distribution of post transplant infections was as follows: bacterial (67,35%), fungal (20,41%), viral (10,20%). Patients who developed infections disclosed significantly higher levels of pre-transplant serum IL-10: 43,26 ± 39,55 pg/ml vs. 21,70 ± 23,34 pg/ml; p 29 pg/ml were at higher risk of having post transplant infections (Logistic regression relative hazard 3.64 (p= 0.021; 95% confidence interval: 1.28- 10.87). Conclusion We demostrated that in lung recipients with pre-transplant higher levels of serum IL-10, the prevalence of post-transplant infections was higher which suggest a potential role of individual anti-inflammatory responses in the predisposition to infection.

s S131 visits. A novel approach for quantifying dd-cfDNA using targeted amplification and next-generation sequencing was used to quantify dd-cfDNA on 109 plasma samples from these 24 patients. 3 to 10 samples were collected between 2 months and 1 year post-transplantation for each patient. Most plasma samples had endomyocardial biopsy rejection grades and geneexpression profiling (GEP) test scores available from the same clinic visits. Results: Median dd-cfDNA was 0.79% (interquartile range [0.38%, 1.30%]). Total between-patient variability (51% CV) was similar to within-patient variability (45% CV). Analytical variability was 17%. The ratio of betweenpatient variability to within-patient variability was 1.6 times lower for ddcfDNA than for GEP. No effect of recipient gender, age, CMV serologic status, or time post-transplantation was seen on % dd-cfDNA measurements. Conclusion: In this longitudinal study of non-rejecting heart transplant recipients, the withinand between-patient variabilities of dd-cfDNA were shown to be of similar size, and significantly larger than the analytical variability of the assay. The ratio of between-patient variability to within-patient variability was significantly less than in GEP, suggesting that dd-cfDNA does not depend as strongly on patient-specific factors as does GEP. dd-cfDNA showed no dependence on patient age, gender, CMV serologic status, or time since transplant in this cohort. Taken together, these characteristics indicate that dd-cfDNA is a stable analyte in non-rejecting patients. (Study sponsored by CareDx, Inc.)

(PD-1) and increased levels of the T-box factor eomesodermin (Eomes) unlike tetramer+ cells from controllers. While impaired effector function persisted in many relapsers from acute infection, the expression of high PD-1 levels on CMV-specific CD8+ T cells was only detected during chronic infection, and not acute primary infection, suggesting exhaustion. Conclusion: Thus, impaired CMV-specific T cell responses from relapsers are not for lack of CMV-specific cells, but rather, cells that are dysfunctional with an exhausted phenotype. Ongoing studies are focusing on whether effector function can be rescued in these CMV-specific CD8+ T cells.