Clinical Transplantation最新文献

{"title":"Combined Heart and Liver Transplantation: A Single Center Experience and Review of National Data","authors":"Amen Z. Kiani,&nbsp;Jessica Lindemann,&nbsp;Neeta Vachharajani,&nbsp;Angela L. Hill,&nbsp;Diego F. Chaparro,&nbsp;Sakil S. Kulkarni,&nbsp;Janis Stoll,&nbsp;Sarah A. F. Henkel,&nbsp;Pirooz Eghtesady,&nbsp;Dilip Nath,&nbsp;Jacob R. Miller,&nbsp;William C. Chapman,&nbsp;Majella B. Doyle,&nbsp;Adeel S. Khan","doi":"10.1111/ctr.70277","DOIUrl":"https://doi.org/10.1111/ctr.70277","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Combined heart-liver transplantation (CHLT) is a high-risk procedure that is infrequently performed in select patients with end-stage heart and liver disease. This study details a single center experience with simultaneous (en bloc or sequential) CHLT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a single center retrospective review of 12 simultaneous CHLT performed over a 12-year period. Studied variables included basic clinical data, intraoperative and postoperative details, and outcomes. A comparison of our outcomes to the national cohort was also performed using the UNOS registry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twelve CHLTs (five pediatric, seven adult) were performed between 2011 and 2023. Mean age was 32 years (range 7–62 years, 75% male). Congenital heart disease with cardiac cirrhosis (58%) and amyloidosis (25%) were the most common indications. Liver and heart wait list times were 125 and 116 days, respectively. The majority of CHLTs were performed en-bloc (<i>n</i> = 8; 67%) and four (33%) were performed sequentially (liver following heart). Mean post-operative ICU and total length of stay (LOS) were 16 and 28 days, respectively, with six patients requiring unplanned return to OR (three for hemoperitoneum, three for hemopericardium). There were no intraoperative deaths, and one patient died on POD 1 from hyperacute rejection. None of the patients required re-transplant after a median follow-up of 37.5 months. Both overall and graft survival for the cohort at 1-, 3-, and 5-years remained 92%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CHLT remains the only viable option for carefully selected patients with end-stage heart and liver failure and is associated with excellent patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 8","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144861711","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 Between Transjugular Intrahepatic Shunt (TIPS) and Waitlist Outcomes in Simultaneous Liver Kidney (SLK) Transplant Candidates","authors":"Kathryn Schmidt,&nbsp;Tristan Meier,&nbsp;Kristin Cole,&nbsp;Jody C. Olson,&nbsp;Timucin Taner,&nbsp;Samy Riad,&nbsp;Douglas A. Simonetto","doi":"10.1111/ctr.70279","DOIUrl":"https://doi.org/10.1111/ctr.70279","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The association between transjugular intrahepatic portosystemic shunt TIPS and waitlist outcomes in simultaneous liver-kidney (SLK) transplant recipients remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Between 2003 and 2023, we examined the scientific registry of transplant recipients. All adult candidates with overlapping waiting lists for liver and kidney transplants (<i>N</i> = 15 087) were analyzed (entire cohort). Candidates without TIPS (<i>n</i> = 13 980) and with (<i>n</i> = 1107) were followed through November 30, 2023, and the following outcomes were analyzed: death, SLK transplant, liver- or kidney-alone transplant, or removal from the list. The Aalen–Johansen method was used to calculate the cumulative incidence rates of the outcomes, where the outcomes were considered competing risks. Mixed effects Cox proportional hazard models were used to compare the outcomes by TIPS status. We separately analyzed dialysis-dependent candidates (<i>n</i> = 10 370).