Clinical Transplantation最新文献

{"title":"Delayed Graft Function After Simultaneous Heart-Kidney Transplantation Across Heart Allocation Eras: Predictors and Impact on Kidney Graft Survival in a National Cohort.","authors":"Somaya Zahran, Tyler Zemla, Byron Smith, Andrew Rosenbaum, Naim S Issa, Hatem Amer, Andrew J Bentall, Alexander R Cortez, Samy M Riad","doi":"10.1111/ctr.70679","DOIUrl":"10.1111/ctr.70679","url":null,"abstract":"<p><strong>Background: </strong>Delayed graft function (DGF) is common after simultaneous heart-kidney (SHK) transplantation, yet its predictors and long-term consequences in contemporary practice remain incompletely defined. We evaluated the incidence, determinants, and impact of DGF on kidney graft outcomes in a national SHK cohort.</p><p><strong>Methods: </strong>Using the Scientific Registry of Transplant Recipients, between 2014-2025, we identified adult SHK recipients. After exclusions, 1637 recipients were analyzed. Baseline characteristics were compared by DGF status. Multivariable logistic regression identified DGF predictors. Cox proportional hazards models assessed DGF association with death-censored and overall kidney graft survival.</p><p><strong>Results: </strong>DGF occurred in 29.1% of recipients (n = 477). Independent predictors of higher DGF odds included higher recipient BMI, pre-transplant dialysis, longer cold ischemia time, and higher refitted KDRI (all p < 0.01). In the adjusted models for long-term kidney graft outcomes, DGF was associated with higher death-censored graft loss (HR 2.02, 95% CI 1.11-3.65; p = 0.021) and overall graft loss (HR 2.04, 95% CI 1.47-2.82; p < 0.001). DGF rates and graft outcomes did not differ by heart allocation era (p = 0.179), and DGF was not associated with higher kidney (p = 0.133) or heart rejection (p = 0.848) at 1 year.</p><p><strong>Conclusion: </strong>DGF is frequent after SHK transplantation and identifies a high-risk subgroup with substantially inferior long-term kidney graft survival, independent of rejection and allocation era. Given the frequency of DGF and its adverse outcomes, future studies are needed to evaluate kidney-after-heart safety-net utilization and post-heart-transplant renal recovery to optimize outcomes and promote judicious kidney allocation in SHK candidates at high risk for DGF.</p>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 9","pages":"e70679"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148955055","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":"Changing Brain Death Donation Dynamics in Spain: A National Overview of Neurocritical Care and Organ Donation Trends.","authors":"Mario Royo-Villanova, Juan Antonio Encarnación, Clara Manso, José Moya, Alejandro Ortin, Elisabeth Coll, Beatriz Domínguez-Gil","doi":"10.1111/ctr.70695","DOIUrl":"https://doi.org/10.1111/ctr.70695","url":null,"abstract":"<p><strong>Background: </strong>Donation after brain death (DBD) has declined in Spain despite sustained transplantation activity and marked growth in donation after circulatory death (DCD). We examined whether this transition was driven by controlled or uncontrolled DCD and contextualized it alongside national trends in neurocritical care and organ utilization.</p><p><strong>Methods: </strong>We conducted a descriptive ecological analysis of aggregated national data from the Spanish National Transplant Organization, healthcare registries, and epidemiological sources for 2015-2024. Annual DBD, controlled DCD (cDCD), uncontrolled DCD (uDCD), donation-potential indicators, mechanical thrombectomy, decompressive craniectomy, and organ recovery and utilization were examined.</p><p><strong>Results: </strong>Actual DBD decreased from 1537 (33.0 per million population [pmp]) to 1246 donors (25.6 pmp). cDCD increased from 211 (4.5 pmp) to 1294 donors (26.6 pmp), whereas uDCD decreased from 103 (2.2 pmp) to 22 donors (0.5 pmp); thus, cDCD accounted for 98.3% of DCD activity in 2024. Donation-potential indicators fell during the COVID-19 pandemic and partially recovered thereafter. Mechanical thrombectomy increased from 2160 to 8762 procedures and decompressive craniectomy from 456 to 729. In 2024, DBD donors generated more recovered and implanted organs per donor than Maastricht category III cDCD donors (3.6 vs. 3.1 and 2.8 vs. 2.3, respectively).</p><p><strong>Conclusions: </strong>Spain's DCD expansion was almost entirely driven by controlled donation, while uDCD declined. These findings demonstrate a reconfiguration of deceased-donation pathways but do not establish patient-level substitution between DBD and cDCD. Linked individual-level studies are required to determine the contributions of neurocritical care, end-of-life decisions, and perfusion technologies.