American College of Clinical Pharmacy
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SOTSAP 2025


Format to Purchase:
Member Price:
$88.00
Nonmember Price:
$132.00
ASHP members, please call (913)492-3311 to receive multi-book discounts at the member rate. Your ASHP membership number and expiration date are required.

ACCP’s Self-Assessment Programs are home study series that provide clinical pharmacists with pertinent therapeutic updates to enhance their practice skills and improve patient outcomes.

The latest release in ACCP’s Solid Organ Transplantation Self-Assessment Program (SOTSAP) features comprehensive reviews, timely evidence-based updates, and case series on various topics relating to immunosuppression, infectious diseases, and management of complex comorbidities. The target audience for SOTSAP 2025 is board-certified and advanced-level clinical pharmacists caring for adult and pediatric solid organ transplant candidates and recipients.

Faculty Panel Chair Nicole A. Pilch, Pharm.D., FAST, BCPS, BCTXP, CPHQ
Pilch

The book contains 8 learning activities with a total available 16.5 continuing pharmacy education (CPE) and/or BCTXP recertification credits. Content was developed under the leadership of Faculty Panel Chair Nicole A. Pilch, Pharm.D., MSCR, BCPS, BCTXP, CPHQ, Senior Clinical Consultant, Transplantation/Gastroenterology/Hepatology, Remote, Wolters Kluwer, Atlanta, Georgia, and Professor, Clinical Pharmacy and Outcomes Sciences, Medical University of South Carolina, Charleston, South Carolina.

Each SOTSAP release has continuing education activities that cover the most recent published data (past 3–5 years) on a specific therapeutic area or patient-care problem. This content is provided as an electronic book (interactive PDF) with high-level updates designed, as appropriate to the topic, in three formats:

  • Traditional review-style chapters
  • Case series (major sections of learning content bookended by a sample case and its explained answer)
  • Recorded webcast (PowerPoint presentation; includes PDF of the transcribed narrative)

Every SOTSAP release comes in two full-color online formats: (1) interactive PDFs you can save to your desktop or print; and (2) an e-media version you can view on an e-reader, tablet, iOS or Android smart phone.

SOTSAP chapters and features are fully referenced, with clickable hyperlinks to literature compilers such as PubMed. Other links provide ready access to clinical practice guidelines, official recommendations, and patient assessment tools. Graphics focus on pivotal studies, patient care scenarios, and take-home points that can be readily integrated into clinical practice.

Release Date: November 17, 2025
BCTXP Deadline: November 17, 2026
ACPE Deadline: November 17, 2028

Editor(s): Campara M, McDermott JK
ISBN: 978-1-964074-30-6
Publication Year: 2025
Format: PDF and ePub

Contents

Chapter: Calcineurin Inhibitor Management and Minimization Strategies

This advanced learning activity explores personalized approaches to calcineurin inhibitor (CNI) therapy in solid organ transplantation. Clinical pharmacists will gain actionable insights into extended-release tacrolimus formulations, pharmacogenomic-guided dosing, and CNI-sparing regimens using mTOR inhibitors and belatacept. Emphasis is placed on optimizing immunosuppression through individualized pharmacokinetics, minimizing toxicity, and improving adherence.

Chapter: Immunosuppressive Strategies in Special Transplants

This activity explores immunosuppressive management in complex transplant populations, including intestinal, allogenic islet cell, uterus, face, and upper limb transplants. Clinical pharmacists will learn to tailor regimens using agents such as tacrolimus, sirolimus, azathioprine, and IL-2 receptor antagonists, balancing efficacy, safety, and patient-specific factors. Emphasis is placed on minimizing toxicity, managing rejection, and optimizing outcomes in nontraditional transplant settings.

Chapter: Endocrine Updates: Posttransplant Diabetes/Osteoporosis

This chapter equips clinical pharmacists to manage endocrine complications in solid organ transplant recipients, focusing on posttransplant diabetes (PTD) and osteoporosis. Learners will explore risk factors, immunosuppressive impacts, and evidence-based use of GLP-1 receptor agonists, SGLT2 inhibitors, DPP-4 inhibitors, and bone-modifying agents. Emphasis is placed on optimizing glycemic control, preserving bone health, and improving cardiovascular and renal outcomes.

