Clinical Transplantation最新文献

{"title":"Identifying the Views and Needs of Family Physicians on Providing Care to Living Kidney Donors: A Cross-Sectional Survey","authors":"Katya Loban,&nbsp;Emilie Trinh,&nbsp;Kathleen Gaudio,&nbsp;Diya Nijjar,&nbsp;Jorane-Tiana Robert,&nbsp;Ngan Lam,&nbsp;Scott McKay,&nbsp;Heather Badenoch,&nbsp;Marie-Chantal Fortin,&nbsp;Ann Bugeja,&nbsp;Rahul Mainra,&nbsp;Christine Dipchand,&nbsp;Shaifali Sandal","doi":"10.1111/ctr.70085","DOIUrl":"10.1111/ctr.70085","url":null,"abstract":"<p>Optimizing the long-term care and follow-up of living kidney donors (LKDs) has been challenging, and prior LKDs have reported suboptimal healthcare experiences. Long-term care of LKDs is largely undertaken by primary care practitioners such as family physicians (FPs). We conducted a cross-sectional survey of Canadian FPs (<i>n</i> = 151). In our sample, 21.9% of participants reported that ≥1 patient had expressed interest in becoming a LKD, and 39.9% provided care to prior LKDs. While 55.5% knew how to find information on living kidney donation, 75.5% reported that information was not available in their practice. Only a minority had formal training in living kidney donation (&lt;5%), and self-reported knowledge was low (median = 3 [scale 1 = not strong to 10 = very strong]). Knowledge improved significantly with educational activities, resources, experience, and practice needs. Attitudes toward living kidney donation were generally favorable with 71.5% stating that FPs should be involved in post-donation care. Clinical care guidelines (78.8%) were the most desired resource, followed by clear communication and reliable contact at transplant centers. Our findings inform the transplant community of an avenue to optimize LKD care by better-supporting FPs, who provide care to LKDs. This may enhance data collection on LKD outcomes and potentially increase donation rates.</p>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051938","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":"Outcomes of Liver Transplant for Hepatic Epithelioid Hemangioendothelioma","authors":"Emily L. Larson,&nbsp;Yusuf Ciftci,&nbsp;Reed T. Jenkins,&nbsp;Alice L. Zhou,&nbsp;Jessica M. Ruck,&nbsp;Benjamin Philosophe","doi":"10.1111/ctr.70087","DOIUrl":"10.1111/ctr.70087","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Hepatic epithelioid hemangioendothelioma (HEH) is a rare indication of liver transplant with limited evidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adult recipients undergoing first-time liver-only transplant from 2002 to 2021 in the United States were identified using the UNOS/OPTN database. We compared post-transplant outcomes of recipients receiving liver transplant for HEH versus other diagnoses. Survival was visualized using Kaplan-Meier curves and compared using log-rank test and multivariable Cox regression. Propensity score matching for recipient age, sex, and MELD was performed, with baseline characteristics and survival compared between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 111 558 liver transplant recipients identified, 121 (0.1%) underwent transplant for HEH. Donors to HEH recipients were more often living donors. Recipients with HEH were younger, more likely to be female, and had lower BMI. Recipients with HEH had higher albumin, lower bilirubin, lower INR, and lower serum creatinine, as well as lower MELD scores and rates of ascites and encephalopathy. Similar post-transplant survival was observed for recipients with HEH (16.6 [lower 95% CI 14.9] years) and non-HEH diagnoses (13.8 [95% CI 13.6–13.9] years, log-rank <i>p</i> = 0.28), even after adjusting for baseline donor and recipient characteristics (aHR 1.28 [95% CI 0.94–1.74], <i>p</i> = 0.12). The propensity score matched cohort also had similar post-LT survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This national study represents the largest known report on liver transplant for HEH. The survival of recipients with HEH was similar to other etiologies, supporting the use of liver transplantation (LT) in advanced HEH.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"39 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045836","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":"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}