Clinical Transplantation最新文献

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Management of Cytomegalovirus Infection in Allogeneic Hematopoietic Stem Cell and in Solid Organ Transplantation: Updated Recommendations by the GITMO, SITO, SIMIT, and AMCLI Italian Societies 同种异体造血干细胞和实体器官移植中巨细胞病毒感染的处理:GITMO、SITO、SIMIT和AMCLI意大利学会的最新建议
IF 1.9 4区 医学
Clinical Transplantation Pub Date : 2025-07-25 DOI: 10.1111/ctr.70255
Corrado Girmenia, Tiziana Lazzarotto, Massimo Martino, Francesca Bonifazi, Fausto Baldanti, Pierangelo Clerici, Franco Citterio, Luciano De Carlis, Giovanni Barosi, Paolo Antonio Grossi
{"title":"Management of Cytomegalovirus Infection in Allogeneic Hematopoietic Stem Cell and in Solid Organ Transplantation: Updated Recommendations by the GITMO, SITO, SIMIT, and AMCLI Italian Societies","authors":"Corrado Girmenia,&nbsp;Tiziana Lazzarotto,&nbsp;Massimo Martino,&nbsp;Francesca Bonifazi,&nbsp;Fausto Baldanti,&nbsp;Pierangelo Clerici,&nbsp;Franco Citterio,&nbsp;Luciano De Carlis,&nbsp;Giovanni Barosi,&nbsp;Paolo Antonio Grossi","doi":"10.1111/ctr.70255","DOIUrl":"https://doi.org/10.1111/ctr.70255","url":null,"abstract":"<div>\u0000 \u0000 <p>New options for prevention and therapy of cytomegalovirus (CMV) infection and new tests for antiviral immune reconstitution are leading to increased complexity in the management of CMV after allogeneic hematopoietic stem cell (allo-HSCT) and solid organ transplantation (SOT) recipients. To inform the optimal care of these patients, under the auspices of the Italian GITMO, SITO, SIMIT, and AMCLI transplant, infectious, and clinical microbiology societies, we updated the guidelines published in 2019. New recommendations were produced using a consensus-building methodology after a comprehensive review of articles released from 2019 to 2025 (March). Five domains and 31 key questions were selected through a series of questionnaires using a Delphi process. The recommendations on CMV management in transplant recipients were related to diagnostics, prevention, and treatment. Key recommendations include: in both allo-HSCT and SOT, donor and recipient should be evaluated for anti-CMV serological status before transplant for risk stratification; monitoring of CMV infection after transplant should be performed by assaying CMV DNAemia with real time PCR; CMV-specific cell mediated immunity should be monitored after transplantation in allo-HSCT and SOT; in CMV seropositive adult allo-HSCT recipients with negative CMV DNAemia, letermovir prophylaxis is recommended; there is no mandatory indication to universal prophylaxis in SOT recipients; preemptive antiviral therapy is recommended in patients with clinically significant CMV infection (CS-CMV-i); in patients with resistant or refractory CMV infection or disease after first-line antiviral therapy, oral maribavir is recommended as second line antiviral therapy. In conclusion, these recommendations aim to guide clinical practice and improve outcomes in this high-risk population.</p>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 8","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144705378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Conditions Associated With the Onset of Cancer After Heart Transplant: Longitudinal Study in 335 Recipients 与心脏移植后癌症发病相关的条件:对335名受者的纵向研究
IF 1.9 4区 医学
Clinical Transplantation Pub Date : 2025-07-25 DOI: 10.1111/ctr.70243
Fabian Patauner, Filomena Boccia, Silvia Masini, Giuliana Autiero, Raffaella Gallo, Lorenzo Bertolino, Irene Mattucci, Daniela Pinto, Roberto Andini, Cristiano Amarelli, Rosa Zampino, Emanuele Durante-Mangoni
