Clinical Transplantation最新文献

{"title":"Fatigue, Sleep Problems, and Self-Efficacy Before and After Heart Transplantation: A 5 Year Follow-Up.","authors":"Marita Dalvindt, Hannah Lindahl Veungen, Annika M Kisch, Annette Lennerling, Maria Hjorth, Anna Forsberg","doi":"10.1111/ctr.70341","DOIUrl":"10.1111/ctr.70341","url":null,"abstract":"<p><strong>Introduction: </strong>Fatigue is a troublesome symptom after heart transplantation and is poorly studied in a long-term perspective. One hypothesis is that there is a strong relationship between fatigue, sleep problems, and self-efficacy, and that fatigue decreases self-efficacy. The aim of this study was to explore self-reported fatigue from the time on the waiting list to 5 years after heart transplantation and its association with self-efficacy and sleep problems.</p><p><strong>Methods: </strong>In this multicenter, longitudinal cohort study 48 heart recipients, 12 women and 36 men with a median age of 57 years, were followed from pre-transplant to 5 years post-transplant. Three instruments were used: (1) the transplant-specific Organ Transplant Symptom and Well-Being Instrument (OTSWI), (2) the Swedish version of the Multi-Dimensional Fatigue Inventory (MFI), and (3) the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6G).</p><p><strong>Results: </strong>Sleep problems decreased after transplantation, but after 3-5 years, there were no differences in comparison with pre-transplant. Self-efficacy improved for the whole group from pre-transplant up to 5 years after heart transplantation. General fatigue predicted self-efficacy.</p><p><strong>Conclusion: </strong>Fatigue plays a pivotal role in self-efficacy after heart transplantation. It reduces self-efficacy due to causing uncertainty and should constitute a primary target for future interventions.</p>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 10","pages":"e70341"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12520161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285308","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}

{"title":"Accuracy of CYP3A5 Pharmacogenomics Recommended Dosing of Tacrolimus With Concomitant Azole Antifungals Early Post-Lung Transplant.","authors":"Christine Pham, Kathy Le, Curt Bay, Rhiannon Garcia, Michael D Nailor, Kellie J Goodlet, Sofya Tokman","doi":"10.1111/ctr.70345","DOIUrl":"https://doi.org/10.1111/ctr.70345","url":null,"abstract":"<p><strong>Introduction: </strong>Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines recommend tacrolimus starting doses based on CYP3A5 phenotypes but do not consider CYP3A4 interactions. Azoles inhibit CYP3A4 metabolism, and suggested % reduction in tacrolimus dose by azole has been published. We evaluated the accuracy of CPIC tacrolimus dose recommendations based on CYP3A5 phenotype in lung transplant recipients (LTRs) treated with azole.</p><p><strong>Methods: </strong>The primary outcome was accuracy (±30%) of actual vs. expected tacrolimus dose (mg/kg/day) at 1 M, 2 M, and 3 M post-LT. Secondary outcomes were median tacrolimus dose (mg/kg/day) and % difference in actual vs. expected tacrolimus dose between 1 M, 2 M, and 3 M. Formulas for expected dose were used sequentially: (1) manufacturer-recommended dose, (2) CPIC starting dose adjustment, and (3) % tacrolimus dose reduction by azole. Each patient served as their own control for calculating the % difference in dose.</p><p><strong>Results: </strong>85 LTRs with pharmacogenetic information were included; 91% were poor CYP3A5 metabolizers. Accuracy of CPIC and azole adjusted dose decreased at 1 M, 2 M, and 3 M (40%, 29%, and 18%; p = 0.002). Accuracy between CYP3A5 expressers and non-expressers did not show a difference at 1 M (38% vs. 40%, p = 1.00), but differences were significant at 2 M (75% vs. 25%, p = 0.002) and 3 M (63% vs. 14%, p = 0.002). Tacrolimus dose (mg/kg/day) decreased (0.03, 0.02, 0.02; p < 0.001) and % difference in actual vs. expected dose increased (-22, -35, -46; p < 0.001) between 1 M, 2 M, and 3 M post-LT. Percent difference in actual vs. expected dose was not found to be significant between phenotypes (p = 0.067).</p><p><strong>Conclusions: </strong>Use of an adjusted tacrolimus starting dose based on CYP3A5 phenotype and predicted azole CYP3A4 inhibition was poorly predictive of the actual required tacrolimus dose among LTRs during the early post-transplant period in CYP3A5 non-expressers. CYP3A5 expressers demonstrated a higher degree of accuracy and would benefit from further investigation in a larger cohort. Lower tacrolimus doses with patient-specific modifications are required in LTRs within the first 3 M post-LT receiving azole antifungals to ensure therapeutic levels.</p>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 10","pages":"e70345"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285232","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}