</p>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 9","pages":"e70695"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024038","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":"Beyond Treatment Claims: Closing the Psychiatric Care Loop after Kidney Transplantation.","authors":"Fen-Lan Lin, Lien-Chung Wei","doi":"10.1111/ctr.70683","DOIUrl":"10.1111/ctr.70683","url":null,"abstract":"","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 9","pages":"e70683"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982238","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":"Native Versus Allograft BK Polyomavirus Nephropathy: A Matched Cohort Study of Clinicopathological Features and Outcomes.","authors":"Tong Wu, Shicong Yang, Ling Hong, Xianghong He, Qihua Wang, Jue Wang, Zeying Jiang, Zhixin Huang, Daiwen Lu, Gang Huang, Wenfang Chen","doi":"10.1111/ctr.70693","DOIUrl":"https://doi.org/10.1111/ctr.70693","url":null,"abstract":"<p><strong>Background: </strong>BK polyomavirus nephropathy (BKPyVN) is a well-recognized cause of graft dysfunction and loss in kidney transplant recipients (KTRs). However, its clinical and pathological features in the native kidneys of non- KTRs remain poorly defined. We aimed to characterize native-kidney BKPyVN and compare it with allograft BKPyVN.</p><p><strong>Methods: </strong>We retrospectively analyzed the clinical, virological, pathological and prognostic features of native-kidney BKPyVN. A 1:4 matched cohort of KTRs with allograft BKPyVN served as the control group. Diagnosis was established by kidney biopsy with SV40-T immunohistochemical confirmation and supported by BKPyV DNA detection in urine and/or plasma.</p><p><strong>Results: </strong>Nine patients with native-kidney BKPyVN were identified, including 6 who had undergone hematopoietic stem cell transplantation, 2 lung and 1 heart-lung transplantation. All underwent kidney biopsy for progressive kidney dysfunction. At diagnosis, all had marked BKPyV DNAviruria, and plasma BKPyV DNA was detectable in 8 of 9 patients. Tubular basement membrane (TBM) C4d staining was observed in 8 of 9 cases and correlated with the extent of tubular SV40-T positivity. Compared with allograft BKPyVN, native-kidney BKPyVN presented with higher plasma BKPyV DNA levels, greater intrarenal viral load and more severe tubulointerstitial injury (all p < 0.05). Kaplan-Meier analysis showed lower 12-month ESRD-free survival in patients with native-kidney BKPyVN than in those with allograft BKPyVN (p = 0.001).</p><p><strong>Conclusions: </strong>Native-kidney BKPyVN is associated with advanced tubulointerstitial injury, frequent TBM C4d deposition and poor short-term renal outcomes. The greater severity than allograft BKPyVN may largely reflect delayed diagnosis in the absence of routine BKPyV surveillance. Earlier BKPyV testing and timely kidney biopsy should be considered in high-risk patients with otherwise unexplained kidney dysfunction.</p>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 9","pages":"e70693"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015720","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":"What Explains the Pattern of Fibrosis in Chronic Graft-Versus-Host Disease?","authors":"Mohammadamin Noorafrooz,&nbsp;Hoda Kavosi,&nbsp;Robert Peter Gale","doi":"10.1111/ctr.70670","DOIUrl":"10.1111/ctr.70670","url":null,"abstract":"<div>\u0000 \u0000 <p>Fibrosis is common in diverse conditions but has different patterns across tissues and organs despite shared cellular and molecular pathways reasons for which are mostly unexplained. In this review we discuss chronic graft-Versus-host disease (G<i>v</i>HD), progressive systemic sclerosis (PSS), idiopathic pulmonary fibrosis (IPF), primary myelofibrosis (PMF), chronic lung allograft dysfunction (CLAD) and VEXAS syndrome to explore potential mechanisms underlying these patterns of fibrosis. We propose the distribution of fibrosis reflects a complex interplay between aetiology, initiating stimuli, local immune response, tissue-specific micro-environment and host susceptibility. Distinguishing systemic and local drivers of fibrosis is needed to understand and explain these patterns. A deeper understanding of early, tissue-specific events governing fibrotic responses may allow development of preventive and therapeutic strategies.