{"title":"Conditions Associated With the Onset of Cancer After Heart Transplant: Longitudinal Study in 335 Recipients","authors":"Fabian Patauner,&nbsp;Filomena Boccia,&nbsp;Silvia Masini,&nbsp;Giuliana Autiero,&nbsp;Raffaella Gallo,&nbsp;Lorenzo Bertolino,&nbsp;Irene Mattucci,&nbsp;Daniela Pinto,&nbsp;Roberto Andini,&nbsp;Cristiano Amarelli,&nbsp;Rosa Zampino,&nbsp;Emanuele Durante-Mangoni","doi":"10.1111/ctr.70243","DOIUrl":"https://doi.org/10.1111/ctr.70243","url":null,"abstract":"<p>Cancer is among the major causes of death after heart transplant (HTx). Risk factors for cancer occurrence in this setting are not well established. This was a retrospective observational study of patients who underwent HTx between 2006 and 2019 and were followed up until May 2024. Clinical variables possibly associated with cancer were assessed with univariable and multivariable analyses. Survival analysis was carried out drawing Kaplan Meier curves and a Cox regression with time-varying covariates were performed to overcome the immortal-time-bias. Three-hundred-thirty-five HTx recipients were included, of whom 42 (12.5%) developed cancer after a median of 6.3 years. In univariable analysis, older age at HTx, smoking history, alcohol use, male sex, ischemic heart disease before HTx, use of cyclosporine rather than tacrolimus, and increased length of follow-up were associated with cancer. Upon multivariable analysis, ischemic heart disease (OR 2.70 [1.19–6.11], <i>p</i> = 0.017) and length of follow-up (OR 1.02 [1.00–1.04], <i>p</i> = 0.007) were independently associated with cancer occurrence. Cox regression revealed a higher risk of mortality among patients with cancer (HR 3.400, [2.026–5.709], <i>p</i> &lt; 0.001). HTx recipients with prior ischemic cardiomyopathy and a longer survival time after transplant show a higher risk of developing cancer. Cancer significantly impairs post-transplant survival.</p>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 8","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ctr.70243","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144705437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Addition of a Temporary Portocaval Shunt Does Not Reduce Acute Kidney Injury in Caval-Sparing Liver Transplantation 临时门静脉分流不能减少保留门静脉的肝移植的急性肾损伤
IF 1.9 4区 医学
Clinical Transplantation Pub Date : 2025-07-25 DOI: 10.1111/ctr.70259
Lars C. Pietersen, Niels Broekman, Marije Reekers, Hein Putter, Maarten E. Tushuizen, Ian P. J. Alwayn, Bart van Hoek, Andries E. Braat
{"title":"Addition of a Temporary Portocaval Shunt Does Not Reduce Acute Kidney Injury in Caval-Sparing Liver Transplantation","authors":"Lars C. Pietersen,&nbsp;Niels Broekman,&nbsp;Marije Reekers,&nbsp;Hein Putter,&nbsp;Maarten E. Tushuizen,&nbsp;Ian P. J. Alwayn,&nbsp;Bart van Hoek,&nbsp;Andries E. Braat","doi":"10.1111/ctr.70259","DOIUrl":"https://doi.org/10.1111/ctr.70259","url":null,"abstract":"<p>Acute kidney injury (AKI) is a common complication following liver transplantation (LT), with multifactorial etiology. It is believed that perioperative hemodynamic instability could lead to AKI. A temporary portocaval shunt (TPCS) could possibly prevent this, but its beneficial effect is still controversial, especially in caval-sparing LT. Therefore, the aim of this study was to evaluate whether the use of a TPCS during hepatectomy reduces the incidence and severity of post-LT AKI in caval-sparing LT, defined according to AKIN criteria. Between January 2005 and August 2023, all orthotopic LTs performed in a single center were retrospectively analyzed and were divided into a TPCS group (<i>n</i> = 134) and a no-TPCS group (<i>n</i> = 260). Serum creatinine was collected right before LT and daily during the first week post-LT. In multivariate analysis, TPCS was not related to AKI, while diabetes mellitus (<i>p</i> = 0.01) and LabMELD (<i>p</i> = 0.02) were. When comparing TPCS and no-TPCS groups, no differences were seen in median increase of serum creatinine post-LT (TPCS; 12 µmol/L (-4–52) versus no-TPCS; 14 µmol/L ± (-3–52) (<i>p</i> = 0.94)), number of post-LT AKI (TPCS; 31% versus no-TPCS; 33% (<i>p</i> = 0.57)), or severity of post-LT AKI (<i>p</i> = 0.90). In conclusion, the application of a TPCS during hepatectomy is not associated with less post-LT AKI or less severe post-LT AKI when using a caval-sparing LT technique.</p>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 8","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ctr.70259","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144705435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transplantation of Severely Steatotic Liver Grafts After Machine Perfusion Remains a Risky Challenge 机器灌注后严重脂肪变性肝移植仍然是一个危险的挑战