{"title":"Impact of Potassium-Binders on the Interpretation of Bone Mineral Density Following Kidney Transplantation.","authors":"Anders Åsberg, Karsten Midtvedt, Jørn Petter Lindahl, Hege Pihlstrøm, Jens Bollerslev, Kristin Godang","doi":"10.1111/ctr.70352","DOIUrl":"https://doi.org/10.1111/ctr.70352","url":null,"abstract":"<p><strong>Background: </strong>Following kidney transplantation (KTx), episodes of hyperkalemia are common and effectively treated with sodium zirconium cyclosilicate (SZC, Lokelma) or patiromer (PAT, Veltassa). The presence of SZC/PAT in the gastrointestinal tract may, if radio dense, influence the interpretation of lumbar spine (LS) dual-energy x-ray absorptiometry (DXA)-scans. We investigated the effect with/without PAT/SZC in KTx on LS DXA readings.</p><p><strong>Methods: </strong>A prospective, single-center study of KTx recipients in need of potassium-lowering therapy was performed. All participants performed two LS DXA-scans, the first after at least 3 days of SZC/PAT treatment and the second after a 2-week washout.</p><p><strong>Results: </strong>Eighteen KTx patients (8 SZC, 10 g/day vs. 10 PAT, 8.4 g/day) were included and provided two valid DXA-scans (mean age 63 ± 12 years, 12 males). The change in LS BMD determinations in the SZC group was 2.48 ±12.21%, while there was no change in the PAT group, -0.25 ± 2.28%. The absolute root mean squared difference (RMSD) change was 0.102 ± 0.084 g/cm² and 0.021 ±0.013 g/cm² after SZC and PAT washout, respectively (p = 0.008).</p><p><strong>Conclusion: </strong>In KTx, treatment with SZC, but not PAT, significantly influenced the DXA-scan interpretation of the LS region. After a 2-week washout period, SZC interference was without clinical implications on DXA-scans.</p><p><strong>Summary: </strong>The potassium lowering drug sodium zirconium cyclosilicate (Lokelma) is radiopaque and therefore acts as a confounder on DXA interpretations in kidney transplant recipients. Patiromer (PAT, Veltassa) has no such effect.</p>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 10","pages":"e70352"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285233","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}

{"title":"Similarities and Differences Between Allogeneic Hematopoietic Cell and Organ Transplantation and What We Can Learn From Each Other to Guide Global Health Strategy.","authors":"Hildegard T Greinix, Arthur Matas, Mickey B C Koh, Lydia Foeken, Nina Worel, Amanda Vinson, Hassan Ibrahim, Deirdre Sawinski, Adriana Seber, Maryam Valapour, Yoshiko Atsuta, Thilo Mengling, John Lake, Thomas Wekerle, Daniel Weisdorf","doi":"10.1111/ctr.70346","DOIUrl":"10.1111/ctr.70346","url":null,"abstract":"<p><strong>Background: </strong>Allogeneic hematopoietic cell transplantation (HCT) and solid organ transplantation (SOT) have evolved into successful, curative treatments for many severe congenital and acquired diseases. Both use medical products of human origin and should therefore have overarching regulatory frameworks. Both require critical decisions about donor selection, donor/recipient matching, immunosuppression, and long-term care, all tasks best performed by a trained, highly specialized multidisciplinary team. Both need committed institutions and governmental support for their success. Whereas the main barrier for performing SOT is the lack of suitable organs, access to a transplant center is the main limitation for HCT, which remains a highly specialized, complex, resource-intensive, and costly medical procedure.</p><p><strong>Methods and results: </strong>Here, we describe the main indications for HCT and SOT, their similarities and differences regarding donor selection, treatment prior to transplant, intensity and duration of immunosuppression after transplantation, their main complications, and consequences of donation for living donors.</p><p><strong>Conclusions: </strong>Strategies to improve worldwide access to HCT and SOT are discussed, as well as future developments in this highly innovative field of medicine.</p>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 10","pages":"e70346"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12525906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291324","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}