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the entire cohort, the 1-year cumulative incidence of death in those without TIPS was higher than in those with (12.5% vs. 9%). In the dialysis-dependent cohort, the 1-year death incidence was 13.3% versus 8.8% in those without TIPS and those with, respectively. In the multivariable Cox proportional hazard models, TIPS was associated with a 29% lower mortality risk in the entire cohort (HR = 0.71, 95% CI: 0.60–0.84, <i>p</i> &lt; 0.001) and a 33% lower risk of mortality in the dialysis-dependent cohort. The likelihood of receiving SLK was lower for recipients with TIPS in the univariable analysis. However, this association was attenuated after adjustment. The causes of removal were similar irrespective of TIPS status in both cohorts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this large cohort of SLK candidates, those with TIPS had a better waitlist survival, irrespective of their dialysis requirements before transplantation. Prospective studies are needed to validate these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 8","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833254","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":"Population Pharmacokinetics and Limited Sampling Strategy of Mycophenolate Mofetil for Patients in Early Period After Kidney Transplantation","authors":"Kunhong Deng,&nbsp;Jinlong Liu,&nbsp;Yaxin Liu,&nbsp;Jie Huang,&nbsp;Qiong Xi,&nbsp;Guoping Yang","doi":"10.1111/ctr.70275","DOIUrl":"https://doi.org/10.1111/ctr.70275","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Mycophenolate mofetil (MMF) is widely used as an immunosuppressant in kidney transplantation. The pharmacokinetics (PK) of its active metabolite, mycophenolic acid (MPA), exhibit significant inter- and intra-individual variability. The early post-operative period is crucial for renal function recovery, and MPA exposure is linked to acute rejection. Due to the difficulty of implementing intensive sampling, limited sampling strategies (LSSs) are clinically important for MMF therapeutic drug monitoring for early-stage kidney transplant patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Demographic data, MPA plasma drug concentrations, and laboratory results for 137 patients in early period after kidney transplantation (within 30 days after surgery) were retrospectively analyzed. A population pharmacokinetic (PPK) model for MMF was developed using nonlinear mixed-effects modeling to assess the impact of covariates on the PK characteristics of MPA. Individualized initial dosing regimens were proposed based on Monte Carlo simulations. Using virtual population data, LSSs were developed through multiple linear regression (MLR), Bayesian estimation, and machine learning (ML).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A two-compartment model with first-order absorption with a lag time and first-order elimination best described the PK data of MPA. Sex and weight were identified as significant covariates for CL/F and Vc/F, respectively. The recommended initial dose for male patients was 0.75 or 1 g twice daily, while for female patients, it was 0.5 or 0.75 g twice daily. The Bayesian estimation demonstrated the lowest prediction error among the LSSs approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A PPK model and LSSs for MMF in Chinese kidney transplant patients in the early post-operative period were successfully developed, providing a valuable reference for MMF therapeutic drug monitoring.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 8","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833253","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":"Six- Versus Four-Hour Iohexol Clearance for Glomerular Filtration Rate Measurement in Living Kidney Donor Candidates","authors":"Syed Ali Husain,&nbsp;Jacob S. Stevens,&nbsp;Sumit Mohan","doi":"10.1111/ctr.70276","DOIUrl":"https://doi.org/10.1111/ctr.70276","url":null,"abstract":"","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 8","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832878","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":"Treatment Options for Bronchiolitis Obliterans Secondary to Hematopoietic Cell Transplantation in Children: A Systematic Review","authors":"Amirali Kalantari,&nbsp;Zahra Karimizadeh,&nbsp;Maryam Behfar,&nbsp;Amir Ali Hamidieh","doi":"10.1111/ctr.70274","DOIUrl":"https://doi.org/10.1111/ctr.70274","url":null,"abstract":"<div>\u0000 \u0000 <p>Bronchiolitis obliterans (BO) is a chronic obstructive lung disease affecting bronchioles and smaller airways, often secondary to infection, hematopoietic cell transplantation (HCT), or lung transplantation. Despite its associated morbidity and mortality post-HCT, no standard treatment exists. This systematic review aimed to compare treatment outcomes for post-HCT BO in children. Eligible studies were