</p>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863896","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":"Comment on “Accuracy of CYP3A5 Pharmacogenomics Recommended Dosing of Tacrolimus with Concomitant Azole Antifungals Early Post-Lung Transplant”","authors":"Prateek Pandey,&nbsp;Amit Kumar Mishra,&nbsp;Shubham Singh","doi":"10.1111/ctr.70672","DOIUrl":"10.1111/ctr.70672","url":null,"abstract":"","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863885","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":"Real-World Use of Normothermic Machine Perfusion in Liver Transplantation: A Multi-Institutional Experience From the National Organ Perfusion Registry","authors":"Alexander R. Cortez,&nbsp;Wei San Loh,&nbsp;Sarah Sheskey,&nbsp;Hillary J. Braun,&nbsp;Aashna Mehta,&nbsp;Christopher Connelly,&nbsp;Austin Schenk,&nbsp;Musab Alebrahim,&nbsp;Raj Patel,&nbsp;Lori A. McLamb,&nbsp;Andrew Barbas,&nbsp;Steven A. Wisel,&nbsp;Garrett R. Roll,&nbsp;Kyle H. Sheetz","doi":"10.1111/ctr.70664","DOIUrl":"10.1111/ctr.70664","url":null,"abstract":"<p>Normothermic machine perfusion (NMP) has enabled increased utilization of high-risk liver allografts; however, real-world data describing use, perfusion logistics, and associated outcomes remain limited. We established the National Organ Perfusion Registry (NOPR), a multicenter collaborative registry designed to capture granular perfusion data not available in the national transplant datasets. Adult liver transplant recipients who underwent transplantation using NMP between 2022 and 2024 at nine U.S. centers were included. Registry data were linked to the United Network for Organ Sharing (UNOS) Standard Transplant Analysis and Research files to obtain donor and recipient characteristics and post-transplant outcomes. Descriptive analyzes were performed to characterize the indications for NMP use, procurement practices, perfusion timing parameters, and early graft outcomes. A total of 545 NMP liver transplants were analyzed, including 282 donations after circulatory death (DCD) and 263 donations after brain death (DBD). DCD was the most common indication for NMP, and its incidence increased substantially during the study period. Perfusion practices varied, including procurement strategy, device use, time from cross-clamp to NMP initiation, and total perfusion duration. Despite this heterogeneity, early outcomes were favorable, with a 90-day death-censored graft failure rate of 1.7%, and no difference between DCD and DBD grafts. Recipients of DCD grafts had a shorter post-transplant length of stay than DBD recipients. In this multicenter, real-world cohort analysis, NMP was associated with low rates of early graft failure across diverse centers and perfusion practices. These findings support the feasibility of contemporary NMP use and underscore the importance of continued multicenter evaluation to refine perfusion strategies.</p>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863880","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":"Feasibility and Acceptability of a Group-Based Relapse Prevention Program for Liver Transplant Recipients With Alcohol-Associated Liver","authors":"Sasha Deutsch-Link,&nbsp;Sophia Hurr,&nbsp;Heather Gallagher,&nbsp;Ellen W. Green,&nbsp;Christian S. Hendershot,&nbsp;Marie-Josee Lynch,&nbsp;Daniel Velez,&nbsp;Hersh Shroff","doi":"10.1111/ctr.70667","DOIUrl":"10.1111/ctr.70667","url":null,"abstract":"<div>\u0000 \u0000 <p>Alcohol-associated liver disease (ALD) has become the leading indication for liver transplantation (LT) in the United States. Contemporary practice has shifted toward broader LT access for medically urgent patients with limited pretransplant abstinence or alcohol use disorder (AUD) treatment experience. These patients require AUD treatment post-LT; however, standardized treatment protocols in this setting remain limited. In response to this need, our center implemented a virtual monthly group-based relapse prevention program (RPP) for liver transplant recipients (LTRs) transplanted for ALD. The aim of this quality improvement initiative was to examine the feasibility and acceptability of our program. Sessions were administered virtually by a licensed clinical addiction specialist. We collected data from the electronic health record, patient survey data, and qualitative feedback via a focus group at program completion. Of 46 patients contacted, 41% (<i>n</i> = 19) completed initial enrollment, and 30% (<i>n</i> = 14) attended at least one session. The majority of patients (61%) were male and those who enrolled were transplanted more recently (15 versus 26 months post-LT). Attendance was higher in patients with private insurance and a diagnosis of alcohol-associated hepatitis. Our program was well-received overall by participants, as seen in both patient satisfaction scores and qualitative feedback. Although focus group participants felt the program was not essential for maintaining abstinence, largely due to an already established commitment to abstinence, they valued the sense of community and purpose it provided. With rising ALD burden and broader access to urgent LT, structured and accessible posttransplant AUD interventions remain an important and unmet need.