{"title":"The Effect of Goal-Directed Protocols for the Management of Brain-Dead Potential Organ Donors: An Integrative Review After Meta-Analysis","authors":"Elaine Milanez Clezar,&nbsp;Daniela Braga Lopes,&nbsp;Vanessa Girardi de Lima,&nbsp;Juliano Ramos,&nbsp;Glauco Adrieno Westphal","doi":"10.1111/ctr.70330","DOIUrl":"10.1111/ctr.70330","url":null,"abstract":"<div>\u0000 \u0000 <p>The management of brain-dead potential organ donors is critical in the process of organ donation, and the implementation of goal-oriented protocols can optimize outcomes. The aim of this review was to critically explore the main publications that evaluated the impact of multifaceted goal-guided protocols for the management of potential organ donors on outcomes. This integrative review analyzed the effect measures of the studies that were selected and critically evaluated according to their respective designs. The quality of each study was independently graded using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The studies were divided into four subgroups according to the outcomes analyzed: number of organs recovered per donor, number of organs transplanted per donor, losses of brain-dead potential donors due to cardiovascular collapse, and primary renal graft dysfunction. Among 2888 articles identified in the initial search, 18 were selected. Multifaceted goal-guided protocols were associated with a larger number of recovered and transplanted organs, fewer donor losses due to cardiovascular collapse, and less primary graft dysfunction. The following goals were related to better outcomes: mean arterial pressure ≥ 65 mmHg, ≤ 1 vasopressor, vasopressin, thyroid hormone, pH 7.3–7.5, PaO₂/FiO₂ ≥ 300, sodium &lt; 155 mEq/L, and blood glucose ≤ 180 mg/dL. We observed a positive association between the adoption of multifaceted goal-directed protocols for the management of brain-dead potential organ donors and the outcomes analyzed. The limitations of the already published studies highlight the need for further investigation of the gaps in existing information on the subject.</p>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 10","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198197","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}

{"title":"Impact of Donor and Recipient Sex on Long-Term Outcomes Following Living Donor Kidney Transplantation: A Retrospective Dual-Center Study","authors":"Yitian Fang,&nbsp;Lisa B. Westenberg,&nbsp;Julie J. M. Hamm,&nbsp;Jacqueline van de Wetering,&nbsp;Stephan J. L. Bakker,&nbsp;Ron W. F. de Bruin,&nbsp;Robert A. Pol,&nbsp;Robert C. Minnee","doi":"10.1111/ctr.70335","DOIUrl":"10.1111/ctr.70335","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The impact of donor and recipient sex on living donor kidney transplantation (LDKT) remains debated. This study investigates the impact of donor-recipient sex combinations on long-term transplant outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A dual-center retrospective study was conducted at Erasmus Medical Center (EMC) and University Medical Center Groningen (UMCG), including all LDKT patients between 2010 and 2020. Transplantations were categorized into male donor-male recipient (MDMR, <i>n</i> = 476), female donor-male recipient (FDMR, <i>n</i> = 765), male donor-female recipient (MDFR, <i>n</i> = 463), and female donor-female recipient pairs (FDFR, <i>n</i> = 372). The primary outcome was graft survival. Secondary outcomes included patient survival, delayed graft function (DGF), acute rejection, and graft function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 10-year death-censored graft survival rates were 85.5% (MDMR), 85.4% (FDMR), 82.8% (MDFR), and 81.8% (FDFR) (<i>p</i> = 0.38), while corresponding 10-year patient survival rates were 73.3%, 70.7%, 74.8%, and 73.6%, respectively (<i>p</i> = 0.28). Male recipients had a slightly higher DGF rate compared to females (6.9% vs. 5.6%, <i>p</i> = 0.29). The incidence of acute rejection ranged from 15.5% to 18.3% across all combinations (<i>p</i> = 0.76). FDFR pairs in recipients ≥ 60 years had significantly better graft survival (95.9% vs. 86.6% vs. 87.0% vs. 80.7%, <i>p</i> = 0.048). Cox regression model confirmed this protective effect of female donor kidneys in aged female recipients (adjusted HR 0.24, 95% CI: 0.06–0.91, <i>p</i> = 0.036). MDMR pairs consistently showed superior long-term graft function but this advantage did not translate into better graft survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Female recipients aged 60 or older benefit from improved graft survival when receiving female donor kidneys. While MDMR pairs consistently exhibited superior eGFR, this advantage did not translate into better graft survival.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 10","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12478291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184771","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}

{"title":"Effectiveness of a Personal Vaccination Recommendation Letter to Liver Transplant Patients and Family Physicians for Improving the Vaccination Status","authors":"Dorothea Dehnen,&nbsp;Maia Milzkott,&nbsp;Benjamin Borchardt,&nbsp;Anette Graute,&nbsp;Katja Dehnen,&nbsp;Kerstin Herzer,&nbsp;Katharina Willuweit,&nbsp;Anna Herwig,&nbsp;Jassin Rashidi-Alavijeh,&nbsp;Birgitta Weltermann","doi":"10.1111/ctr.70239","DOIUrl":"https://doi.org/10.1111/ctr.70239","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Vaccination rates of immunosuppressed liver transplant recipients need to improve. We compared the effectiveness of a three-arm randomized intervention on vaccination rates in liver transplant recipients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two hundred and eighty-nine liver transplant recipients were randomly assigned to three groups: (1) patient intervention, (2) family physician intervention, and (3) combined patient and family physician intervention. The intervention consisted of a yellow information letter, which was personalized and sent to either the patient (1), the family physician (2), or both (3) in December 2016.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Irrespective of the assigned intervention group, a significant increase in vaccination rates from baseline to follow-up after 2 years was observed for tetanus (53%–56%), pertussis (52%–57%), hepatitis A (44%–49%), hepatitis B (64%–71%), pneumococci (68%–75%), and the sequential pneumococcal vaccination (12%–22%). Comparing the interventions, the vaccination rate for hepatitis A was significantly higher at follow-up for intervention (3) (OR = 9.07, <i>p</i> = 0.043) and (2) (OR = 9.91, <i>p</i> = 0.034) than for intervention (1). Concerning the vaccination rate for hepatitis B, an odds ratio of 9.13 was observed for intervention (2) (<i>p</i> = 0.006) compared to (1). Interventions (2) and (3) were generally superior to the patient-centered intervention alone, with the exception of influenza vaccination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results show the importance of family physicians in improving vaccination rates in liver transplant recipients. Establishing low-threshold communication channels, for example, via the electronic patient record, could improve cooperation between physicians in specialized outpatient clinics and family physicians.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>German Clinical Trials Register (DRKS: DRKS00035422). Registration was done retrospectively due to time constraints and lack of human resources.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 10","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ctr.70239","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146664","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}