retrieved from PubMed, Scopus, and Web of Science using terms “bronchiolitis obliterans” and “hematopoietic stem cell transplantation,” including clinical trials, cohorts, cross-sectional studies, case reports, and case series. We analyzed treatment response, pulmonary function improvement, and survival. No significant differences were observed in response between treatment categories (<i>p</i> &gt; 0.18); however, complex multidrug or cell-based regimens showed the highest overall response (66%). Immunosuppressive regimens had the highest non-response rate (42%), possibly due to treatment bias. FEV1 change was not statistically different (<i>p</i> = 0.33), but FAM (corticosteroids, macrolide antibiotics, and leukotriene receptor antagonists)-based and systemic steroid regimens showed numerically better improvement. Survival differed significantly between treatment groups (<i>p</i> = 0.01), highest with FAM-based and lowest with immunosuppressive regimens. These findings suggest clinical benefits from advanced or FAM-based therapies, especially in milder cases. Further large-scale studies are needed to confirm these results.</p>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 8","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144832877","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":"En Bloc Heart-Lung Transplantation: Past and Present. A Systematic Review","authors":"Ryaan EL-Andari,&nbsp;Nicholas M. Fialka,&nbsp;Abrar Alam,&nbsp;Isha Khonde,&nbsp;Jason Weatherald,&nbsp;Kieran Halloran,&nbsp;Jayan Nagendran","doi":"10.1111/ctr.70270","DOIUrl":"https://doi.org/10.1111/ctr.70270","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>En bloc heart-lung transplantation (HLTx) has been utilized for the past 50 years for the treatment of end-stage heart and lung disease, with significant evolution in the field over that time. This is a systematic review of HLTx and a description of the evolution and outcomes in this patient population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Pubmed and Embase were searched for all articles on HLTx from the time of database inception. A total of 1513 articles were screened, and after exclusion, 29 were included in this systematic review.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Reported cases of HLTx were more common in the early era (before 2000), for the indications of cystic fibrosis, Eisenmenger's syndrome, and pulmonary hypertension. In the contemporary era (2000–present), patients were not as commonly transplanted for cystic fibrosis, with pulmonary hypertension and congenital heart disease comprising the majority of cases. Rates of short-term mortality tended to be lower in more recent studies, with only recent studies reporting long-term survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>HLTx has evolved substantially. In tandem with isolated heart and lung transplantation, the indications for transplant, medical therapy, and outcomes have changed over time. While HLTx is used less frequently in contemporary times compared to the early days of cardiothoracic transplantation, indications for HLTx continue to exist, and the use of HLTx will continue to be indicated. Centers with experience in HLTx should continue to report trends in patient management and outcomes, to continue to guide continued refinement in the field of HLTx.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 8","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ctr.70270","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144809192","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":"Correction to “Predictive Factors for Adverse Pregnancy Outcomes After Renal Transplantation”","authors":"","doi":"10.1111/ctr.70261","DOIUrl":"https://doi.org/10.1111/ctr.70261","url":null,"abstract":"<p>You JY, Kim MK, Choi SJ, et al. Predictive factors for adverse pregnancy outcomes after renal transplantation. <i>Clin transplant</i>. 2014;28(6):699-706. doi:https://doi.org/10.1111/ctr.12367</p><p>In the article cited above, a footnote indicating that the first two authors, Ji Yeon You and Moon-Kyung Kim, are co-first authors was omitted from the published article.</p><p>We apologize for this error.