Solid Organ Transplantation Pharmacy Specialty Review Course and Practice Exam (No Recert Credit (Cert # L219316)

ACPE Numbers: Various – see listing below
Pre-Sale Date: 06/16/2021
Content Release Date: 07/14/2021
Expiration Date: 06/14/2022
Activity Type: Application-based
CE Credits: 22.75 (ACPE)
Activity Fee: $425 (ASHP member); $625 (non-member) 

Activity Overview

This online course provides a robust preparatory curriculum for the pharmacy professional preparing for the Board of Pharmacy Specialties (BPS) Solid Organ Transplantation Pharmacy Specialty Certification Examination. Designed based on the domains, tasks, and knowledge statements developed by the BPS for the certification examination, this course will help you prepare for the exam by identifying areas needed for in‐depth review of solid organ transplantation issues by:

  • Reviewing pertinent clinical topics and practice skills
  • Providing exam practice questions
  • Listing valuable references for further study

This course is NOT intended for those obtaining recertification credit. 

These activities are part of the ACCP and ASHP professional development program. 


The American College of Clinical Pharmacy and American Society of Health-System Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Target Audience

These activities are intended for pharmacists who are seeking to update their knowledge and skills commensurate with a board certification examination in the areas listed below.

Recertification Credit

This course consists of 17 activities (see table below) and provides up to 22.75 hours of continuing pharmacy education credit. The Review Course includes case-based presentations for application to real-life scenarios, a practice exam along with correct answers, and links to the reference sources, and domains, tasks, and knowledge statements.                


Learning Module

ACPE Number

Credit Hours

ACPE Expiration Date

Transplant Immunology




Induction and Management of Acute Cellular Rejection




Maintenance of Immunosuppression Part One




Kidney Transplantation




Liver Transplantation




Pancreas and Islet Cell Transplantation and Intestinal Transplantation




Heart Transplantation




Lung Transplantation




Maintenance of Immunosuppression Part Two




Infection Prevention and Management in Solid Organ Transplant Patients




Prevention and Management of Malignancy in Solid Organ Transplant Patients




Primary Care of the Solid Organ Transplant Patient




Special Considerations in Pediatric and Geriatric Transplant Populations




Trial Design and Biostatistics




Continuity of Care and Managing Transitions of Care in the Transplant Patient




Transplant Regulations and Performance Improvement




Transplant Resources, Patient Education, and Transplant Study Endpoints




SUPPLEMENTAL MATERIAL: Approaches to Prevent and Manage Antibody Development




SUPPLEMENTAL MATERIAL: Vascularized Composite Allotransplantation




Learning Objectives

At the end of the presentations, the pharmacist should be able to: 

Transplant Immunology
ACPE #: 0217-9999-21-161-H01-P

  • Differentiate between components of innate and adaptive immunity.
  • Review lymphocyte activation, differentiation and effect mechanisms.
  • Discuss pathways of all recognition and transplant rejection and injury.
  • Assess immunologic risk of rejection.
  • Describe pathways to immunologic tolerance of allograft.

Induction and Management of Acute Cellular Rejection
ACPE #: 0217-9999-21-162-H01-P

  • Outline the principles of induction immunosuppression and how these agents can be used for different organs.
  • Compare and contrast the available induction agents; specifically focusing on mechanism of action, ease of administration, adverse events and economic impact.
  • Evaluate the efficacy of induction therapy among the different organs.
  • Design an induction regimen based on the type of transplant and the patient’s clinical presentation.
  • Compare and contrast the agents available for the treatment of acute cellular rejection.
  • Assess the optimal therapeutic options for management of acute cellular rejection.

Maintenance of Immunosuppression Part One
ACPE #: 0217-9999-21-163-H01-P

  • Differentiate between the pharmacokinetic profiles of immunosuppressive medication formulations utilized in solid organ transplantation.
  • Select the appropriate method for therapeutic drug monitoring of immunosuppressive medications.
  • Design an initial immunosuppression regimen for a solid organ transplant recipient utilizing a patient’s pharmacogenomics data.
  • Revise an immunosuppression regimen for a solid organ transplant recipient based on the presence of pertinent drug-drug interactions.
  • Assess patient-specific data to identify immunosuppression-related adverse effects.
  • Design an appropriate monitoring plan for immunosuppressive medications.