{"title":"Baseline Vascular Pathology in Deceased Donor Kidneys: Differential Impact on Transplant Outcomes by Donor Type","authors":"Junichiro Sageshima,&nbsp;Naeem Goussous,&nbsp;Yvonne Kelly,&nbsp;Caitlin Loseth,&nbsp;Karima Alghannam,&nbsp;Ling-Xin Chen,&nbsp;Lea Matsuoka,&nbsp;Sophoclis Alexopoulos,&nbsp;Richard Perez,&nbsp;Kuang-Yu Jen","doi":"10.1111/ctr.70332","DOIUrl":"https://doi.org/10.1111/ctr.70332","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The impact of kidney vascular pathology on transplant outcomes remains poorly understood, particularly under specific donor conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective single-center study analyzed 837 deceased donor kidney transplants. Based on baseline vascular histology, the kidneys were categorized into two groups: minimal vascular disease (Group 0, <i>n</i> = 637) and significant vascular disease (Group 1, <i>n</i> = 200). Five-year graft survival and 6- and 12-month kidney function were evaluated, along with subgroup analyses of various donor characteristics. Propensity score matching was used to adjust for confounding factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Recipients of kidneys with significant vascular disease showed worse 5-year overall graft survival (64.6% vs. 80.0%, <i>p</i> = 0.0002) and death-censored graft survival (85.6% vs. 91.5%, <i>p</i> = 0.0126). These differences persisted after propensity score matching. The impact was most pronounced in hypertensive donors (53.4% vs. 84.9%) and diabetic donors (52.3% vs. 69.0%). Circulatory death donors showed immediate adverse effects, while brain death donors demonstrated delayed deterioration. Kidneys with significant vascular disease exhibited lower glomerular filtration rates at follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Baseline vascular disease in deceased donor kidneys has a significant impact on transplant outcomes, independent of clinical risk factors. These findings support the incorporation of vascular histological assessment into donor evaluation to enhance risk stratification and optimize post-transplant management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 10","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146765","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}

{"title":"The Changing Transplant Landscape in the Era of Elexacaftor/Tezacaftor/Ivacaftor: A Word of Caution","authors":"Julie Semenchuk,&nbsp;Eliza Tuff-Gordon,&nbsp;Xiayi Ma,&nbsp;Jenna Sykes,&nbsp;Stephanie Y. Cheng,&nbsp;Meghan Aversa,&nbsp;Cecilia Chaparro,&nbsp;Elizabeth Tullis,&nbsp;Anne L. Stephenson","doi":"10.1111/ctr.70317","DOIUrl":"https://doi.org/10.1111/ctr.70317","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Elexacaftor/tezacaftor/ivacaftor (ETI) has dramatically changed the landscape of cystic fibrosis (CF) care, including in those who require lung transplantation. The objectives of the study were to describe the cohort demographics and outcomes of primary lung transplant recipients before and after the availability of ETI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a descriptive study of lung transplants performed at the Toronto Lung Transplant Program for CF during two time periods: 2019 (pre-ETI era) and 2021–2023 (post-ETI era). All subjects were referred from the Adult CF program at St. Michael's Hospital, Toronto. Data were obtained from chart review and the Toronto Lung Transplant database. The Kaplan–Meier method was used to estimate survival probability at 1 year post-transplant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 22 lung transplants performed in 2019 (19 [86.4%] primary and 3 [13.6%] re-transplants) compared to 11 lung transplants (8 [72.7%] primary and 3 [27.3%] re-transplants) in the post-ETI era. In primary transplant recipients, median age was 29.4 years (Range 18.6–67.6 years) in 2019 compared to 30.0 years (Range 19.1–64.0 years) in 2021–2023. In the post-ETI era, none of the individuals had a deltaF508 variant, compared to 84% in 2019. One-year survival probability was lower in the post-ETI era (62.5% vs. 84.2%, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Lung transplant recipients in the post-ETI era were more complex with high-risk characteristics and had worse post-transplant outcomes. This study highlights the importance of further investigation to better understand the impact of ETI on transplant referral patterns, recipient characteristics, and post-transplant outcomes in the CF population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 10","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ctr.70317","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146662","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}

{"title":"A Deceased Donor Kidney Transplant After 10°C Static Storage","authors":"Mark Petrovic,&nbsp;Marissa Kuo,&nbsp;John Dubray,&nbsp;Rachel Forbes,&nbsp;Adam Miller,&nbsp;Peter Reese,&nbsp;Ciara Shaver,&nbsp;Matthew Bacchetta,&nbsp;W. Christian Crannell","doi":"10.1111/ctr.70331","DOIUrl":"https://doi.org/10.1111/ctr.70331","url":null,"abstract":"","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 10","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146663","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}