Clinical Transplantation最新文献

{"title":"Diagnostic and Prognostic Value of Myocardial Extracellular Volume Fraction Assessed Using Cardiovascular Magnetic Resonance in Patients With Restrictive Cardiac Allograft Physiology","authors":"Masaki Tsuji,&nbsp;Michelle M. Kittleson,&nbsp;David H. Chang,&nbsp;Evan P. Kransdorf,&nbsp;Andriana P. Nikolova,&nbsp;Lily K. Stern,&nbsp;Mason Lee,&nbsp;Jon A. Kobashigawa","doi":"10.1111/ctr.70319","DOIUrl":"10.1111/ctr.70319","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Restrictive cardiac allograft physiology (RCP) is associated with poor prognosis following heart transplantation (HT). While cardiac magnetic resonance (CMR) is useful for evaluating HT recipients, its utility for RCP assessment remains unknown. This study aimed to investigate the diagnostic and prognostic value of CMR in patients with RCP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seventy-five HT recipients (median age: 54 [interquartile range (IQR), 40–63] years; 33.3% female) who underwent contrast-enhanced CMR between 2015 and 2023 were included. Patients were grouped by RCP status (RCP⁺ group, <i>n</i> = 30; and RCP⁻ group, <i>n</i> = 45). RCP was defined according to the International Society for Heart and Lung Transplantation guidelines. The primary endpoints were all-cause mortality or redo HT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median HT-to-CMR time was 4.6 (IQR, 1.2–11.0) years. Compared to that of the RCP⁻ group, the RCP⁺ group exhibited significantly higher myocardial T2 (53.1 ± 7.5 vs. 49.7 ± 5.7 ms; <i>p</i> = 0.035) and extracellular volume fraction (ECV) (33.4 ± 6.8% vs. 28.6 ± 6.1%; <i>p</i> = 0.003) values. Multivariate logistic regression analyses revealed an independent association between ECV and RCP (odds ratio = 1.11; 95% CI: 1.02–1.23; <i>p</i> = 0.032). The area under the receiver operating characteristic curve for ECV was 0.73, with 60.7% sensitivity and 83.3% specificity at a cutoff value of 31.5%. After ECV-dependent stratification of patients with RCP, Kaplan–Meier analysis demonstrated significantly higher incidences of primary endpoints in the ECV ≥ 31.5% subgroup than in the ECV &lt; 31.5% subgroup (<i>p</i> = 0.048).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CMR-derived myocardial ECV provides both diagnostic and prognostic value in patients with RCP and may potentially help guide the timing for consideration of re-HT.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 9","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079820","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":"Passenger Lymphocyte Syndrome Presenting With Severe Refractory Thrombocytopenia After Transplantation: A Multi-Recipient Case Series","authors":"Emilee E. Larson,&nbsp;Carlos Aravena,&nbsp;Deepika P. Kulkarni,&nbsp;Charles A. Mouch,&nbsp;Rachel C. Forbes,&nbsp;Bernard J. Dubray,&nbsp;Beatrice P. Concepcion,&nbsp;David Shaffer,&nbsp;Hakim A. Ali","doi":"10.1111/ctr.70295","DOIUrl":"10.1111/ctr.70295","url":null,"abstract":"<div>\u0000 \u0000 <p>Passenger lymphocyte syndrome (PLS) is an immune-mediated complication that can occur following solid organ transplantation, resulting from the transfer of donor-derived lymphocytes that produce alloantibodies targeting recipient antigens. We report a case series of PLS presenting as severe refractory thrombocytopenia in multiple recipients of solid organ transplantation from a single donor.</p>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 9","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085086","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":"Predictors and Prognosis of Right Bundle Branch Block Following Heart Transplantation: A Systematic Review and Meta-Analysis","authors":"Naydeen Mostafa,&nbsp;Omar Almaadawy,&nbsp;Ahmed Elshahat,&nbsp;Muhiddin Dervis,&nbsp;Belal Mohamed Hamed,&nbsp;Amar Asad,&nbsp;Sofian Zreigh,&nbsp;Esraa M. Soliman,&nbsp;Hamed Abdelma'aboud Mostafa,&nbsp;Hossam Elbenawi,&nbsp;Mustafa Ahmed","doi":"10.1111/ctr.70322","DOIUrl":"10.1111/ctr.70322","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Right bundle branch block (RBBB) has a high prevalence among heart transplant recipients and could influence outcomes. Crucially, the predictors of RBBB development after heart transplantation are not well-established. Our study aims to evaluate the preoperative predictors and outcomes of RBBB following heart transplantation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed, Scopus, Web of Science, and Cochrane Library were searched up to November 15, 2024, to identify studies comparing heart transplant recipients with RBBB and without RBBB. Random-effects models were used to estimate the pooled mean difference (MD) and risk ratios (RRs) with 95% confidence intervals (95% CIs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nine studies incorporating 1507 patients were included. Patients who developed RBBB had higher graft ischemia time [MD: 10.0; 95% CI: 2.00–17.91; <i>p</i> = 0.01] and pulmonary vascular resistance (PVR) (MD: 0.44; 95% CI: 0.21–0.68; <i>p</i> &lt; 0.001). There was no significant difference between RBBB and non-RBBB patients in terms of pulmonary artery pressure (MD: 1.83; 95% CI: -0.86–4.53; <i>p</i> = 0.18) or donor age (MD: 1.51; 95% CI: -0.30– 3.31; <i>p</i> = 0.10). There was no significant difference in the prognosis of RBBB patients in terms of acute rejection (RR: 1.06; 95% CI: 0.70–1.61; <i>p</i> = 0.78), chronic rejection (RR: 0.92; 95% CI: 0.60–1.41; <i>p</i> = 0.70), or mortality (RR: 1.87; 95% CI: 0.81–4.31; <i>p</i> = 0.14).