Kidney Transplantation
ACPE #: 0217-9999-21-165-H01-P

  • Evaluate effects of nonadherence on long-term allograft survival.
  • Assess non-pharmacologic and pharmacologic risks of patients undergoing kidney transplant evaluation.
  • Distinguish between absolute and relative contraindications to kidney transplant.
  • Differentiate pathophysiology of and design management strategies for allograft specific complications.
  • Design modifications to therapy that account for patient-specific factors, immunologic risk, and complications after kidney transplant.
  • Assess barriers after kidney transplant and implement strategies to improve adherence.

Liver Transplantation
ACPE #: 0217-9999-21-166-H01-P

  • Distinguish acceptable indications for liver transplantation.
  • Assess liver transplant and living donor candidates for pharmacologic and non-pharmacologic risks using appropriate assessment tools.
  • Evaluate a liver transplant candidate’s immunologic risks and propose immunosuppressive regimens.
  • Interpret pertinent patient care related information to manage immunosuppression and comorbid conditions.
  • Differentiate between immunologic and non-immunologic complications after liver transplant. Evaluate potential causes of medication non-adherence after liver transplantation.

Pancreas and Islet Cell Transplantation and Intestinal Transplantation
ACPE #: 0217-9999-21-167-H01-P

  • Pancreas and Islet Cell Transplantation
    • Demonstrate an understanding for common complications of pancreas transplantation and develop strategies to prevent or treat these complications.
    • Devise a monitoring strategy to evaluate exocrine and endocrine function after pancreas transplantation.
    • Compare and contrast the advantages and disadvantages of pancreas and islet cell transplantation.
  • Intestinal Transplant
    • Describe the etiologies of small bowel transplantation.
    • List the current trends in immunosuppression for small bowel transplantation. Discuss the common complications observed after small bowel transplantation.

Heart Transplant
ACPE #: 0217-9999-21-168-H01-P

  • Describe common indications that may lead to cardiac transplantation.
  • Identify pre-transplant risk factors that may impact outcomes after cardiac transplantation. Describe cardiac specific techniques for rejection surveillance.
  • Understand cardiac specific pathologic findings.
  • List and discuss cardiac specific post-transplant complications and strategies for management.

Lung Transplant
ACPE #: 0217-9999-21-169-H01-P

  • Describe diagnoses that may lead to end-stage lung disease and referral for lung transplantation.
  • Identify indications, absolute contraindications, and relative contraindications for lung transplantation.
  • Formulate a medication regimen for a lung transplant recipient, taking into account immunologic risks and needs, preventative needs, and comorbid diseases.
  • Explain the objective testing used to evaluate lung allograft function.
  • Summarize the presentation and management of common immunologic complications after lung transplantation.
  • Summarize the presentation and management of common non-immunologic complications after lung transplantation.

Maintenance of Immunosuppression Part Two
ACPE #: 0217-9999-21-170-H01-P

  • Kidney
    • Create an evidence-based maintenance regimen for a kidney transplant recipient that accounts for patient-specific factors.
    • Evaluate the role of extended-release tacrolimus formulations and novel immunosuppression regimens.
  • Liver
    • Compare and contrast maintenance immunosuppression regimens for liver transplant recipients. Design evidence based maintenance immunosuppression regimens for liver transplant recipients.
  • Pancreas
    • Design a maintenance immunosuppression regimen for the prevention of rejection after pancreas transplant.
    • Design a maintenance immunosuppression regimen for the prevention of rejection after islet cell transplant.
  • Heart
    • Describe common immunosuppression approaches in cardiac transplantation. Discuss alternate approaches to immunosuppression.
  • Lung
    • Compare and contrast the benefit, risk, and role of each maintenance immunosuppressant medication in lung transplantation.
    • Design evidence-based maintenance immunosuppression regimens for lung transplant recipients.

Infection Prevention and Management in Solid Organ Transplant Patients
ACPE #: 0217-9999-21-171-H01-P

  • Develop appropriate pre-transplant serologic testing recommendations and interpretation of these results.
  • Identify risk factors associated with post-transplant infections and the epidemiology and timing of these infections.
  • Design strategies to prevent post-transplant opportunistic infections, including prophylaxis regimens and monitoring parameters.
  • Formulate treatment plans for bacterial, viral, and fungal infections in solid-organ transplant recipients.
  • Develop monitoring plans for patients receiving antimicrobials, complete with management of adverse effects and intolerances.