</p>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863900","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":"Primary Language, Social Determinants of Health, and the Lived Patient Experience After Heart Transplantation: A Comparative Qualitative Study","authors":"Mansi K. Shah,&nbsp;Zara Latif,&nbsp;Carolina Lemos,&nbsp;Adi Hertz,&nbsp;Elena Donald,&nbsp;Byron Fuselier,&nbsp;Jordan Lindekens,&nbsp;Fabian Vargas,&nbsp;Afsana Rahman,&nbsp;Farhana Latif,&nbsp;Kevin J. Clerkin,&nbsp;Gabriel Sayer,&nbsp;Nir Uriel,&nbsp;Ersilia M. DeFilippis","doi":"10.1111/ctr.70660","DOIUrl":"https://doi.org/10.1111/ctr.70660","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Over 4,500 individuals undergo heart transplantation (HT) in the United States every year. Limited qualitative data exist evaluating challenges and barriers in the evaluation and post-transplant process and their association with primary language spoken.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted semi-structured interviews with individuals who received HT at a high-volume urban academic medical center between 2015 and 2024. Primary English and Spanish speaking patients were included; interviews were conducted by a certified Spanish speaker. Interviews were audio-recorded and transcribed for thematic analysis. Themes were compared based on primary language spoken.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>34 HT recipients (median age 61 years, 38% women) participated in this study. Forty-one percent (<i>n</i> = 14) identified Spanish as their primary language. Three key thematic differences emerged based on primary language spoken: (1) perception of the transplant process and emotional needs, (2) financial concerns while awaiting transplant, and (3) methods of communication. Spanish speaking patients more commonly relied on family support, faith, and public assistance programs to navigate the transplant process. English speaking patients, on the other hand, more frequently struggled with the morality of accepting a transplant. Additionally, English speaking patients more commonly had increased financial resources, highlighting the intersection with education and other social determinants of health (SDOH).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study identifies key differences in the experiences of HT recipients based on the patient's primary spoken language and inter-related SDOH. This study can inform future studies focused on the impact of health policy changes and the expansion of social support systems on transplant allocation among linguistically diverse communities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849356","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":"Factors Associated With Weight Management Referral Acceptance and Uptake in Kidney Transplant Candidates","authors":"Linda-Marie Lavenburg,&nbsp;Harry Morford,&nbsp;Susan Stark,&nbsp;Sanjana Kamat,&nbsp;Mariela Sierra Mendoza,&nbsp;Michele Molinari,&nbsp;Chethan Puttarajappa","doi":"10.1111/ctr.70659","DOIUrl":"https://doi.org/10.1111/ctr.70659","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Obesity is a significant barrier to kidney transplantation (KT). KT candidates with obesity are often referred to weight management programs (WMP) but patients' acceptance for WMP referral and their subsequent follow-through are unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Methods</h3>\u0000 \u0000 <p>Using a single-center study, we evaluated the effectiveness of referrals to medical or surgical WMPs among KT candidates to initiate obesity care. We examined factors associated with patients establishing care and any effects of referral acceptance on BMI, KT waitlisting and transplantation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median age was 57 years, 49% were male, 56% were White, 79% were on dialysis, and 53% were from high social disadvantage areas. Thirty patients (50.8%) accepted WMP referral but only 9 (15.3%) contacted WMP. Patients accepting referral had higher BMI [median 47 vs. 45; <i>p</i> = 0.002] and resided closer to the KT center [20 vs. 48 miles; <i>p</i> = 0.010]. In multivariable models, referral acceptance decreased 2% with each mile away from KT center (OR 0.98; 95%CI: 0.96–1.00) and increased by 22% with every 1 unit increase in BMI (OR 1.22, 95%CI: 1.03–1.45). Among patients accepting referral, every 1-year increase in age reduced odds of contacting WMP by 17% (OR 0.83, 95%CI: 0.74–0.96).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A large share of KT candidates with obesity do not establish care with WMPs. Increasing age and distance to KT center were contributing factors to low referral acceptance and engagement. Efforts aimed at obesity management in KT should consider these barriers. WMPs integrated within KT programs may overcome barriers to establishing care with WMPs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 9","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ctr.70659","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849257","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}