Clinical Transplantation最新文献

{"title":"Anatomical Size Disparities in Liver Transplantation: Imaging-Derived Abdominal Dimensions and Their Association With Waitlist Outcomes","authors":"Rafal Mazur,&nbsp;Alyssa Stetson,&nbsp;Alissa Cutrone,&nbsp;David Cron,&nbsp;Joel Adler,&nbsp;Shimul Shah,&nbsp;Heidi Yeh","doi":"10.1111/ctr.70634","DOIUrl":"10.1111/ctr.70634","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The objective of this study is to evaluate the association between two imaging-derived measures—anteroposterior diameter (APD) and lateral abdominal wall–IVC distance (L-IVC)—and liver transplant (LT) waitlist outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective cohort study of 520 adult LT candidates listed at a single academic transplant center from January 1, 2015, to December 31, 2023. APD and L-IVC were measured using cross-sectional abdominal imaging and categorized into three groups using interquartile thresholds: APD (&lt;15.0 cm, 15.0–20.0 cm, &gt;20.0 cm) and L-IVC (&lt;10.0 cm, 10.0–12.5 cm, ≥12.5 cm). The primary outcome was time to LT; the competing outcome was waitlist removal due to death or clinical deterioration. Sub-distribution hazard ratios (SHRs) were estimated using competing risks regression. Harrell's C-statistic and bootstrap comparisons were used to evaluate discrimination versus height, BMI, and body surface area (BSA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 520 candidates (mean [SD] age, 55.7 [10.9] years; 37.5% women), small APD (SHR = 0.51; CI: 0.33–0.72; <i>p</i> = 0.02) and L-IVC (SHR = 0.39; CI: 0.21–0.62: <i>p</i> &lt; 0.001) were associated with lower transplant probability. Candidates with larger APD (&gt;20.0 cm) had the highest risk of waitlist removal (SHR = 1.47; CI:1.02–1.87; <i>p</i> = 0.04). L-IVC was most strongly associated with LT (C-statistic = 0.65) and waitlist removal (C-statistic = 0.67). In sex-stratified models, men with small APD or L-IVC had significantly lower transplant probability, while women with mid-range APD (15.0–20.0 cm) or L-IVC ≥ 12.5 cm had the highest transplant likelihood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Anatomical measurements derived from imaging are more strongly associated with liver transplant waitlist outcomes, outperforming height, BMI, and BSA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 8","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673200","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":"Comparing Early Graft Dysfunction Scores in Liver Transplantation After Ex-Situ Normothermic Machine Perfusion","authors":"Kejal Shah,&nbsp;Sydney Castellanos,&nbsp;April J. Logan,&nbsp;Leonid Gorelik,&nbsp;Annelise Nolan,&nbsp;Manoj Iyer,&nbsp;Lauren Von Stein,&nbsp;Wei Chen,&nbsp;Ayato Obana,&nbsp;Ashley Limkemann,&nbsp;Navdeep Singh,&nbsp;Sylvester Black,&nbsp;William K. Washburn,&nbsp;Austin D. Schenk,&nbsp;Musab Alebrahim,&nbsp;Sai Rithin Punjala","doi":"10.1111/ctr.70632","DOIUrl":"10.1111/ctr.70632","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>As normothermic machine perfusion (NMP) maintains liver grafts in a near-physiologic state, uncoupling ischemia–reperfusion injury from the recipient, the validity of early graft dysfunction scores from the static cold storage (SCS) era are uncertain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All liver grafts that were transplanted following NMP at our center between 08/19/2022 and 05/31/2024 were analyzed. We assessed associations between the early graft dysfunction scores and graft survival in the NMP era and identified factors linked to pronounced dysfunction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 126 NMP-perfused liver grafts, seven (5.5%) were discarded after viability assessment. Among the 107 transplanted livers (41%-DBD, 59%-DCD), neither the liver graft assessment following transplantation (L-GrAFT7) nor the model for early allograft function (MEAF) scores correlated with early graft loss. Early allograft dysfunction (EAD) occurred in 40% of cases and was associated with lower 6‑month graft survival compared with non-EAD cases (89% vs 100%, <i>p</i> = 0.04). Higher donor BMI, longer agonal and anastomosis times, post-reperfusion syndrome, and suboptimal pump parameters (impaired glucose metabolism, delayed lactate clearance, increased bicarbonate use, elevated perfusate transaminases) correlated with EAD. Grafts exceeding conventional viability thresholds (increased bicarbonate use to maintain pH &gt;7.2, lactate rise &gt;2 mmol/L within 6 h post-clearance, and perfusate ALT &gt;6000 U/L) were successfully utilized without compromising short-term outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In the NMP era, EAD identifies a high-risk subgroup with inferior short-term graft survival. Trajectory-based scores did not correlate with early graft loss. Pump variables may help guide decision-making when considering the use of liver grafts with an increased likelihood of EAD in select recipients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 8","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13439351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673051","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":"Bovine