Chapter: Posttransplant Malignancy

This activity equips clinical pharmacists to assess, prevent, and manage malignancies in solid organ transplant recipients. Topics include posttransplant lymphoproliferative disorder (PTLD), Kaposi sarcoma, and skin cancers, with emphasis on immunosuppression strategies, EBV monitoring, and emerging therapies such as immune checkpoint inhibitors (ICIs). Learners will explore evidence-based approaches to balancing cancer risk and graft preservation.

Chapter: Management of Invasive Fungal Infections

This learning activity equips clinical pharmacists to optimize antifungal therapy in solid organ transplant recipients. It covers the epidemiology, prophylaxis, and treatment of invasive fungal infections including candidiasis, aspergillosis, cryptococcosis, and endemic mycoses. Learners will explore antifungal pharmacology, therapeutic drug monitoring (TDM), stewardship strategies, and emerging agents.

Chapter: Adherence Tools and Strategies

This chapter equips clinical pharmacists to assess, monitor, and manage medication adherence in solid organ transplant recipients. Learners will explore proactive, reactive, and hybrid adherence strategies, direct and indirect monitoring tools, and patient-centered interventions to reduce graft rejection and improve outcomes.

Chapter: Weight-Loss Management Approaches

This activity explores evidence-based strategies to manage obesity in solid organ transplant recipients. Learners will evaluate surgical and pharmacologic options—including GLP-1 receptor agonists, tirzepatide, and orlistat—alongside behavioral and lifestyle interventions. It also addresses the impact of donor and recipient obesity on transplant outcomes.

Case Series: Posttransplant Neurologic Complications and Management

This case series equips clinical pharmacists to identify, assess, and manage neurologic complications in solid organ transplant recipients. Topics include postoperative delirium, seizure management, posterior reversible encephalopathy syndrome (PRES), and progressive multifocal leukoencephalopathy (PML). Learners will explore pathophysiology, diagnostic strategies, and evidence-based interventions.

Chapter: Calcineurin Inhibitor Management and Minimization Strategies

Faculty

Stephanie Hamel, Pharm.D., BCTXP
Clinical Pharmacist Specialist – Liver Transplant/Hepatology
Department of Pharmaceutical Services
Vanderbilt University Medical Center
Nashville, Tennessee

Reviewers

Angela T. Logan, Pharm.D., BCPS, BCTXP
Solid Organ Transplant Pharmacotherapy Specialist
Department of Pharmacy
Tampa General Hospital
Tampa, Florida
Tricia Bockenstedt, Pharm.D., BCTXP
Solid Organ Transplant Pharmacy Specialist
Department of Pharmacy
University of Iowa Healthcare
Iowa City, Iowa

Chapter: Immunosuppressive Strategies in Special Transplants

Faculty

Nicole Wilson, Pharm.D., MS, BCTXP
Transplant Clinical Pharmacist
Department of Pharmacy
Baylor University Medical Center, part of Baylor Scott & White Health
Dallas, Texas

Reviewers

Jeong M. Park, Pharm.D., MS, FCCP, FAST, BCTXP
Clinical Professor
Department of Clinical Pharmacy
College of Pharmacy, University of Michigan
Ann Arbor, Michigan
Kelsey Del Valle, Pharm.D., BCTXP, BCPS
Clinical Pharmacist Specialist, Solid Organ Transplant
College of Pharmacy, Pharmacotherapy Division
University Health Transplant Institute
The University of Texas at Austin
The University of Texas Health Science Center at San Antonio
San Antonio, Texas

Chapter: Endocrine Updates: Posttransplant Diabetes/Osteoporosis

Faculty

Bethany Lane, Pharm.D., BCTXP
Clinical Pharmacy Specialist, Solid Organ Transplant
Department of Pharmacy
University of Maryland Medical Center
Baltimore, Maryland

Reviewers

Kimberly A. Trobaugh, Pharm.D., BCPS
Transplant Clinical Pharmacist
Department of Pharmacy Services
University of Kentucky HealthCare
Lexington, Kentucky
Nicole R. Alvey, Pharm.D., FAST, BCPS, BCTXP
Associate Professor of Clinical Sciences
Doctor of Pharmacy Program
Roosevelt University College of Science, Health and Pharmacy
Schaumburg, Illinois
Clinical Pharmacy Specialist, Solid Organ Transplant
Department of Pharmacy
Rush University Medical Center
Chicago, Illinois
Mary Grace Fitzmaurice, Pharm.D., BCTXP
Clinical Pharmacy Specialist – Solid Organ Transplant
Department of Pharmacy, Transplant Institute
Henry Ford Health
Detroit, Michigan