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite the association of RBBB with graft ischemia time and PVR, post-transplant RBBB had no significant impact on mortality or graft rejection. Further research focusing on the identification period and applied definition of RBBB is recommended.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 9","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069175","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":"Cellular Cancer Immunotherapy in the Liver Transplant Population for HCC: An Attractive Therapeutic Option for the Next Decade","authors":"Dongdong Yu,&nbsp;Shuchan Li,&nbsp;Hao Chen,&nbsp;Lidong Wang","doi":"10.1111/ctr.70313","DOIUrl":"https://doi.org/10.1111/ctr.70313","url":null,"abstract":"<div>\u0000 \u0000 <p>Immunocytotherapy has emerged as a promising therapeutic tool against hepatocellular carcinoma (HCC). Liver transplantation (LT) remains the primary option for curing HCC; however, post-transplant tumor recurrence and the development of new malignancies significantly impact patient prognosis. The application of immune cell therapy in LT for HCC may reestablish antitumor immunity following transplantation without increasing the risk of rejection. In this review, we provide a concise overview of the suppressive tumor-immune status and its impact on tumor recurrence and the development of neoplastic tumors after LT for HCC. We also examine the latest cellular cancer immunotherapy regimens for solid tumors, with a particular focus on HCC, and discuss their limitations. Finally, we summarize the challenges of applying cellular cancer immunotherapy in LT, including the potential induction of acute rejection and the suppressive effects of immunosuppressive agents, as well as potential coping strategies. In conclusion, cellular cancer immunotherapy may offer a potentially effective treatment for tumor recurrence in LT for HCC.</p>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 9","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145051158","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":"Integrating Alpha-Fetoprotein and Protein Induced by Vitamin K Antagonist-II as Surveillance Tools After Liver Transplantation for Hepatocellular Carcinoma: A Novel Protocol for Early Detection of Tumor Recurrence","authors":"Jiyoung Kim,&nbsp;Kwang-Woong Lee,&nbsp;Jae-Yoon Kim,&nbsp;Jaewon Lee,&nbsp;Hyun Hwa Choi,&nbsp;Su young Hong,&nbsp;Jeong-Moo Lee,&nbsp;Suk Kyun Hong,&nbsp;YoungRok Choi,&nbsp;Nam-Joon Yi,&nbsp;Kyung-Suk Suh","doi":"10.1111/ctr.70314","DOIUrl":"https://doi.org/10.1111/ctr.70314","url":null,"abstract":"<div>\u0000 \u0000 <p>Hepatocellular carcinoma (HCC) is a cancer prevalent worldwide, and liver transplantation (LT) is a curative treatment option. However, post-transplantation recurrence remains a significant concern, necessitating the identification of predictive factors and early detection of patients with recurrence. Alpha-fetoprotein (AFP) and proteins induced by vitamin K absence-II (PIVKA-II) are recognized HCC diagnostic markers. However, standardized protocols for testing intervals and supplemental imaging incorporation are limited. This study explored the integration of both tumor markers as surveillance tools and suggested different surveillance protocols based on recurrence risk. We conducted a retrospective analysis of 708 patients who underwent living donor liver transplantation (LDLT) for HCC. Patients were categorized into four groups based on models for tumor recurrence after liver transplantation (MoRAL) scores and tumor marker normalization after LT. Group 1, with the lowest risk, showed 12.5% recurrence at 15 months, whereas Group 4 showed 96.2% recurrence within 5 months. Integrating AFP and PIVKA-II yielded an overall 82% sensitivity for recurrence detection. As 28.0% of patients with HCC recurrence in Group 1 revealed recurrence without tumor marker elevation, we propose a novel HCC surveillance protocol with differentiated intervals based on specific risk groups. This approach is promising for enhancing early detection and post-transplantation outcomes.</p>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 9","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038444","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 Timing Impacts Renal Graft Outcomes in Simultaneous Heart-Kidney Transplantation","authors":"Brendan P. Lovasik,&nbsp;Neeta Vachharajani,&nbsp;Paighton Miller,&nbsp;Greg Martens,&nbsp;Yiing Lin,&nbsp;Jason Wellen,&nbsp;Jennifer Yu","doi":"10.1111/ctr.70312","DOIUrl":"10.1111/ctr.70312","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Simultaneous heart-kidney (SHK) transplantation is widely administered as a treatment for end-stage cardiorenal disease. However, the impact of renal transplant timing as a concurrent (heart and kidney transplanted simultaneously) or staggered (heart transplant followed by kidney transplant) procedure on post-transplant outcomes has not been investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective analysis of the UNOS STAR for SHK transplants that occurred in the United States between 2010 and 2024. Institutional SHK transplant data were similarly reviewed for specific patient-level factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Approximately two-thirds (<i>N</i> = 1668) of SHK transplants were performed using the staggered approach, with the remaining one-third performed concurrently (<i>N</i> = 868). Univariate analysis of concurrent versus staggered SHK transplants indicated that staggered SHK transplant was associated with a higher rate of delayed graft function (DGF; 31.4 vs. 25.6%, respectively; <i>p </i>= 0.003) and lower 1-year renal graft survival (89.9 vs. 84.5%, respectively; <i>p </i>&lt; 0.001). A multivariable regression analysis showed that these differences in DGF (HR 1.29, 95% CI 1.05–1.58, <i>p</i> = 0.014) and 1-year graft survival (HR 1.39, 95% CI 1.05–1.83, <i>p</i> = 0.020) remained when other factors were controlled. In multivariable Cox analysis, staggered SHK was associated with lower overall patient survival (HR 0.81, <i>p</i> = 0.045) but no differences in death-adjusted graft survival or need for renal retransplantation (both <i>p</i> &gt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The results from this study indicate that discrepant outcomes in SHK transplantation result from the timing of renal transplantation, with concurrent SHK demonstrating superior outcomes in a large national dataset.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 9","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032912","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":"Effect of Total Psoas Muscle Area and Serum Albumin on Outcomes After Lung Transplantation","authors":"Domingo J. Franco-Palacios,&nbsp;Carlos R. Franco-Palacios,&nbsp;Sarah Crowley,&nbsp;Lisa L. Allenspach,&nbsp;Lisa Stagner,&nbsp;Julio Pinto Corrales,&nbsp;Kaitlin Olexsey,&nbsp;Lisa Waynick,&nbsp;Jane Simanovski,&nbsp;Humza Bhatti,&nbsp;Ryann Laier,&nbsp;Adele Myszenski,&nbsp;Yichu Wang,&nbsp;Mei Lu,&nbsp;Thomas Song","doi":"10.1111/ctr.70308","DOIUrl":"10.1111/ctr.70308","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sarcopenia of the psoas muscle and hypoalbuminemia indicate poor nutritional status, inflammation, and frailty in lung transplant (LT) candidates, correlating with worse post-transplant outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective study of LT recipients (2015–2023) examining the association of total psoas muscle area (TPA) and serum albumin with hospital stay, survival, and pulmonary function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred thirty-two LT recipients (mean age 59.56 ± 10.65 years, BMI 26.73 ± 5.55 kg/m², 65% males), 95% underwent bilateral LT. Higher TPA was associated with shorter hospital and ICU stays (<i>p</i> = 0.001). Similarly, higher albumin levels were associated with reduced hospital and ICU stays (<i>p</i> &lt; 0.001). Hospital survivors had higher TPA (17.5 ± 6.1 vs. 14.6 ± 5.2 cm², <i>p</i> = 0.02) and higher albumin levels (3.25 ± 0.73 vs. 2.75 ± 0.85 mg/dL, <i>p</i> = 0.01). Long-term survivors had higher TPA (17.8 ± 6.35 vs. 15.9 ± 5.51 cm², <i>p</i> = 0.07) and higher albumin levels (3.29 ± 0.75 vs. 2.97 ± 0.78 mg/dL, <i>p</i> = 0.01). On multivariate analysis, albumin and male gender remained independent predictors of hospital and long-term survival. TPA was positively associated with post-transplant pulmonary function based on FVC and FEV1 (<i>p</i> &lt; 0.001), while albumin levels showed no association.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In the present study of LT recipients, higher TPA and albumin levels were linked to shorter hospitalization, and albumin independently predicted survival. TPA, but not albumin, was associated with pulmonary function post-transplant.