</p>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 8","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ctr.70261","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144782303","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":"Causes of Prolonged Cold Ischemia Time After Arrival of Deceased Donor Kidney at Implanting Center: Results From a Prospective Audit","authors":"Mariyam Mujeeb,&nbsp;Balint Borbas,&nbsp;Andrei Tanase,&nbsp;Bynvant Sandhu,&nbsp;Nicholas Barnett,&nbsp;Rhana Zakri,&nbsp;Dilan Dabare,&nbsp;Kamlesh Patel,&nbsp;Ugochukwu Okafor,&nbsp;Tobi Ayorinde,&nbsp;Abigail Chan,&nbsp;Suresh Hanji,&nbsp;Reza Motallebzadeh,&nbsp;Awad Alawad,&nbsp;Verity Brooker,&nbsp;Christopher Chalklin,&nbsp;Sapna Gupta,&nbsp;Laszlo Szabo,&nbsp;Ahmed Malik,&nbsp;Omer Mustafa,&nbsp;Abbas Ghazanfar,&nbsp;Haitham Soliman,&nbsp;Rowland Storey,&nbsp;Gintaras Petrosius,&nbsp;Khadija Tariq,&nbsp;Catherine Boffa,&nbsp;Rupesh Sutaria,&nbsp;Jeevan Gopal,&nbsp;Hussein Khambalia,&nbsp;Zia Moinuddin,&nbsp;Viswakumar Prabakaran,&nbsp;Rania Khattab,&nbsp;Aimen Amer,&nbsp;Laura Martin,&nbsp;Susannah Houston,&nbsp;Andrew Jackson,&nbsp;Sameh Mayaleh,&nbsp;Anna Rizzello,&nbsp;Sushma Shankar,&nbsp;Sanjay Sinha,&nbsp;Sachith Arachchige,&nbsp;Charalampos Konstantinou,&nbsp;Kama Muhammad,&nbsp;John O'Callaghan,&nbsp;Karim Hamaoui,&nbsp;Neil Russel,&nbsp;Somaiah Aroori","doi":"10.1111/ctr.70227","DOIUrl":"https://doi.org/10.1111/ctr.70227","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Deceased donor kidney transplants often face delays, leading to prolonged cold ischemia time (CIT), yet data on post-allograft arrival delays are scarce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This audit aims to identify and characterize the delays contributing to CIT prolongation after allograft arrival at the implanting center.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Data was collected prospectively from 14 UK centers between February and September 2022. Timelines from allograft arrival to the implanting center to implantation were recorded for adult deceased donor kidney-only transplants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median CIT for all 446 allografts [(donation after cardiac death (DCD), 48.2% and donation after brain death (DBD), 51.6%)] was 11:08 h (interquartile range (IQR): 08:15–15:12). A total of 42% of DCD and 15% of DBD allografts exceeded the national recommended duration of 12 and 18 h, respectively. CIT was prolonged in centers with dedicated transplant theaters, with a median CIT of 13:41 (IQR: 08:11–15:13) compared to a median CIT of 09:43 (IQR: 07:36–12:29) hours (<i>p</i> &lt; 0.005, 95% CI: −4.40, −2.60) in centers without dedicated transplant theaters. Compared to full cross-match (FXM) results, a higher proportion of Virtual cross-match (VXM) results (75.2% vs. 89.4%, Odds Ratio (OR): 2.79, CI: 1.57–5.0, <i>p</i> &lt; 0.005) were available before the allograft arrived at the implanting center. The proportion of crossmatch results available before the recipient's arrival at the implanting center was 31.7% (46.6% for VXM vs. 4.9% for FXM, OR: 16.76, CI: 7.50, 44.17, <i>p</i> &lt; 0.005). However, no difference was found in CIT between the VXM (median: 11:06, IQR: 08:14–15:20) and FXM (median: 11:00, IQR: 08:34–14:56) groups (<i>p</i> = 0.75, CI: −0.75, 1.02). Qualitative analysis identified theater and staff unavailability as common reasons for delay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Internal center practices have a significant impact on CIT, necessitating intervention to optimize transplant outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 8","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144782304","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":"Lung Transplantation in Men With High-Risk Prostate Cancer","authors":"Jennifer Maling Slota,&nbsp;Ridwan Alam,&nbsp;Benjamin Louis Thomae,&nbsp;Clayton Neill,&nbsp;Nicole Handa,&nbsp;Hee Chul Yang,&nbsp;Hiten D. Patel,&nbsp;Kent Perry Jr,&nbsp;Kent T,&nbsp;Chitaru Kurihara,&nbsp;Ankit Bharat,&nbsp;Ashley E. Ross,&nbsp;Dylan Isaacson","doi":"10.1111/ctr.70269","DOIUrl":"https://doi.org/10.1111/ctr.70269","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Transplantation in patients with active malignancies is controversial due to concerns about immunosuppression accelerating cancer progression and ethical allocation of donor organs. Prostate adenocarcinoma has a non-immunogenic profile and can respond to temporizing non-chemotherapeutic treatments such as androgen deprivation therapy (ADT). We examine two cases of lung transplantation (LT) in patients with high-risk prostate cancer (PCa) diagnosed during pretransplant evaluation, in whom transplantation was prioritized before definitive cancer treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Single-center retrospective review of patients with end-stage organ dysfunction who underwent solid organ transplant between January 2018 and October 2023 after being diagnosed with high-risk PCa and before definitive oncologic treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two patients met inclusion criteria. One had end-stage interstitial lung disease and the other had post-COVID-19 pulmonary fibrosis; both had WHO group III pulmonary hypertension and underwent expedited LT after being diagnosed with high-risk PCa on pretransplant malignancy screening. One patient was treated with ADT pre-transplant and definitive external beam radiotherapy post-transplant. The second patient has not received definitive therapy for his PCa. Both remain alive with ongoing management of their clinically localized cancer at 24 and 10 months post-transplant, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In experienced transplant centers, it is reasonable to prioritize lifesaving transplantation for patients with newly diagnosed, localized high-risk PCa. The favorable prognostic characteristics and treatment options for PCa make it possible to balance the mortality benefit of transplantation with the risks of temporarily deferring cancer treatment even in the setting of high-risk disease. Expanding the recipient pool to include this population should be considered.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 8","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773597","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":"Emerging Therapeutic Strategies for Renal Ischemia-Reperfusion Injury in Kidney Transplantation: Progress and Challenges—A Systematic Review","authors":"Sohail Khan,&nbsp;Dayanna Zuluaga,&nbsp;Lloyd E. Ratner,&nbsp;Laura M. Cogua,&nbsp;Harvey Wang,&nbsp;Jorge Ortiz","doi":"10.1111/ctr.70263","DOIUrl":"https://doi.org/10.1111/ctr.70263","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Ischemia-reperfusion injury (IRI) contributes to delayed graft function (DGF) and long-term allograft loss in kidney transplantation (KTx). Despite decades of investigation, no pharmacologic strategy has achieved clinical translation. This systematic review evaluates investigational therapies for renal IRI (RIRI) reported since 2000.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following the PRISMA 2020 guidelines, a systematic search of PubMed, ClinicalTrials.gov, and the European Union Clinical Trials Register (EUCTR) was conducted for articles published between January 1, 2000, and March 31, 2025. Eligible records included preclinical and clinical investigations evaluating pharmacologic interventions for RIRI in KTx. Narrative reviews, pediatric-only, in silico-only, and in vitro-only records were excluded. A total of 76 full-text reports were assessed for eligibility, with 43 meeting the inclusion criteria. Meta-analysis was not performed due to heterogeneity. Included reports were synthesized by the mechanism of action, developmental stage, and translational status. Risk of bias was qualitatively assessed. This review was not prospectively registered, no formal protocol was prepared, and no external funding was received.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Legacy agents, Diannexin, YSPSL, and I5NP demonstrated initial promise but failed to achieve late-phase clinical efficacy. More recent agents, particularly alkaline phosphatase, complement-targeting biologics, and mesenchymal stem cell (MSC)-derived exosomes, offer mechanistically diverse strategies to attenuate RIRI, though most remain in early development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Most available data remain preclinical and are limited by inconsistent outcome measures and translational bottlenecks. Future efforts should prioritize harmonized animal models, biomarker-defined endpoints, and strategic investment in promising candidates to integrate them into kidney transplant care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 8","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773594","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}