Chapter: Posttransplant Malignancy

Faculty

Kristen R. Szempruch, Pharm.D., BCPS, BCTXP
Clinical Pharmacy Specialist – Abdominal Transplant
Department of Pharmacy
University of North Carolina Medical Center
Adjunct Associate Professor of Clinical Education
University of North Carolina Eshelman School of Pharmacy
Chapel Hill, North Carolina
Krysta Walter, Pharm.D., BCTXP
Solid Organ Transplant Clinical Pharmacist Specialist
Department of Pharmacy
University of Michigan Health
Adjunct Clinical Assistant Professor
University of Michigan College of Pharmacy
Ann Arbor, Michigan

Reviewers

Annie K. Przybylski, Pharm.D., BCPS, BCTXP
Clinical Pharmacy Practitioner, Solid Organ Transplant
Department of Pharmacy
Edward Hines Jr. VA Hospital
Chicago, Illinois
Alejandro De La Vega III, Pharm.D., BCTXP, BCPS
Clinical Pharmacist
Department of Pharmacy Clinical Services
Avel eCare Pharmacy
Sioux Falls, South Dakota

Chapter: Management of Invasive Fungal Infections

Faculty

Kellie J. Goodlet, Pharm.D., FCCP, BCIDP, BCPS, BCTXP
Associate Professor
Department of Pharmacy Practice
Midwestern University
Glendale, Arizona

Reviewers

Marissa M. Brokhof, Pharm.D., BCPS, BCTXP
Clinical Pharmacy Specialist, Solid Organ Transplantation
Department of Pharmacy
Rush University Medical Center
Chicago, Illinois
Stephanie Witek, Pharm.D., BCTXP
Clinical Pharmacy Specialist, Lung Transplant
Department of Pharmacy
Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania

Chapter: Adherence Tools and Strategies

Faculty

Lyndsey J. Bowman, Pharm.D., FCCP, FAST, BCPS, BCTXP
Pharmacotherapy Specialist, Kidney & Liver Transplant Coordinator, Solid Organ Transplant Pharmacists
Department of Pharmacy
Tampa General Hospital
Tampa, Florida
Jennifer Iuppa Melaragno, Pharm.D., FCCP, FAST, BCPS
Abdominal Transplant Clinical Pharmacist
Department of Pharmacy
University of Rochester Medical Center
Rochester, New York

Reviewers

Megan L. Sell, Pharm.D.
Pediatric Clinical Pharmacy Specialist
Department of Pharmacy
Medical University of South Carolina Shawn Jenkins Children’s Hospital
Charleston, South Carolina
Justin K. Chen, Pharm.D., BCTXP
Pharmacist Specialist
Department of Pharmacy
Children’s Healthcare of Atlanta
Atlanta, Georgia
Megan Keck, Pharm.D., BCPS, BCTXP
Clinical Pharmacist Practitioner
Department of Pharmaceutical and Nutrition Care
Nebraska Medicine
Omaha, Nebraska

Chapter: Weight-Loss Management Approaches

Faculty

Dana Pierce, Pharm.D., BCTXP
Clinical Assistant Professor/Clinical Pharmacist
Department of Pharmacy Practice
University of Illinois Chicago
Chicago, Illinois

Reviewers

Evan M. Sisson, Pharm.D., MSHA, BCACP, CDCES
Professor
Department of Pharmacotherapy and Outcomes Science
VCU School of Pharmacy
Richmond, Virginia
Sandra El Hajj, Pharm.D., BCPS, BCTXP
Solid Organ Transplant Pharmacotherapy Specialist
Department of Pharmacy
Cleveland Clinic Abu Dhabi
Abu Dhabi, United Arab Emirates
Michelle Sabbah, Pharm.D., BCTXP
Medication Use Policy Pharmacist
Department of Pharmacy
Northwestern Memorial HealthCare
Chicago, Illinois