Prevention and Management of Malignancy in Solid Organ Transplant Patients
ACPE #: 0217-9999-21-172-H01-P

  • Demonstrate the common pathogenesis of and risk factors for types of malignancy after solid organ transplant.
  • Distinguish between the types of malignancy that are of increased risk before and after solid organ transplant.
  • Assess preventative strategies for malignancy after transplantation.
  • Diagram an overview of immunosuppression management in the setting of malignancy.
  • Compare common treatment approaches to common malignancies after transplantation, including non-melanoma skin cancer, post-transplant lymphoproliferative disorder, and Kaposi’s sarcoma.

Primary Care of the Solid Organ Transplant Patient
ACPE #: 0217-9999-21-173-H01-P

  • Apply general principles and practices of disease prevention to solid organ transplant recipients. Outline unique patient populations that require additional disease screening.
  • Create an immunization plan for a solid organ transplant recipient in both the pre and post-transplant setting.
  • Identify reputable resources for public education and awareness on organ transplantation including organ donation.

Special Considerations in Pediatric and Geriatric Transplant Populations
ACPE #: 0217-9999-21-174-H01-P

  • Pediatrics
    • Discuss practical differences of medication use in children with emphasis on pharmacokinetics, formulations, and monitoring of commonly used immunosuppressants.
    • Describe the etiologic differences for end stage organ disease and discuss associated complications after solid organ transplant in children.
    • Design a pharmacotherapeutic treatment plan for pediatric patients undergoing intended ABO incompatible organ transplantation.
    • Formulate an immunization plan for a pediatric organ transplant candidate.
  • Geriatrics
    • Compare outcomes of transplant recipients by age group.
    • Evaluate geriatric candidates for transplant based on guideline recommendations.
    • Distinguish pharmacokinetic differences among geriatric transplant recipients.
    • Design an immunosuppression regimen for a geriatric transplant recipient.

Trial Design and Biostatistics
ACPE #: 0217-9999-21-050-H04-P

  • Describe hypothesis testing and state the meaning of and distinguish between p values and confidence intervals and measures of central tendency and data spread.
  • Define, compare, and contrast the concepts of internal and external validity, causation, association, bias, and confounding in trial design. Select strategies to eliminate or control for bias and improve internal and external validity.
  • Compare and contrast the advantages and disadvantages of various study designs (e.g., prospective, retrospective, case-control, cohort, cross-sectional, randomized controlled clinical trials, systematic review, meta-analysis).
  • Determine why a statistical test is appropriate or not appropriate, given the sample distribution, data type, and study design. Interpret statistical and clinical significance for results from commonly used statistical tests.
  • Define and evaluate odds ratio, risk/incidence rate, relative risk, number needed to treat, number needed to harm, and other risk estimates.

Continuity of Care and Managing Transitions of Care in the Transplant Patient
ACPE #: 0217-9999-21-175-H04-P

  • Describe the importance of accurate medication, allergy and immunization histories and medication reconciliation in solid organ transplant recipients.
  • Compare the incidence of index length of stay and hospital readmissions among various solid organ transplant recipients.
  • Evaluate the unique role of a pharmacist in the transition of solid organ transplant recipients between healthcare settings as it relates to medication error reduction and cost avoidance.
  • Propose a matrix for roles and responsibilities of the healthcare team in management of transitions and co-management.
  • Differentiate between various medication access resources in solid organ transplant recipients.
  • Illustrate the strategies available for overcoming patient-specific barriers to care following solid organ transplantation.

Transplant Regulations and Performance Improvement
ACPE #: 0217-9999-21-176-H04-P

  • Review regulations for solid organ transplantation (SOT).
  • Compose policies and procedures for SOT pharmacists that are consistent with transplant regulatory requirements.
  • Identify opportunities for SOT pharmacists to participate in QAPI activities to enhance the safety and effectiveness of medication-use process in SOT.
  • Evaluate compliance with institutional guidelines in order to identify areas failing to meet expectations and implement performance improvement initiatives.
  • Implement processes for cost effective care focusing on continuous quality improvement, patient safety and outcomes in order to justify modifications in transplantation pharmacy services.
  • Diagram involvement of SOT pharmacists in collaborative relationships with interdisciplinary transplant team to promote quality patient care across continuum.