Pericardium Patch Application in Living Donor Kidney Transplantation With Multiple Renal Arteries: A Case Series.","authors":"Rockey Dahiya, Sydney Garner, Mariano Sorrentino, Justin Burns, Kristopher P Croome","doi":"10.1111/ctr.70658","DOIUrl":"https://doi.org/10.1111/ctr.70658","url":null,"abstract":"","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 8","pages":"e70658"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13484882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789088","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":"Effect of Pre-Transplant Sensitization on Kidney Allograft Survival Following Simultaneous Liver and Kidney Transplantation: A Decade of Experience from an Academic Transplant Center.","authors":"Andrew D Santeusanio, Fahima Mahir, Matias Facciuto, Ron Shapiro, Veronica Delaney, Thomas Schiano, Jang Moon, Sander Florman, Leona Kim-Schluger, Fasika Tedla, Arjun Bhansali","doi":"10.1111/ctr.70656","DOIUrl":"10.1111/ctr.70656","url":null,"abstract":"<p><strong>Background: </strong>There are conflicting data regarding the impact of pre-transplant sensitization on kidney allograft outcomes following simultaneous liver-kidney (SLK) transplantation.</p><p><strong>Methods: </strong>This was a single-center, retrospective study of adult SLK transplant recipients during the decade from 2010 to 2020. Patients were classified based on complement dependent cytotoxicity crossmatching (CDC-CXM) as well as the presence of donor specific antibodies (DSA) and followed until study conclusion on January 1, 2021. Cox-proportional hazards modeling was performed to identify clinical variables associated with combined patient and allograft survival as well as biopsy proven kidney rejection (BPAR).</p><p><strong>Results: </strong>A total of 90 patients were included in the study (16 positive CDC-CXM and 31 with DSA). Overall patient and allograft survival was 91.1% at 1-year and 68.9% at study conclusion after a median of 4.4 years, with corresponding death-censored kidney survival of 98.8% and 91.2%. In the multivariable analysis, a positive CDC-CXM (HR = 3.79; 95% CI 1.70-8.46) but not pre-formed DSA was associated with patient and graft loss. BPAR occurred in 12 patients (13.3%) and was higher among patients with DSA >5,000 (HR = 3.69; 95% CI 1.14-11.98), although this did not impact overall kidney survival. DSA cleared in 85% of patients following SLK transplant but persisted in three patients with DQ-specific antibodies.</p><p><strong>Conclusions: </strong>A positive CDC-CXM but not the presence of pre-formed DSA was associated with worse outcomes following SLK transplantation, with overall kidney survival primarily driven by death with a functioning allograft. DSA >5,000 MFI increased the risk for BPAR, and DSA to the class II DQ antigen were incompletely cleared following SLK transplant; however, overall kidney survival was not impacted.</p>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 8","pages":"e70656"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13500032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808253","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":"Re-Evaluating Donor-Recipient Risk Scores in the Machine Perfusion Era Using a Large Multicenter Cohort: Do Traditional Predictive Models Still Apply?","authors":"Mingyi Zhang, Michelle Nguyen, Shennen Mao, Ryan Chadha, C Burcin Taner, Amit K Mathur, Kristopher P Croome","doi":"10.1111/ctr.70645","DOIUrl":"10.1111/ctr.70645","url":null,"abstract":"<p><strong>Background: </strong>With increasing use of donation after circulatory death (DCD) donor grafts, the need for accurate risk-stratification tools in liver transplantation has become critical. Machine perfusion has been shown to improve both graft and patient survival. However, existing prediction models were developed in the static cold storage (SCS) era and their accuracy when using machine perfusion remains unknown. Our study aims to study if current scoring systems can predict graft and patient survival for DCD livers preserved using normothermic machine perfusion (NMP).</p><p><strong>Methods: </strong>This was a retrospective study of patient and graft survival in a two-center U.S. DCD NMP cohort (n = 532) between January 2022 and December 2024. Predicted graft and patient survival rates were obtained from established risk scoring systems, including the United Kingdom DCD risk score (UK-DCD), Early Allograft Dysfunction (EAD) Olthoff score, Liver Graft Assessment Following Transplantation (L-GrAFT₇) score, Donor Risk Index (DRI), Balance of Risk (BAR) score, and Survival Outcomes Following Liver Transplant (SOFT) score. Model discrimination was assessed using receiver operating characteristic (ROC) curves (C-statistics). Survival outcomes across risk strata were estimated and compared using Kaplan-Meier (KM) analysis.</p><p><strong>Results: </strong>Across scoring systems, predicted survival consistently underestimated actual graft and patient survival in the NMP DCD cohort. The DRI, SOFT, EAD and L-GrAFT₇ did not demonstrate predictive value. UK-DCD predicted ