Clinical Transplantation最新文献

{"title":"Epidemiology, Treatment, and Outcomes of Gram-Negative Bacteremia in a Multicenter Cohort of Solid Organ Transplant Recipients","authors":"Sarah B. Doernberg,&nbsp;Emily L. Heil,&nbsp;Suiyini Fiawoo,&nbsp;Jae Hyoung Lee,&nbsp;Sara E. Cosgrove,&nbsp;David M. Dobrzynski,&nbsp;Yihan Li,&nbsp;Ryan K. Shields,&nbsp;Emily S. Spivak,&nbsp;Erica J. Stohs,&nbsp;Pranita D. Tamma,&nbsp;Erin K. McCreary","doi":"10.1111/ctr.70160","DOIUrl":"https://doi.org/10.1111/ctr.70160","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Little is known about the epidemiology and management of gram-negative bloodstream infections (GN-BSIs) in patients after solid organ transplant (SOT). We describe epidemiology, treatment approaches, and outcomes in a subset of patients with SOT from a larger cohort with GN-BSI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a multicenter, retrospective cohort study that enrolled unique, consecutive adults with GN-BSI hospitalized at any of 24 participating hospitals between January and December 2019.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 4581 adults in the overall cohort, 298 (6.5%) were SOT recipients, including kidney (177, 59%), liver (67, 22%), heart (23, 8%), lung (12, 4%), and multiorgan (19, 6%) recipients. The most common organisms were <i>Escherichia coli</i> (45%), <i>Klebsiella pneumoniae</i> (20%), and <i>Pseudomonas aeruginosa</i> (15%). Twenty-two percent of <i>E. coli, Klebsiella spp</i>., or <i>Proteus spp</i>. isolates had extended-spectrum beta-lactamase phenotype. Sixty-six (22%) subjects did not receive active empirical therapy within the first 48 h. Median treatment duration was 15 days (IQR 12–18 days). Transition to oral therapy occurred in 161 (54%) patients at a median of 4 days (IQR 3–7 days). Thirty-one patients (10%) had recurrent bacteremia, and 10% of the cohort died within 90 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>In this large cohort of SOT patients with GN-BSI, durations exceeded 14 days in most patients, while more than half transitioned to oral antibiotics. Approximately 1 in 5 did not receive active empirical antibiotics, highlighting the impact of drug resistance and the importance of access to rapid diagnostic tools in this patient population. Mortality aligned with published estimates from other studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ctr.70160","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857161","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":"Perioperative Bleeding Risk in Lung Transplantation After Previous Cardiothoracic Surgery","authors":"Bryan Chow,&nbsp;Morgan A. Rosser,&nbsp;Jacob A. Klapper,&nbsp;Negmeldeen Mamoun,&nbsp;Matthew G. Hartwig,&nbsp;Kevin A. Wu,&nbsp;Jessica L. Poisson,&nbsp;Katherine Young,&nbsp;Kamrouz Ghadimi,&nbsp;Ian J. Welsby,&nbsp;Brandi A. Bottiger","doi":"10.1111/ctr.70151","DOIUrl":"https://doi.org/10.1111/ctr.70151","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Previous cardiothoracic surgery (CTS) is associated with a significant risk of perioperative bleeding in lung transplantation (LT). The types of prior surgery have not been well-defined. We aimed to quantify the risk of perioperative bleeding in LT based on a history of previous CTS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective study of adult patients who underwent bilateral LT and stratified recipients into no prior CTS (No-CTS), minimally invasive CTS (Mi-CTS), or open/invasive CTS (I-CTS). The primary outcome was the occurrence of severe/massive bleeding or worse bleeding by the modified universal definition of perioperative bleeding (UDPB). Multivariable analysis was performed with <i>p</i> value &lt;0.05 for statistical significance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>507 recipients were included. I-CTS had 3.93 higher odds of severe/massive bleeding (95% CI [1.98–7.98]; <i>p</i> &lt; 0.001) and 4.37 higher odds of worse bleeding than No-CTS (95% CI [2.27–8.70]; <i>p</i> &lt; 0.001). I-CTS had 2.38 higher odds of worse bleeding than Mi-CTS (95% CI [1.14–5.11]; <i>p</i> = 0.023). Mi-CTS had a higher risk of severe/massive bleeding and worse bleeding than No-CTS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients with more invasive prior CTS had an increased risk of perioperative bleeding and worse outcomes. More invasive previous surgery predicts bleeding risk and requires more transfusion and hospital resources. Centers should examine opportunities for preoperative optimization, intraoperative management, and intraoperative extracorporeal life support (ECLS) strategies to mitigate this risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846223","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":"Perioperative Point-of-Care Ultrasound Utilization in Abdominal Organ Transplantation. Part I: Preoperative and Intraoperative Care","authors":"Ryan Grell,&nbsp;Jonathan Paul,&nbsp;Kapil Gupta,&nbsp;Nikhil Chawla,&nbsp;Ranjit Deshpande,&nbsp;Lorenzo De Marchi,&nbsp;Jiapeng Huang","doi":"10.1111/ctr.70153","DOIUrl":"https://doi.org/10.1111/ctr.70153","url":null,"abstract":"<p>In this Society for the Advancement of Transplant Anesthesia (SATA) white paper, experts in abdominal transplant anesthesia and critical care reviewed the current literature and practice behaviors to create a comprehensive review of the utilization of point-of-care ultrasound (PoCUS) in abdominal organ transplantation (AOT) and to provide evidenced-based recommendations for clinicians to utilize perioperative PoCUS to improve patient outcomes in real time. Organized by phase of care–preoperative, intraoperative, and postoperative–this paper includes a discussion of transthoracic, pulmonary, gastric, and transesophageal echocardiography. Part I of this paper focuses on preoperative and intraoperative PoCUS while the upcoming Part II focuses on utilizing PoCUS in the immediate postoperative and intensive care setting to guide fluid management, identify venous congestion, identify causes of shock, and estimate hemodynamics in AOT patients.</p>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ctr.70153","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846234","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":"Association of HLA Mismatch With Adverse Cardiovascular Events Following Lung Transplantation: A Single-Center Study","authors":"Nils Gade,&nbsp;Paula Seifert,&nbsp;Michael Gerckens,&nbsp;Carlo Mümmler,&nbsp;Teresa Kauke,&nbsp;Andrea Dick,&nbsp;Tobias Veit,&nbsp;Daniel Roden,&nbsp;Sabine Hoffmann,&nbsp;Marie Scherzer,&nbsp;Julia Höpler,&nbsp;Leonhard Binzenhöfer,&nbsp;Hugo Lanz,&nbsp;Sebastian Michel,&nbsp;Christian Schneider,&nbsp;Michael Irlbeck,&nbsp;Roland Tomasi,&nbsp;Rudolf Hatz,&nbsp;Christian Hagl,&nbsp;Steffen Massberg,&nbsp;Katrin Milger,&nbsp;Jürgen Behr,&nbsp;Enzo Lüsebrink,&nbsp;Nikolaus Kneidinger","doi":"10.1111/ctr.70157","DOIUrl":"https://doi.org/10.1111/ctr.70157","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Coronary artery disease (CAD) is a frequent comorbidity in lung transplant (LuTx) candidates. The impact of allogenic organ transplantation and the corresponding alterations in immune response on the progression of CAD remains poorly understood. In this study, we sought to analyze the effect of donor-recipient overall human leukocyte antigen (HLA) and HLA-DQ mismatch on cardiovascular outcomes following LuTx.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>This retrospective analysis of adult patients receiving lung transplantation at the LMU University Hospital between 2012 and 2018 included 310 patients, the majority of whom (67.4%) had undergone double lung transplantation. There were no significant differences in the incidence of the primary composite endpoint between patients with high/low HLA mismatches (22 [7.9%] vs. 4 [12.9%]; <i>p</i> = 0.311). Numerically higher rates of the primary endpoint, myocardial infarction, and cardiovascular death in the low HLA mismatch group can partially be explained by differences in baseline rates of CAD and coronary sclerosis. Notably, neither HLA-DQ mismatch nor the occurrence of rejection episodes or cytomegalovirus (CMV) infection was associated with the occurrence of cardiovascular events following transplantation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this study cohort, high HLA mismatch and HLA-DQ mismatch were not associated with increased adverse cardiovascular events. Furthermore, neither transplant rejection nor CMV infection increased the risk for cardiovascular events. The high cardiovascular event rates following LuTx necessitate meticulous cardiovascular follow-up, irrespective of immunological matching.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846220","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":"Utilizing Machine Learning to Predict Liver Allograft Fibrosis by Leveraging Clinical and Imaging Data","authors":"Madhumitha Rabindranath,&nbsp;Yingji Sun,&nbsp;Korosh Khalili,&nbsp;Mamatha Bhat","doi":"10.1111/ctr.70148","DOIUrl":"https://doi.org/10.1111/ctr.70148","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Liver transplant (LT) recipients may succumb to graft-related pathologies, contributing to graft fibrosis (GF). Current methods to diagnose GF are limited, ranging from procedural-related complications to low accuracy. With recent advances in machine learning (ML), we aimed to develop a noninvasive tool using demographic, clinical, laboratory, and B-mode ultrasound (US) features to predict significant fibrosis (METAVIR≥F2).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used a nested 10-fold cross-validation approach with grid-search for hyperparameter fine-tuning to train an artificial neural network (ANN) and a support vector machine (SVM) to classify mild fibrosis (F0-F1) and significant fibrosis (F2-F4) on 1131 patients. We calculated Shapley values to identify top-ranked features, determining the contribution of each feature to model predictions. For the imaging-based model, we used 4819 images with 892 studies trained on the residual network 18 (ResNet18) model to classify F0-F1 versus F3-F4.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We determined the ANN performed the best when compared to the SVM and standard biomarkers, with an AUC ranging from 0.77 to 0.81. The ResNet18 model was unable to diagnose advanced GF, leading to the training AUCs ranging from 0.89 to 0.97, while the validation and testing AUCs were 0.43–0.63. Shapley analysis highlighted the following top-ranked features associated with significant GF: hepatitis C at transplant, recipient age, recipient sex, and certain blood markers such as creatinine and hemoglobin.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Noninvasive approaches using ML for predicting significant GF perform well when considering demographic, clinical, and laboratory data; however, this performance is not enhanced with the use of US images.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ctr.70148","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846224","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":"Effect of Renal Transplantation on Left Ventricular Myocardial Deformation in Patients With End-Stage Renal Disease","authors":"Manish Jain,&nbsp;Rakesh Bhat,&nbsp;Hardeep Kaur Grewal,&nbsp;Ashish Nandwani,&nbsp;Dinesh Yadav,&nbsp;Pranaw Kumar Jha,&nbsp;Shyam Bansal,&nbsp;Dinesh Bansal,&nbsp;Vijay Kher,&nbsp;Manish Bansal","doi":"10.1111/ctr.70150","DOIUrl":"https://doi.org/10.1111/ctr.70150","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>End-stage renal disease (ESRD) is associated with significant left ventricular (LV) remodeling. However, the impact of renal transplantation on LV remodeling has not been adequately elucidated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive echocardiography was performed before and after (median time interval 239 days, interquartile range 149–328 days) renal transplantation in 42 patients (mean age 39.1 ± 11.0 years, 79% men). Forty-five apparently healthy age- and gender-matched controls were also included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The patients with ESRD had significantly increased LV mass index, left atrial volume index (LAVI), and the ratio of early diastolic mitral inflow velocity to mitral annular velocity (E/e’), whereas LV global longitudinal strain (GLS), circumferential strain, apical rotation, and twist were reduced. LV ejection fraction (LVEF) was also lower, but the LV global radial strain (GRS) was not different between the two groups. Most of these abnormalities showed improvement after renal transplantation. Nearly one-third of all patients had at least a 10% improvement in LVEF, and roughly half had a 10% or more improvement in the mitral E/e’ ratio and the LV global longitudinal and circumferential strain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study shows that renal transplantation results in a significant regression of LV hypertrophy and an improvement in LV myocardial deformation translating into an improvement in the LV systolic and diastolic function. Further larger and long-term studies are needed to identify the predictors and the clinical significance of these changes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846222","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 Definitions on Public Reporting of Outcome Data","authors":"Kathryn McGaughey,&nbsp;Matthew Wadsworth,&nbsp;David S. Goldberg","doi":"10.1111/ctr.70161","DOIUrl":"https://doi.org/10.1111/ctr.70161","url":null,"abstract":"","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143846221","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":"Long-Term Outcomes of Belatacept Versus Tacrolimus Following T-Cell Depleting Induction in Adult Kidney Transplantation","authors":"Laura E. Newton,&nbsp;Thomas W. D'Angelo,&nbsp;Michael C. Chobanian,&nbsp;Michael F. Daily,&nbsp;Asha M. Zimmerman","doi":"10.1111/ctr.70154","DOIUrl":"https://doi.org/10.1111/ctr.70154","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Belatacept shows promise as an alternative immunosuppressant without the nephrotoxicity of calcineurin inhibitors. Avoiding nephrotoxicity is important with the expanding use of organs at risk of marginal graft function. To date, no large studies have compared belatacept directly with tacrolimus after T-cell depleting induction in renal transplantation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Standard Transplant Analysis and Research file was used to compare adult kidney transplant recipients induced with T-cell depleting agents treated with belatacept to propensity score-matched recipients treated with tacrolimus between August 10, 2011 and June 29, 2023. Kaplan–Meier survival analysis was used to compare death censored graft survival, patient survival, and time to acute rejection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the study period, 4391 adult kidney transplant recipients were treated with belatacept. Estimated GFR improved for belatacept-treated patients through year 9, whereas it decreased for the control group through year 10. Belatacept-treated patients had a higher rejection rate at 5 years (21% vs. 15%, <i>p</i> &lt; 0.001). Death-censored graft survival did not differ between groups (<i>p</i> = 0.383). Among patients who had rejection, death-censored graft survival was superior in belatacept-treated patients at 5 years (70% vs. 60%, <i>p</i> = 0.026). Overall, patient survival did not differ between groups (<i>p</i> = 0.120).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This is the largest longitudinal study to compare outcomes of belatacept versus tacrolimus-based therapy following T-cell depleting induction. Belatacept was associated with improved graft function despite an increased acute rejection rate. There was no difference in overall graft or patient survival compared to tacrolimus. This study suggests that belatacept-based therapy is not inferior to tacrolimus-based therapy following T-cell depletion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143836025","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":"Correction to Clinical Transplantation Articles","authors":"","doi":"10.1111/ctr.70158","DOIUrl":"https://doi.org/10.1111/ctr.70158","url":null,"abstract":"<p>Kuhnert, S., Halim, N., Sommerlad, J., et al., Automated CT Image Processing for the Diagnosis, Prediction, and Differentiation of Phenotypes in Chronic Lung Allograft Dysfunction After Lung Transplantation. <i>Clinical Transplantation</i>, 39 (2026): e70137. https://doi.org/10.1111/ctr.70137.</p><p>Thomas, A.G., Hussain, S., Klitenic, S.B., et al., Effectiveness of a Mobile Health System on Compliance With 2-Year Living Kidney Donor Follow-Up in the United States. <i>Clinical Transplantation</i>, 39 (2026): e70139. https://doi.org/10.1111/ctr.70139.</p><p>Lazzeri, C., Ghinolfi, D., Santini, L.E., Procissi, A.P.o., Cultrera, D., and Peris, A., Improved Utilization Rate in Solid Organ Donors ≥80 Years: The 7-Year Tuscany Experience. <i>Clinical Transplantation</i>, 39 (2026): e70142. https://doi.org/10.1111/ctr.70142.</p><p>Donnelly, C., Patel, S.S., Jaffe, I.S., et al., Association of Functional, Academic, Motor, and Cognitive Deficits in Graft Failure in Pediatric Liver Transplantation. <i>Clinical Transplantation</i>, 39 (2026): e70132. https://doi.org/10.1111/ctr.70132.</p><p>In the above articles, an error occurred in the volume year for the journal citation when the articles first published. The volume year was incorrectly listed as “2026”. This has been corrected to “2025”.</p><p>We apologize for this error.</p>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ctr.70158","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143836023","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":"Decreasing the Risk of Early Sub-Therapeutic Tacrolimus Troughs on Short-Term Outcomes in Low-Moderate Risk Kidney Transplant Recipients Receiving Rabbit Anti-Thymocyte Globulin Induction","authors":"Xinqi Liu,&nbsp;Jennifer Trofe-Clark,&nbsp;Deirdre Sawinski,&nbsp;Brendan Steiner,&nbsp;Shahreen Sharma,&nbsp;Stephanie Witek,&nbsp;Tara Fallah,&nbsp;Maxwell Norris,&nbsp;Chelsea Sammons,&nbsp;Gregory Malat","doi":"10.1111/ctr.70156","DOIUrl":"https://doi.org/10.1111/ctr.70156","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Outcomes are poor in kidney transplant (KTx) recipients with sub-therapeutic tacrolimus troughs. It is unknown if rabbit anti-thymocyte globulin (rATG) induction delays the deleterious impact of early sub-therapeutic tacrolimus troughs. The study aims compared short-term graft outcomes of KTx recipients stratified by tacrolimus troughs at the time of discharge from index admission.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Single-center retrospective cohort study compared adult KTx recipients with sub-therapeutic versus therapeutic discharge tacrolimus troughs (defined as &lt; vs. ≥ 8 ng/mL). Successful primary/secondary KTx between 10/2017 and 12/2019, who received rATG induction and tacrolimus-based immunosuppression and had an index admission length of stay ≤5 days were included. The primary composite outcome analyzed the 3-month risk of rejection, graft loss, or de novo donor-specific antibodies (dnDSA). Cox regression analysis assessed the association of early sub-therapeutic tacrolimus troughs on short-term graft outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 411 recipients included, 335 (81.5%) were discharged with a tacrolimus trough &lt;8 ng/mL versus 76 (18%) ≥8 ng/mL. Our population consisted of 30% black/non-Hispanic, 10% with a history of previous KTx, 60% deceased donors, and low cPRA (median 0%), which was in the low immunological risk range. No significant difference was identified in the primary outcome (13.4% vs. 9.2%, <i>p</i> = 0.44). Cox regression analysis identified no association between sub-therapeutic tacrolimus troughs at discharge and the primary outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>KTx recipients receiving rATG induction, discharged with sub-therapeutic tacrolimus troughs (&lt;8 ng/mL) have comparable short-term graft outcomes versus those discharged with therapeutic troughs (≥8 ng/mL). This suggests that delaying discharge to reach therapeutic troughs is not necessary.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ctr.70156","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143836303","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}