Case Series: Posttransplant Neurologic Complications and Management

Faculty

Benito Valdepeñas, Pharm.D., BCTXP
Clinical Assistant Professor/Clinical Pharmacist/Director of Clinical Research
Department of Pharmacy Practice and Surgery
University of Illinois Chicago
Chicago, Illinois
Rachel Christensen, Pharm.D.
Clinical Assistant Professor/Clinical Pharmacist – Solid Organ Transplant
Department of Pharmacy Practice
University of Illinois Chicago Retzky College of Pharmacy
Chicago, Illinois

Reviewers

Neha Patel, Pharm.D., BCPS
Abdominal Transplant Clinical Specialist
Department of Pharmacy
Houston Methodist
Houston, Texas
Katie Myers, Pharm.D., BCPS, BCTXP
Clinical Pharmacy Manager – Solid Organ Transplant
Department of Pharmacy
Montefiore Medical Center
Bronx, New York
Vicky Lewis, BS Pharm, RPh, BCOP, BCTXP
Clinical Pharmacy Specialist
Department of Renal Transplant
Texas Health Harris Methodist Hospital
Fort Worth, Texas

CPE Credit

The American College of Clinical Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

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

The American College of Clinical Pharmacy and the American Society of Health-System Pharmacists are approved by BPS as a provider for the recertification of BCTXP.

BPS is an autonomous division of the American Pharmacists Association. 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. BPS, through its specialty councils, is responsible for specialty examination content, administration, scoring, and all other aspects of its certification programs. BPS is totally separate and distinct from ACCP. For information about BPS specialty recertification the BPS recertification process, go to: www.bpsweb.org/

To receive recertification credit, posttests must be submitted prior to the recertification posttest deadline (see above). Only completed tests are eligible for credit; no partial or incomplete tests will be processed. You may complete one or all available posttests for credit.

The passing point to earn recertification credit is based on an expert analysis of the assessment items in each posttest. Any posttest submitted before the recertification test deadline that meets this passing point will earn recertification credits. These credits will be assigned as of the date of test submission and reported within 48 hours to BPS. For statements of recertification credit, visit www.bpsweb.org.

In accordance with BPS guidelines concerning remediation for products launched in 2024 and after, posttests that do not reach the passing point for recertification credit will generate a second-chance test option. This test will automatically appear in the learner’s My Account page and will have assessment items presented in a different order. To qualify for recertification credit, the second-chance test must be submitted before the recertification deadline stated above.

The ACCP Recertification Dashboard is a free online tool that can track recertification credits as they are earned through ACCP and schedule new opportunities for credits from upcoming ACCP professional development programs. Questions regarding the number of hours required for recertification should be directed to BPS at www.bpsweb.org.

Target Audience: The target audience for SOTSAP 2025 is board-certified and advanced-level clinical pharmacists caring for adult and pediatric solid organ transplant candidates and recipients.

Contents

Chapter: Calcineurin Inhibitor Management and Minimization Strategies

Activity Number: 0217-9999-25-215-H01-P
Contact Hour(s): 2.00
Activity Type: Application Based
Learning Objectives

1. Convert an immediate-release tacrolimus regimen to extended-release tacrolimus on the basis of patient-specific factors.

2. Assess the risk-benefit of calcineurin inhibitor (CNI) minimization strategies in solid organ transplant recipients.

3. Develop a patient care plan for transition to an alternative immunosuppression regimen that minimizes CNI exposure.

4. Evaluate CYP3A5 genotype data to predict the tacrolimus metabolism phenotype.

5. Apply patient-specific pharmacogenetics to selecting a posttransplant tacrolimus regimen.

Chapter: Immunosuppressive Strategies in Special Transplants

Activity Number: 0217-9999-25-216-H01-P
Contact Hour(s): 1.00
Activity Type: Application Based
Learning Objectives

1. Design a maintenance plan for immunosuppression for an intestinal transplant (ITx) recipient.

2. Distinguish patient scenarios that may warrant the use of adjunctive or alternative maintenance agents in an ITx recipient.

3. Apply evidence of allogenic islet cell maintenance immunosuppressive outcomes to patient scenarios.

4. Analyze maintenance immunosuppressive regimens for face, limb, and uterus transplant (UTx) recipients.

5. Convert maintenance immunosuppressive medications for face, limb, and UTx recipients to alternative or adjunctive agents on the basis of patient-specific factors.