IF 1.9 4区 医学
Clinical Transplantation Pub Date : 2025-07-25 DOI: 10.1111/ctr.70260
Riccardo Cirelli, Adam M. Thorne, Otto B. van Leeuwen, Bianca Lascaris, Veerle A. Lantinga, Silke B. Bodewes, Marius C. van den Heuvel, Robert J. Porte, Vincent E. de Meijer
{"title":"Transplantation of Severely Steatotic Liver Grafts After Machine Perfusion Remains a Risky Challenge","authors":"Riccardo Cirelli,&nbsp;Adam M. Thorne,&nbsp;Otto B. van Leeuwen,&nbsp;Bianca Lascaris,&nbsp;Veerle A. Lantinga,&nbsp;Silke B. Bodewes,&nbsp;Marius C. van den Heuvel,&nbsp;Robert J. Porte,&nbsp;Vincent E. de Meijer","doi":"10.1111/ctr.70260","DOIUrl":"https://doi.org/10.1111/ctr.70260","url":null,"abstract":"<p>Liver transplantation is the treatment of choice for patients with end-stage liver disease. However, donor shortages have increased the use of high-risk and extended criteria donor livers, including livers donated after circulatory death and those with severe steatosis. Severe donor liver steatosis is associated with poor outcomes due to high susceptibility to ischemia-reperfusion injury. Ex situ machine perfusion, combining hypothermic oxygenated perfusion and normothermic perfusion (termed the DHOPE-COR-NMP protocol), has emerged as a promising strategy to mitigate injury, assess liver viability, and improve transplant outcomes. Here, we present two patients who received very steatotic donor livers following resuscitation and viability assessment using DHOPE-COR-NMP. Although both steatotic donor liver functioned well during NMP and met all of our clinically validated viability criteria, the outcome after transplantation was complicated. One recipient suffered from pulmonary fat emboli syndrome, likely due to significant loss of fat from the donor liver. The second patient required retransplantation and histopathological examination of the donor liver revealed massive lipopeliosis in zones III of the explanted liver. With the increasing incidence of steatotic donor livers, further research to prevent steatosis-related posttransplant complications is becoming progressively important. At present, transplantation of severely steatotic liver grafts remains a risky challenge, even after ex situ machine perfusion.</p>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 8","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ctr.70260","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144705436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Belatacept Pharmacokinetic Analysis of Belatacept Early Steroid Withdrawal Trial (BEST) to Clinical Outcomes and Compared With Reported BENEFIT and BENEFIT-EXT Pharmacokinetic Analysis Belatacept早期类固醇停药试验(BEST)对临床结果的药代动力学分析,并与报道的获益和BENEFIT- ext药代动力学分析进行比较
IF 1.9 4区 医学
Clinical Transplantation Pub Date : 2025-07-24 DOI: 10.1111/ctr.70172
Alexandra Pyatt, Melissa McGowan, Ryota Tanaka, Bradley Miyagawa, Tomoyuki Mizuno, Adele Rike Shields, Annette Christianson, Patricia West-Thielke, John P. Leone, E. Steve Woodle, Dixon Kaufman, Alexander Wiseman, Arthur J. Matas, Alexander A. Vinks, Rita R. Alloway
{"title":"Belatacept Pharmacokinetic Analysis of Belatacept Early Steroid Withdrawal Trial (BEST) to Clinical Outcomes and Compared With Reported BENEFIT and BENEFIT-EXT Pharmacokinetic Analysis","authors":"Alexandra Pyatt,&nbsp;Melissa McGowan,&nbsp;Ryota Tanaka,&nbsp;Bradley Miyagawa,&nbsp;Tomoyuki Mizuno,&nbsp;Adele Rike Shields,&nbsp;Annette Christianson,&nbsp;Patricia West-Thielke,&nbsp;John P. Leone,&nbsp;E. Steve Woodle,&nbsp;Dixon Kaufman,&nbsp;Alexander Wiseman,&nbsp;Arthur J. Matas,&nbsp;Alexander A. Vinks,&nbsp;Rita R. Alloway","doi":"10.1111/ctr.70172","DOIUrl":"https://doi.org/10.1111/ctr.70172","url":null,"abstract":"<p>Belatacept (BELA) pharmacokinetic (PK) studies informed dosing strategies used in phase 3 studies, where fixed mg/kg dosing compared a less intensive (LI) and more intensive (MI) regimen. The LI regimen was preferred due to a better risk/benefit profile. We compared PK parameters observed in the BELA Early Steroid Withdrawal Trial (BEST) with previous reports. BELA trough samples were analyzed using a validated quantitative enzyme-linked immunoassay. Clearance (CL) was estimated with Bayesian estimation using a published BELA population PK model. Significantly higher CL was observed in subjects &lt;60 years old and African American (AA) patients, leading to decreased BELA exposure. No differences in allometrically scaled CL were observed by BMI or sex; however, overall BELA exposure was greater in males. There were no differences in exposure in subjects with rejection; however, subjects with infection had significantly higher exposure. BELA PK was not different between alemtuzumab and rabbit-antithymocyte globulin induction groups without steroids, but overall drug exposure was higher than previously reported in trials co-administering with basiliximab and steroids. Future studies to optimize BELA dosing strategies are warranted as BELA exposure in this analysis exceeded Phase 3 target thresholds.</p><p><b>Trial Registration</b>: ClinicalTrials.gov identifier: NCT 01729494</p>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 8","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ctr.70172","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Incidence, Risk Factors, and Prognosis of Acute Kidney Injury in Elderly Patients With Acute Leukemia Undergoing Haploidentical Hematopoietic Stem Cell Transplantation 单倍体造血干细胞移植治疗老年急性白血病患者急性肾损伤的发生率、危险因素及预后
IF 1.9 4区 医学
Clinical Transplantation Pub Date : 2025-07-24 DOI: 10.1111/ctr.70257
Wei Sun, Shengye Lu, Yaqin Wu, Zhengli Xu, Rui Ma, Xiaodong Mo, Yu Wang, Lanping Xu, Xiaohui Zhang, Xiaojun Huang, Yuqian Sun
{"title":"Incidence, Risk Factors, and Prognosis of Acute Kidney Injury in Elderly Patients With Acute Leukemia Undergoing Haploidentical Hematopoietic Stem Cell Transplantation","authors":"Wei Sun,&nbsp;Shengye Lu,&nbsp;Yaqin Wu,&nbsp;Zhengli Xu,&nbsp;Rui Ma,&nbsp;Xiaodong Mo,&nbsp;Yu Wang,&nbsp;Lanping Xu,&nbsp;Xiaohui Zhang,&nbsp;Xiaojun Huang,&nbsp;Yuqian Sun","doi":"10.1111/ctr.70257","DOIUrl":"https://doi.org/10.1111/ctr.70257","url":null,"abstract":"<div>\u0000 \u0000 <p>We explored the incidence, risk factors, and clinical characteristics of acute kidney injury (AKI) within 100 days posttransplantation, and its impact on the prognosis of haploidentical hematopoietic stem cell transplantation (haplo-HSCT) in elderly patients. A total of 224 elderly patients diagnosed with acute leukemia received haplo-HSCT between January 1, 2019, and December 31, 2023 at Peking University People's Hospital. AKI affected 54.9% of the patients, with 33.5% in Stage 1, 18.3% in Stage 2, and 3.1% in Stage 3. Being female and having hypoalbuminemia were independent risk factors for developing severe AKI. Three-year overall survival for AKI Stages 0, 1, 2, and 3 were 73.4%, 75.9%, 56.6%, and 14.3%, respectively (<i>p</i> = 0.000). The 3-year event-free survival rates were 70.7%, 73.0%, 46.2%, and 0% (<i>p</i> &lt; 0.001). The 3-year transplantation-related mortality was 13.8% for Stages 0–1 and 48.1% for Stages 2–3 (<i>p</i> &lt; 0.001). Our study showed that more than half of elderly patients who underwent haplo-HSCT developed AKI. Being female and having hypoalbuminemia before transplantation were at a significantly higher risk for severe AKI. Experiencing Stage 2 or more severe AKI was found to be an independent risk factor for increased mortality.</p>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 8","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long-Term Results of Normothermic Machine Perfusion in Kidney Transplants: A Pilot Study 常温机器灌注在肾移植中的长期效果:一项初步研究
IF 1.9 4区 医学
Clinical Transplantation Pub Date : 2025-07-24 DOI: 10.1111/ctr.70225
