Clinical Transplantation最新文献

{"title":"The Impact of Gender, Ethnicity, and the COVID-19 Pandemic on Organ Donation Intentions Over 50 Years in New Zealand","authors":"Natalie E. Allen,&nbsp;Jie Zhang,&nbsp;Charles N. J. McGhee,&nbsp;Akilesh Gokul,&nbsp;Rachael Niederer","doi":"10.1111/ctr.70089","DOIUrl":"10.1111/ctr.70089","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To identify the demographics and trends of individuals intending to donate their organs, based on intentions at the time of driver's license registration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were collected from 4 742 475 individuals first registering for a New Zealand (NZ) driver's license, between January 1, 1974, and November 16, 2023, with positive or negative organ donor intentions recorded. Gender, ethnicity, and year of registration were collected. Predictors of positive organ donation intention were examined with a multivariate logistic regression model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A positive response to the question regarding organ donation intentions was reported in 2 476 914 individuals (52.2%). This included 1 201 275 males (48.4%) and 1 275 639 females (56.4%). Positive organ donation intention was reported in 1 695 672 NZ Europeans (66.2%), 246 303 Māori (36.2%), 76 749 Pasifika (27.6%), 273 879 Asians (34.4%), 52 137 Middle Eastern, Latin American and African (MELAA) (47.0%), 48 876 “Other” ethnicity (63.5%), and 83 298 “Not otherwise specified” (34.7%). On multivariate logistic regression, the female gender was associated with an increased likelihood of organ donation intention (OR 1.37, <i>p</i> &lt; 0.001), and driver's license registration in a more recent year was associated with an increased likelihood of organ donation intention (OR 1.02, <i>p</i> &lt; 0.001). Compared to all other ethnicities, NZ Europeans were associated with a higher likelihood of positive organ donation intention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This is the largest study of organ donation intention published in Australasia. It demonstrates a higher likelihood of organ donation intentions in females, ethnic differences, and increasing donation intention rates over time. Further investigation is required to explore the difference between intentions and end-of-life organ donation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021581","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":"Utility of the 6-Min Walk Test for Assessing Physical Performance in Pediatric Heart Transplant Recipients","authors":"Heidi Mäenpää,&nbsp;Tiina Ojala,&nbsp;Juuso Tainio,&nbsp;Jari Arokoski,&nbsp;Timo Jahnukainen","doi":"10.1111/ctr.70061","DOIUrl":"10.1111/ctr.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Physical performance capacity (PPC) of pediatric heart transplant (HT) recipients is reportedly low to normal, and longitudinal follow-up of these patients is recommended. However, no recommendation for a follow-up method is available. In this study, the correlation between the 6-min walk test (6MWT), various clinical parameters, and a physical performance test set was evaluated to develop a simple follow-up tool for PPC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifteen pediatric HT patients and 392 historical controls were tested at a median age of 15.4 years. PPC was tested with a 6MWT and a physical performance test set consisting of six different components assessing muscle endurance, strength, speed, and flexibility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Controls outperformed recipients across all test domains except the leg lift and sit-and-reach test. The 6MWT distance correlated well with the physical performance test set results; the correlations were with leg lift (r_s = 0.622, <i>p</i> = &lt;0.05), repeated squatting (r_s = 0.851, <i>p</i> = &lt;0.001, sit-up (r_s = 0.738, <i>p</i> = &lt;0.05), back extension (r_s = 0.747, <i>p</i> ≤ 0.001), and total physical performance capacity (r_s = 0.873, <i>p</i> = &lt;0.001). Indexed 6MWT results or total physical performance capacity set had no statistically significant associations with any of the clinical parameters tested.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study supports recent findings suggesting that the 6MWT is a suitable method for longitudinal follow-up in children with HT. We recommend performing the 6MWT annually in these patients, to be used to motivate and encourage them to enhance their physical activity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001367","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":"Negative Pressure Ventilation Ex-Situ Lung Perfusion Preserves Porcine and Human Lungs for 36-Hours","authors":"Keir Forgie,&nbsp;Sayed Himmat,&nbsp;Katie Du,&nbsp;Alynne Ribano,&nbsp;Abeline Watkins,&nbsp;Nicholas M. Fialka,&nbsp;Sanaz Hatami,&nbsp;Mubashir Khan,&nbsp;Xiuhua Wang,&nbsp;Ryan Edgar,&nbsp;Katie-Marie Buswell-Zuk,&nbsp;Darren H. Freed,&nbsp;Jayan Nagendran","doi":"10.1111/ctr.70083","DOIUrl":"10.1111/ctr.70083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Preclinically, 24-hour continuous Ex-Situ Lung Perfusion (ESLP) is the longest duration achieved in large animal models and rejected human lungs. Here, we present our 36-hour Negative Pressure Ventilation (NPV)-ESLP protocol applied to porcine and rejected human lungs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Five sets of donor domestic pig lungs (45-55 kg) underwent 36-hour NPV-ESLP. Two sets of clinically rejected human lungs were preserved on 36-hour NPV-ESLP. Graft function was assessed via physiologic parameters, edema formation, and cytokine profiles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Porcine and human lung function was stable with mean partial pressure of oxygen divided by the fraction of inspired oxygen (PaO2/FiO2; PF) ratios throughout preservation of 473±11.79 and 554.7±13.26, respectively (mean±standard error of the mean). In porcine lungs, mean compliance (Cdyn) during ESLP was 33.96±2.18, pulmonary artery pressure (PAP) 13.03±0.53, and pulmonary vascular resistance (PVR) 481.20 ±21.86. In human lungs, mean Cdyn was 82.68±3.54, PAP 6.00±0.33, and PVR 184.00±9.71. Average percentage weight-gain was 34.47±13.22 in porcine lungs and 116.3±6.65 in rejected human lungs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>NPV-ESLP can preserve porcine lungs and human lungs for 36-hours with acceptable physiologic function. Greater weight-gain in the human lungs is likely due to prolonged ischemic time prior to ESLP and use of an acellular perfusate. Continuous 36-hour NPV-ESLP could support therapies for endothelial protection and mitigate fluid accumulation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001280","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":"Association of Grit and Resilience With Short-Term Post-Transplant Outcomes in Lung Allograft Recipients","authors":"Alexander G. Dragnich,&nbsp;Kaitlyn C. Chapin,&nbsp;Ke Xu,&nbsp;Jinyuan Liu,&nbsp;Loren Lipworth,&nbsp;Ciara M. Shaver,&nbsp;Anil J. Trindade","doi":"10.1111/ctr.70082","DOIUrl":"10.1111/ctr.70082","url":null,"abstract":"<p>The importance of mental toughness on lung transplant outcomes is unknown. We performed a pilot study to assess whether pretransplant grit and resilience are associated with short-term posttransplant outcomes. We enrolled 31 lung transplant candidates, of whom 7 (26%) had greater mental toughness, defined as the upper tertile for both grit and resilience within our cohort. There were no differences in baseline characteristics between patients with higher and lower mental toughness. Greater mental toughness was associated with a shorter hospital length of stay (LOS) [12 days (interquartile range, IQR 10–12) vs. 17 days (IQR 14–24), <i>p</i> = 0.02] and reduced posttraumatic stress severity [median 0 (IQR 0–2) vs. 6.5 (IQR 4–9), <i>p</i> &lt; 0.01]. On multivariable analyses adjusting for age and Duke Activity Status Index, greater mental toughness was associated with a shorter hospital LOS [beta = −11.96 (95% CI 0.05–23.86), <i>p</i> &lt; 0.05] and reduced PTSD [beta = −10.7 (95% CI −21.6–0.04), <i>p</i> = 0.053]. Lung transplant candidates with greater mental toughness may have improved short-term outcomes.</p>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969924","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":"Liver Transplantation in Well-Selected Class III Obese Recipients Yields Good Outcomes","authors":"Kevin Yi,&nbsp;Vicki Avery,&nbsp;John McCall,&nbsp;Hannah Giles,&nbsp;Helen Lindsay,&nbsp;Ed Gane,&nbsp;David Orr,&nbsp;Louise Barbier","doi":"10.1111/ctr.70060","DOIUrl":"10.1111/ctr.70060","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Previous guidelines considered body mass index (BMI) over 40 kg/m² a relative contra-indication to liver transplantation (LT). The aims were to examine the selection process and study outcomes of patients with Class I–III obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective analysis of outcomes of obese patients assessed for LT at our center between 2010 and 2023, divided into three groups: Class I (BMI30-34.9 kg/m²), Class II (BMI35-39.9 kg/m²), and Class III (BMI&gt;40 kg/m²). Survival of non-obese adult patients was used for comparison.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three hundred fifteen patients with BMI ≥30 kg/m² were assessed for LT. Seventeen (5.4%) were not wait-listed due to comorbidities. One hundred sixty-eight patients were transplanted: 100 Class I, 43 Class II, and 25 Class III. There were no differences in postoperative complications (Clavien-Dindo Grade 3 or more; 41%, 42%, 48% for Class I–III obesity respectively) or patient and graft survival (5-y rates 84.4% and 82.7%, respectively, for the whole cohort) according to the different classes of obesity. Furthermore, patient and graft survival was not different between non-obese and obese patients (<i>p</i> = 0.932).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>With a rigorous selection process, short-term outcomes after LT for patients with Class III obesity were comparable to patients with Class I–II obesity. Long-term survival was identical for obese and non-obese patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969930","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":"Tailoring Kidney Transplant Strategies: Unraveling the Impact of Acute Kidney Injury and Preservation Methods Across Different Strata of Kidney Risk","authors":"Daniel M. Kaufman,&nbsp;James D. Perkins,&nbsp;Nicolae Leca,&nbsp;Ramasamy Bakthavatsalam,&nbsp;Lena Sibulesky","doi":"10.1111/ctr.70078","DOIUrl":"10.1111/ctr.70078","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The use of donor kidneys with acute kidney injury (AKI) aims to expand the organ pool, but uncertainty remains regarding their outcomes across different Kidney Donor Profile Index (KDPI) groups and preservation methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed 108 160 deceased donor kidney transplants from the OPTN database, focusing on adult recipients of kidneys from donors with or without AKI between December 2014 and December 2022. Propensity matching was used for each KDPI group (1–20, 21–59, 60–84, and 85–100), comparing donors with AKIN stages 0–1 to AKIN stages 2–3. Cox proportional hazards analysis assessed graft survival by AKIN stages and preservation type.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The use of AKIN stage 2–3 kidneys significantly increased over the study period. AKIN does not negatively impact graft survival in the KDPI 1–20 group and is linked to improved survival in KDPI 21–59 and 60–84. In the KDPI 85–100 group, AKIN stage 2–3 shows a trend toward increased graft failure. Pump preservation reduces delayed graft function (DGF) across most KDPI groups but does not consistently improve long-term survival, except in KDPI 85–100.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Transplantation with AKIN stage 2–3 kidneys is viable, but outcomes vary by KDPI group. Tailored guidelines should consider transplant center capabilities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962067","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":"Does Weekend Discharge Affect Readmission and Survival in Liver Transplant Patients? Insights From a Cohort Study","authors":"Ayato Obana,&nbsp;Miho Akabane,&nbsp;Hannah Chi,&nbsp;Nolan Ladd,&nbsp;Matthew Yoder,&nbsp;Lily Kaufman,&nbsp;Rithin Punjala,&nbsp;Kejal Shah,&nbsp;Matthew Hamilton,&nbsp;Ashley Limkemann,&nbsp;Austin Schenk,&nbsp;Navdeep Singh,&nbsp;Black Slyvester,&nbsp;Khalid Mumtaz,&nbsp;Kenneth Washburn,&nbsp;Musab Alebrahim","doi":"10.1111/ctr.70081","DOIUrl":"10.1111/ctr.70081","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Weekend hospital discharges are often associated with reduced staffing, potentially impacting the quality of patient care. We studied the effects of weekend discharge after liver transplantation (LT) on early readmission rates, overall survival (OS), and graft survival (GS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We analyzed data from the Ohio State University Wexner Medical Center database (January 2016 to December 2023). The study included initial LT recipients (LTRs) including donation after brain death (DBD) and donation after cardiac death (DCD). Primary outcomes encompassed early readmission rates, and secondary outcomes included OS and GS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cohort comprised 915 LTRs (645 DBD, 270 DCD), with 156 (17.0%) weekend and 759 (83.0%) weekday discharges. Regarding discharge disposition, 681 (74.4%) patients were discharged home, 210 (22.9%) were discharged to healthcare facilities. No significant differences were identified in the length of hospital stay (8 days vs. 9 days, weekend vs. weekday, respectively, <i>p</i> = 0.22) or 30-day readmission (29.5% vs. 32.5%, weekend vs. weekday, respectively, <i>p</i> = 0.75). There were no significant differences in OS (90.9% vs. 92.7% at 1-year, 84.4% vs. 88.0% at 3-year, weekend vs. weekday, <i>p</i> = 0.27) and GS (90.9% vs. 91.5% at 1-year, 84.0% vs. 86.6% at 3-year, weekend vs. weekday, <i>p</i> = 0.50). Multivariate logistic analysis showed no significant impact of weekend discharge (OR: 0.84 [0.57–1.22], <i>p</i> = 0.35) or discharge disposition (OR: 1.00 [0.75–1.33], <i>p</i> = 1.00) on 30-day readmission. Multivariate Cox regression analysis found no significant impact of weekend discharge or discharge disposition on OS and GS (all <i>p</i> &gt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Weekend discharge does not impact early readmission, OS, or GS in LTRs. These findings are a testament to our multidisciplinary team efforts and suggest that with appropriate discharge planning and follow-up care, the timing of discharge may be less critical than previously assumed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962065","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":"Kidney Donation by Psoriasis Patients: Potential Challenges and Approach From a Dermatologist's Perspective","authors":"Sheetanshu Kumar,&nbsp;Hitaishi Mehta,&nbsp;Sree Yazhini Ramar,&nbsp;Anuradha Bishnoi","doi":"10.1111/ctr.70076","DOIUrl":"10.1111/ctr.70076","url":null,"abstract":"","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945822","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":"Amyloidosis and Heart Transplantation in a New Era","authors":"Melissa A. Lyle,&nbsp;Juan Maria M. Farina,&nbsp;Erin Wiedmeier-Nutor,&nbsp;Vanda Lindpere,&nbsp;Molly Klanderman,&nbsp;Jose N. Nativi-Nicolau,&nbsp;Juan Carlos Leoni Moreno,&nbsp;Rohan M. Goswami,&nbsp;Daniel S. Yip,&nbsp;Parag C. Patel,&nbsp;Taimur Sher,&nbsp;Andrew N. Rosenbaum,&nbsp;Omar F. AbouEzzeddine,&nbsp;Barry A. Boilson,&nbsp;Sudhir S. Kushwaha,&nbsp;Alfredo L. Clavell,&nbsp;David E. Steidley,&nbsp;Brian W. Hardaway,&nbsp;Robert L. Scott,&nbsp;Lisa M. LeMond,&nbsp;Rafael Fonseca,&nbsp;Morie A. Gertz,&nbsp;Angela Dispenzieri,&nbsp;Martha Grogan,&nbsp;Julie L. Rosenthal","doi":"10.1111/ctr.70070","DOIUrl":"10.1111/ctr.70070","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The prognosis in patients with advanced cardiac amyloidosis (CA) remains poor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We sought to describe survival post heart transplantation (HT) in amyloid compared with non-amyloid recipients, highlight waitlist times within the new allocation system across three Organ Procurement and Transplantation Network (OPTN) regions, and describe multiorgan transplantation (MOT) in hereditary amyloidosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a retrospective review of end-stage CA patients who underwent HT at Mayo Clinic from January 2007 to December 2020. Wait time was compared in the new versus old OPTN allocation era starting December 18, 2018 by Wilcoxon rank sum test. All-cause mortality for those with and without CA was compared using Kaplan–Meier estimates with log rank analysis, censoring December 16, 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-five patients with CA underwent HT between 2007 and 2020, 8 light chain amyloidosis (AL) (14.5%), 28 hereditary transthyretin (ATTRv) (50.9%), 17 wildtype transthyretin (ATTRwt) (30.9%), and 2 hereditary apolipoprotein A1 (AApoA1) amyloidosis patients (3.6%). No significant difference in overall survival post-transplant was seen in amyloid compared with non-amyloid (<i>p</i> = 0.816). Median time to HT was shorter in the new system, 45 days (IQR 24, 78) versus 174 days (IQR 76.5, 483.5), <i>p</i> = 0.006. There was a decline in MOT in hereditary amyloidosis over time with the concomitant rise in disease-targeted therapies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HT survival in CA patients was similar to non-amyloid patients. The new allocation system benefits this cohort with shorter wait times. There is less MOT in hereditary amyloidosis with increased utilization of disease-targeted therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945818","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":"Use of LCP-Tacrolimus in Kidney Transplant Recipients With Altered Gastrointestinal Anatomy","authors":"Sarah E. Bova,&nbsp;Bethany Lane,&nbsp;Mohamed M. Ibrahim","doi":"10.1111/ctr.70079","DOIUrl":"10.1111/ctr.70079","url":null,"abstract":"","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945846","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}