Chapter: Endocrine Updates: Posttransplant Diabetes/Osteoporosis

Activity Number: 0217-9999-25-217-H01-P
Contact Hour(s): 3.00
Activity Type: Application Based
Learning Objectives

1. Assess risk factors for developing posttransplant diabetes (PTD) in solid organ transplant (SOT) recipients.

2. Develop a patient care plan for managing PTD in SOT recipients.

3. Analyze the role of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) or sodium-glucose cotransporter-2 (SGLT2) inhibitors for managing PTD according to available evidence for their use in SOT recipients.

4. Assess risk factors for developing osteoporosis in SOT recipients.

5. Develop a patient care plan for managing osteoporosis after transplantation in SOT recipients.

6. Analyze the risk-benefit of modifying immunosuppressive regimens after transplantation to alleviate the risk of developing PTD and/or osteoporosis.

Chapter: Posttransplant Malignancy

Activity Number: 0217-9999-25-218-H01-P
Contact Hour(s): 2.50
Activity Type: Application Based
Learning Objectives

1. Evaluate risk factors for developing malignancy after transplantation.

2. Develop a patient care plan for managing posttransplant lymphoproliferative disorders (PTLDs) in solid organ transplant recipients (SOTRs).

3. Evaluate the evidence for modifications to maintenance immunosuppressive regimens in SOTRs with Kaposi sarcoma.

4. Design a monitoring plan to evaluate the response to the therapeutic options used to treat skin cancer in SOTRs.

5. Assess current data on the use of immune checkpoint inhibitors (ICIs) in SOTRs.

Chapter: Management of Invasive Fungal Infections

Activity Number: 0217-9999-25-219-H01-P
Contact Hour(s): 3.50
Activity Type: Application Based
Learning Objectives

1. Assess the epidemiology and risk factors for the common fungal infections encountered in solid organ transplant recipients.

2. Distinguish the spectrum of activity and pharmacologic properties of common antifungals.

3. Justify appropriate posttransplant antifungal prophylaxis according to organ type and other patient-specific considerations.

4. Design an optimal antifungal treatment regimen and monitoring plan for a solid organ transplant recipient with an invasive fungal infection.

Chapter: Adherence Tools and Strategies

Activity Number: 0217-9999-25-220-H01-P
Contact Hour(s): 2.00
Activity Type: Application Based
Learning Objectives

1. Assess the impact of nonadherence and current challenges for effective adherence assessment in solid organ transplant (SOT) recipients.

2. Distinguish the differences between available adherence monitoring strategies and tools for use in SOT recipients.

3. Evaluate and implement the most appropriate adherence monitoring strategy according to transplant program needs.

4. Develop a management plan to address nonadherence.

Chapter: Weight-Loss Management Approaches

Activity Number: 0217-9999-25-221-H01-P
Contact Hour(s): 1.50
Activity Type: Application Based
Learning Objectives

1. Evaluate the incidence, risk factors, and complications for weight gain in solid organ transplant recipients.

2. Analyze the pros and cons of surgical weight-loss techniques.

3. Design a medication regimen to increase weight loss before and after transplantation.

4. Develop nonpharmacologic recommendations to increase weight loss before and after transplantation.

5. Assess perioperative factors and techniques that improve posttransplant outcomes.

Case Series: Posttransplant Neurologic Complications and Management

Activity Number: 0217-9999-25-222-H01-P
Contact Hour(s): 1.00
Activity Type: Application Based
Learning Objectives

1. Assess risk factors for postoperative delirium and devise patient-specific treatment strategies.

2. Develop an effective treatment strategy for managing seizures in solid organ transplant (SOT) recipients.

3. Demonstrate an understanding of the pathophysiology and therapeutic approach to posterior reversible encephalopathy syndrome (PRES).

4. Analyze clinical data to create a comprehensive treatment strategy in SOT recipients with progressive multifocal leukoencephalopathy (PML).

Disclosures


Commercial Support

The American College of Clinical Pharmacy does not solicit or accept external commercial/financial support for its continuing pharmacy education activities. No commercial/financial support has been solicited or accepted for this activity.