Volume 34 Number 2

The December TJA edition’s theme is 'Communication, transparency and equity, the foundation for best transplant practice'. It is inspired by the excellent work recently undertaken by the TSANZ Kidney Allocation Working Group to design an updated deceased donor kidney allocation algorithm for Australia. The need to review and evolve the existing renal allocation algorithm and the objectives for improving donor kidney-recipient matching parameters to support better recipient outcomes, is nicely described by Dr Sarah White and Professor Kate Wyburn in this edition’s Guest Editorial. As part of this project, the working group recognised the importance of consumer consultation to ensure that the updated renal allocation algorithm reflected the values and expectations of those on the renal transplant waiting list.

In this edition Dr White has also kindly shared the salient results of that consumer consultation in her article Consumer Perspectives on a New Australian Kidney Allocation Algorithm. Analysis of the consumer feedback revealed recurrent themes around the lack of proactive communication with transplant candidates about allocation systems, the need for transparency about how these systems work (particularly transplant waiting times) and the importance of fairness and equity in donor kidney-recipient matching.

The goals of the renal allocation algorithm project hold relevance for all transplant specialties. They highlight the need for continuous review of our practices to ensure we are achieving equitable and clinically optimal post-transplant outcomes. Equally imperative is transparent communication of our processes and practices to our transplant consumers. These themes flow through many articles in this TJA edition.

Churchill Fellowship recipient Dr Louise Fuller, a senior physiotherapist with the Lung Transplant Service at The Alfred Hospital in Melbourne, takes us on a journey across four countries as she investigates lung transplant rehabilitation models in international adult lung transplant units. Her findings and insights have subsequently informed the development of Australia’s first position statement on rehabilitation after lung transplant.

Liver Transplant Coordinator Sarah Mikowski reflects on her unit’s experience undertaking their first case of Organ Donation After Transplantation (ODAT). Her clinical reflection suggests that while there may be clinical, ethical, and psychosocial complexities associated with organ “re-use”, ODAT may offer the potential to expand the donor organ pool for some transplant specialties.

Compliance with post-transplant treatment has been long recognised as an important factor influencing post-transplant outcomes. In her article, Renal Transplant Nurse Practitioner Jane van der Jeugd advocates for the shifting of terminology from “compliance” to “adherence”. This shift emphasises a more collaborative, shared decision making approach between patient and clinicians, an approach that may help enhance long term graft survival.

Further examples of the impressive work being undertaken by our transplant nursing community were showcased at the 2025 TNA conference held in Brisbane in October. We would like to congratulate the winners of the conference’s best oral paper and best poster awards. Best paper was awarded to Fleur Tuthill for her presentation 'The greatest gift of all. What motivates people to become living kidney donors, what barriers do they face and what can we do to increase donation rates?' Best poster was awarded to Melissa Stanley for her work on 'Improving equity and access to liver kidney donor transplantation'. Their abstracts are included in this edition. Congratulations to the Queensland conference team for planning and hosting a very successful meeting. A conference report and photos also appear in this edition.

The TJA Editorial Board is already preparing the 2026 TJA editions with plans for some exciting contributions from authors across our global transplant network. Importantly we want to feature articles that highlight the amazing work undertaken by our local donation and transplant teams. Please consider submitting a manuscript or get in contact with our Editorial Team to discuss an article idea and how to get started.  All authors, in particular first-time authors, will receive mentorship and support throughout the process. Author guidelines and contact information is available on the TNA website TJA page.

TJA Editor Bronwyn Levvey and I would like to thank all our wonderful TNA members for their support and for everything you do for the transplant community. We wish everyone a Merry Christmas and hope the new year brings you inspiration and new opportunities both personally and professionally. We look forward to sharing more informative and topical TJA editions with you in 2026.

Libby John, Associate Editor TJA

Author(s)

Libby John
Associate Editor TJA