Iacopo Cristoferi, Sarah Bouari, Elsaline Rijkse, Marian C. Clahsen-van Groningen, Andrew P. Stubbs, Hendrikus J. A. N. Kimenai, Robert C. Minnee
{"title":"Long-Term Results of Normothermic Machine Perfusion in Kidney Transplants: A Pilot Study","authors":"Iacopo Cristoferi,&nbsp;Sarah Bouari,&nbsp;Elsaline Rijkse,&nbsp;Marian C. Clahsen-van Groningen,&nbsp;Andrew P. Stubbs,&nbsp;Hendrikus J. A. N. Kimenai,&nbsp;Robert C. Minnee","doi":"10.1111/ctr.70225","DOIUrl":"https://doi.org/10.1111/ctr.70225","url":null,"abstract":"","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 8","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cultural Influences, Considerations, and Challenges for Organ Donation and Liver Transplantation Around the World 世界各地器官捐献和肝移植的文化影响、考虑和挑战
IF 1.9 4区 医学
Clinical Transplantation Pub Date : 2025-07-24 DOI: 10.1111/ctr.70252
Sher-Lu Pai, Manhal Izzy, Alfred Kow Wei Chieh, Iman F. Montasser, Nyingi Kemmer, Uzung Yoon, Emmanouil Giorgakis, Nazia Selzner, Keri E. Lunsford, Chiara Becchetti, Flávia Heinz Feier, Sarwa Darwish Murad, Martin Montenovo, Victoria Aguilera, Oya M. Andacoglu
{"title":"Cultural Influences, Considerations, and Challenges for Organ Donation and Liver Transplantation Around the World","authors":"Sher-Lu Pai,&nbsp;Manhal Izzy,&nbsp;Alfred Kow Wei Chieh,&nbsp;Iman F. Montasser,&nbsp;Nyingi Kemmer,&nbsp;Uzung Yoon,&nbsp;Emmanouil Giorgakis,&nbsp;Nazia Selzner,&nbsp;Keri E. Lunsford,&nbsp;Chiara Becchetti,&nbsp;Flávia Heinz Feier,&nbsp;Sarwa Darwish Murad,&nbsp;Martin Montenovo,&nbsp;Victoria Aguilera,&nbsp;Oya M. Andacoglu","doi":"10.1111/ctr.70252","DOIUrl":"https://doi.org/10.1111/ctr.70252","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Although liver transplantation (LT) rates have increased globally, the demand for organs still exceeds the supply. This review highlights cultures with significant influences on organ donation and LT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a literature search for articles related to cultures, ethnologies, philosophies, policies, religions, socio-economic factors, and other influences affecting organ donation in LT around the world.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There are astonishing similarities between different cultures. In Africa, Asia, and Europe, people often view the postmortem bodies as sacred and believe that their bodies are gifts from “God” or ancestors. To respect the gift of life, to have a chance in reincarnation, or to enjoy life after death, many believe that their bodily sanctity must be preserved. In Asia, Europe, and Latin America, there is a general reluctance to speak about death. Religions also play an important role in people's views on organ donation. Different regions around the world have similar challenges to organ donation, such as misconceptions about organ trafficking, political and economic instability, and a lack of governmental or religious support.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Addressing the complexities of organ donation and LT requires a multifaceted approach. Culturally sensitive education tailored to diverse communities can dispel myths and misconceptions surrounding organ donation. Fostering partnerships between healthcare providers, religious leaders, community organizations, and policymakers can further facilitate open dialogues and promote organ donation as a noble act to save lives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Social Media</h3>\u0000 \u0000 <p>Similar cultures around the world post challenges for organ donation. Organizations should foster partnerships between healthcare providers, politicians, and religious leaders to promote donation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 8","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Extracorporeal Photopheresis in the Treatment of Cardiac Allograft Rejection in the Modern Era: A Single-Center Experience 体外光移植术治疗当代异体心脏移植排斥反应:单中心经验
IF 1.9 4区 医学
Clinical Transplantation Pub Date : 2025-07-23 DOI: 10.1111/ctr.70247