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 9","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ctr.70308","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032886","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":"Pre-Donation Cardiac Arrest and Liver Transplantation Outcomes: Implications for Ischemic Preconditioning","authors":"Dharesh Raj Amarnath,&nbsp;Samuel J. Tingle,&nbsp;Georgios Kourounis,&nbsp;Chris Freise,&nbsp;Garrett R. Roll,&nbsp;Seiji Yamaguchi,&nbsp;Charles Rickert,&nbsp;Colin H. Wilson","doi":"10.1111/ctr.70309","DOIUrl":"https://doi.org/10.1111/ctr.70309","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Liver transplantation is the definitive treatment for end-stage liver disease and some cancers. The use of livers from donors following pre-donation cardiac arrest (PDCA), especially with prolonged downtime duration, has been limited outside of the US due to fears over inferior outcomes from ischemic injury. However, PDCA may induce ischemic preconditioning, paradoxically improving post-transplant outcomes. We analyzed the impact of PDCA occurrence and downtime duration on liver transplantation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used the UNOS registry on adult liver transplantation (2010–2023), and included both donation after brain death (DBD) and donation after circulatory death (DCD) donors. Multivariable regression models were used to analyze the associations. Multiple imputation was used for missing data, and restricted cubic spline modelling to account for non-linear relationships.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 74,592 recipients, 32,631 (43.7%) received a liver from a PDCA donor. PDCA occurrence was associated with a small improvement in graft survival (aHR = 0.914, 95% Cl = 0.851–0.982). Interaction terms revealed this benefit was more pronounced among the following donor groups: DCD, moderately raised alanine aminotransferase (ALT), short admission-to-donation time and older donors. These novel associations are all in keeping with a preconditioning effect. Increasing PDCA downtime duration was also associated with a small improvement in graft survival (aHR per doubling = 0.953, 95% Cl = 0.917–0.991). Similar associations were seen with secondary outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The use of livers from donors with PDCA, including those with prolonged downtime duration, is a safe and simple approach to expand the donor pool internationally. Interaction terms and non-linear modelling provided clinical evidence for ischemic preconditioning from PDCA, which represents the largest real-world demonstration of this phenomenon.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 9","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ctr.70309","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022247","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":"Answer to the Comments of H. Daungsupawong et al. About the Study Entitled Persistence of a High Seroconversion Rate 3.2 ± 0.13 Years After Last COVID-19 Vaccination in Heart Transplant Recipients","authors":"Robin Arcani,&nbsp;Pierre Ambrosi","doi":"10.1111/ctr.70318","DOIUrl":"https://doi.org/10.1111/ctr.70318","url":null,"abstract":"","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 9","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145021894","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":"A 12-Year Analysis of Equity and Efficiency in Living Kidney Donation at a Rural American Center","authors":"Benjamin Limburg,&nbsp;Kaleb Dobbs,&nbsp;Els Reuvekamp,&nbsp;Sujit Vijay Sakpal","doi":"10.1111/ctr.70315","DOIUrl":"https://doi.org/10.1111/ctr.70315","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In the United States, a severe organ shortage precipitates an extensive transplant waitlist. Living donor kidneys are functionally superior to those from deceased donors and offer an alternative to close the supply-demand gap.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review of 2147 patients who self-referred to begin the living kidney donation workup process at our center between June 1, 2012, and October 1, 2023 was conducted with subsequent statistical analysis of gathered data. National Kidney Registry (NKR) affiliation began February 1, 2018, and the pre- and post-NKR periods were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The pre-NKR period saw 894 total referrals (42%) compared to 1253 post-NKR (58%). Post-NKR donors increased to 89 from 47 pre-NKR with similar times between stages except for a significantly shorter referral-to-lab review post-NKR (47.0 vs. 56.5 days, <i>p</i> &lt; 0.01). A notable decrease in referrals from Indigenous Peoples was observed (121 [14%] to 93 [7%], <i>p</i> &lt; 0.01) yet donations increased (2 [4%] to 7 [8%], <i>p</i> = 0.042). Donors originating from South Dakota increased (26–54, <i>p</i> = 0.59) post-NKR, and significantly more patients pursued nondirected referral (25 [3%] vs. 173 [14%], <i>p</i> &lt; 0.01) with similar proportions following through with donation. Reasons for dropout during the process were similar between the periods, yet quantitative distributions differed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>NKR affiliation coincided with encouraging results, in many cases similar to broad national trends, attesting to improved connectivity and impact on focal population groups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 9","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022249","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}