Transplant Resources, Patient Education, and Transplant Study Endpoints
ACPE #: 0217-9999-21-177-H04-P

  • List key government organizations and transplant societies that influence the practice of solid organ transplantation.
  • Compare practice-defining guidelines within the field of solid organ transplantation.
  • Assess patients’ barriers to understanding their medication regimen and adapt education strategy to foster patient competency.
  • Describe appropriate monitoring strategies for transplant medications requiring REMS participation.
  • Formulate an appropriate contraceptive regimen for a female transplant recipient of childbearing age.
  • Evaluate patient risk factors for non-adherence and implement a plan to improve compliance.
  • Review transplant study end points used in the literature to establish efficacy of clinical intervention.


Full faculty bios 

Sarah Bova, Pharm.D., BCPS
Solid Organ Transplant Clinical Pharmacy Specialist
University of Maryland Medical Center
Baltimore, Maryland 

Kimberly Boyle, Pharm.D., BCPS
Cardiothoracic Transplant Clinical Specialist
Vanderbilt University Medical Center Nashville, Tennessee 

Maya Campara, Pharm.D., BCPS*
Clinical Associate Professor
University of Illinois at Chicago College of Pharmacy
Clinical Pharmacist, Solid Organ Transplant
University of Illinois at Chicago College of Medicine
Chicago, Illinois 

Amanda J. Condon, Pharm.D., BCPS
Advanced Clinical Pharmacist, Solid Organ Transplant
Medical City Dallas
Dallas, Texas 

Steven Gabardi, Pharm.D., BCPS*
Abdominal Organ Transplant Clinical Specialist
Brigham and Women’s Hospital
Assistant Professor of Medicine
Harvard Medical School
Boston, Massachusetts 

Jennifer C. Hagopian, Pharm.D., BCPS
Clinical Pharmacy Specialist, Solid Organ Transplant
Barnes-Jewish Hospital
Saint Louis, Missouri 

Tim Humlicek, Pharm.D.
Clinical Pharmacy Specialist, Solid Organ Transplant
Texas Children’s Hospital
Houston, Texas 

Tiffany E, Kaiser, Pharm.D., BCPS
Transplant Clinical Pharmacist
Director Transplant Quality Program
Division of Digestive Disease
The University of Cincinnati College of Medicine
Cincinnati, Ohio 

Claire Kane, Pharm.D., BCPS
Clinical Pharmacist
Northwestern Memorial Hospital
Chicago, Illinois 

Alicia C. Lichvar, Pharm.D., M.S., BCPS
Clinical Assistant Professor
University of Illinois at Chicago
Chicago, Illinois 

Cassie Stromayer Muran, Pharm.D., BCPS
Abdominal Transplant Clinical Pharmacist
Loyola University Medical Center
Maywood, Illinois 

Lisa Potter, Pharm.D., BCPS*
Clinical Coordinator, Transplant Pharmacy Services
University of Chicago Medicine
Chicago, Illinois 

Bharath Ravichandran, Pharm.D., BCPS
Clinical Pharmacy Specialist, Transplant
University of Maryland Medical Center
Baltimore, Maryland 

Chelsea Sammons, Pharm.D.
Clinical Pharmacy Specialist
Residency Program Director, PGY2 Solid Organ Transplant
The Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania 

Michael Shullo, Pharm.D.
Associate Vice President-Transplant Services Professor
West Virginia University Hospitals
Morgantown, West Virginia 

Maressa Santarossa, Pharm.D., BCPS, BCIDP
Transplant Infectious Diseases Clinical Pharmacist
Loyola University Medical Center
Maywood, Illinois 

Lindsey P. Toman, Pharm.D., BCPS*
Clinical Pharmacy Specialist, Solid Organ Transplant
PGY2 Solid Organ Transplant Residency Program Director
The John Hopkins Hospital
Baltimore, Maryland 