Gal Rubinstein, Andrea Fernandez Valledor, Cathrine M. Moeller, Julia Baranowska, Daniel Oren, David Kyung Taek Oh, David Bae, Adil Yunis, Dor Lotan, Afsana Rahman, Jayant K. Raikhelkar, Justin A. Fried, Ersilia M. DeFilippis, Kevin J. Clerkin, Farhana Latif, Gabriel T. Sayer, Nir Uriel
{"title":"Extracorporeal Photopheresis in the Treatment of Cardiac Allograft Rejection in the Modern Era: A Single-Center Experience","authors":"Gal Rubinstein,&nbsp;Andrea Fernandez Valledor,&nbsp;Cathrine M. Moeller,&nbsp;Julia Baranowska,&nbsp;Daniel Oren,&nbsp;David Kyung Taek Oh,&nbsp;David Bae,&nbsp;Adil Yunis,&nbsp;Dor Lotan,&nbsp;Afsana Rahman,&nbsp;Jayant K. Raikhelkar,&nbsp;Justin A. Fried,&nbsp;Ersilia M. DeFilippis,&nbsp;Kevin J. Clerkin,&nbsp;Farhana Latif,&nbsp;Gabriel T. Sayer,&nbsp;Nir Uriel","doi":"10.1111/ctr.70247","DOIUrl":"https://doi.org/10.1111/ctr.70247","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Extracorporeal photopheresis (ECP) has gained recognition as a valuable adjunctive antirejection therapy, particularly in heart-transplantation (HT) patients at elevated risk for rejection or those experiencing recurrent antibody-mediated rejection (AMR) despite appropriate treatment. We evaluated the safety and clinical effects of ECP in HT recipients with high immunologic risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All HT recipients who underwent ECP between February 2020 and January 2024 were included in this retrospective, single-center study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifteen patients who underwent ECP were identified. Twelve patients completed ECP and were followed for a median of 11.2 months (3.9–19.9). The time from transplant to ECP initiation was 5.3 years (1.3–13). The most common indication for ECP was AMR (60%). During ECP, immunosuppression regimens were maintained or de-escalated in 93% of the patients. Reduction in donor specific antibodies (DSA), peripheral gene expression profiling (GEP), and donor-derived cell-free DNA (dd-cfDNA) levels were observed in 64%, 57%, and 67% of the patients, respectively. Eighty-three percent of the patients were free from rejection during the follow-up period. Overall survival was 87%, and no deaths were related to ECP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In our single-center experience, ECP resulted in a decrease in immunosuppression use, and a reduction in DSA, GEP, and dd-cfDNA levels with a high freedom-from-rejection rate.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 8","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Life-Saving Benefit of the Living Donor Kidney Evaluation: A Mini Review 活体肾脏评估的救命效益:一个小回顾
IF 1.9 4区 医学
Clinical Transplantation Pub Date : 2025-07-23 DOI: 10.1111/ctr.70253
Matthew L. Holzner, Arthur Matas, Sun-Cheol Park, Alan Langas, Arika Hoffman, Nils Heyne, Martina Guthoff, Stuart Flechner, Ron Shapiro
{"title":"The Life-Saving Benefit of the Living Donor Kidney Evaluation: A Mini Review","authors":"Matthew L. Holzner,&nbsp;Arthur Matas,&nbsp;Sun-Cheol Park,&nbsp;Alan Langas,&nbsp;Arika Hoffman,&nbsp;Nils Heyne,&nbsp;Martina Guthoff,&nbsp;Stuart Flechner,&nbsp;Ron Shapiro","doi":"10.1111/ctr.70253","DOIUrl":"https://doi.org/10.1111/ctr.70253","url":null,"abstract":"<div>\u0000 \u0000 <p>While there has been an appropriate focus on characterizing the risks associated with living kidney donation, little attention has been paid to the potential benefit to the donor of undergoing the living donor evaluation. This review highlights four studies from the United States and Europe across 30 years demonstrating that the living donor evaluation leads to the detection of previously undiagnosed medical problems in potential donors, including serious cancers. Potential donors should be counseled on the possible benefit of undergoing evaluation.</p>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 8","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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