* Content Matter Experts 



Nicole R. Alvey, Pharm.D., BCPS, FAST
Jamie Benken, Pharm.D,, BCPS
Lyndsey Bowman, Pharm.D., BCPS, FAST
Jennifer Trofe-Clark, Pharm.D., BCPS, FCCP, FAST
David K. Choi, Pharm.D., BCACP
Kyle L. Dawson, Pharm.D., MBA, BCPS
Nicole S. Ejaz, Pharm.D.
Linda J. Fitzgerald, Pharm.D., BCPS
Reed Hall, Pharm.D., BCPS
Lynley Heinrich, Pharm.D., BCPS
Edward T. Horn, Pharm.D., BCCCP
Arin Jantz, Pharm.D., BCPS
Jennifer K. McDermott, Pharm.D., BCPS
Jennifer Iuppa Melaragno, Pharm.D., BCPS
Jeong M. Park, MS, Pharm.D., FCCP, BCPS
Natalia M. Panek, Pharm.D., BCPS 

Supplemental Materials

Robin Klasek, Pharm.D., BCPS
Medical Science Liaison
Takeda Pharmaceuticals
Boston, Massachusetts

Angela Maldonado, Pharm. D., CPP, BCPS, FAST
Medical Science Liaison
Hansa Biopharma AB
Lund, Sweden  

Field Testers



In accordance with the Accreditation Council for Continuing Medical Education’s Standards for Commercial Support and the Accreditation Council for Pharmacy Education’s Standards for Commercial Support, ASHP requires that all individuals involved in the development of activity content disclose their relevant financial relationships. A person has a relevant financial relationship if the individual of his or her spouse/partner has a financial relationship (e.g. employee, consultant, research grant recipient, speakers bureau, or stockholder) in any amount occurring the in the last 12 months with a commercial interest whose products or series may be discussed in the educational activity content over which the individual has control. The existence of these relationships is provided for the information of participants and should not be assumed to have an adverse impact on the content. 

All faculty and planners for ASHP education activities are qualified and selected by ASHP and required to disclose any relevant financial relationships with commercial interests. ASHP identifies and resolves conflicts of interest prior to an individual’s participation in development of content for an educational activity. Anyone who refuses to disclose relevant financial relationships must be disqualified from any involvement with a continuing pharmacy education activity. 

Faculty Disclosures:

  • Board of Directors: Lisa Potter (American Society of Transplantation)
  • Clinical Investigator: Lisa Potter (Astelias, Bristol Myers Squibb)
  • Consultant/Advisory Board Member: Cassie Stromayer Muran (Consultant/Ad Board: Veloxis Pharmaceuticals), Lisa Potter (Sanofi), Michael Shullo (Natera), Lindsey P. Toman (Wolters Kluwer(Lexi- comp))
  • Speakers Bureau: Jennifer C. Hagopian (Veloxis Pharmaceuticals) 

Reviewer Disclosures:

  • Consultant/Advisory Board Member: Lindsey Bowman (Veloxis Pharmaceuticals), Jennifer Trofe-Clark (MedActionPlan)
  • Clinical Investigator: Jennifer Trofe-Clark (Veloxis Pharmaceuticals
  • Employee: Jennifer Iuppa Melaragno (Husband- Bristol-Myers Squibb)
  • Grant Funding/Research Support: Jennifer Trofe-Clark (Veloxis Pharmaceuticals), Reed Hall (Care Dx)
  • Major Stockholder: Natalia M. Panek (Amarin Pharma, Inc.)

Speakers Bureau:

  • Lyndsey Bowman (Veloxis Pharmaceuticals), Jennifer Trofe-Clark (Veloxis Pharmaceuticals) 

All other planners, presenters, reviewers, ACCP and ASHP staff and others with an opportunity to control content report no financial relationships relevant to this activity. 

Methods and CE Requirements

Activities can be completed in any order. Each activity consists of audio, video, and/or PDFs and evaluations. Learners must review all content and complete the evaluations to receive continuing pharmacy education credit for each activity. 

Follow the prompts to claim, view, or print the statement of credit within 60 days after completing the activity. 

System Technical Requirements

Courses and learning activities are delivered via your Web browser and Acrobat PDF. For all activities, you should have a basic comfort level using a computer and navigating web sites. 

View the minimum technical and system requirements for learning activities. 


These activities were developed by ACCP and ASHP. 

To maintain its strict, independent standards for certification, BPS does NOT endorse or provide review information, preparatory courses, or study guides for Board Certification Examinations.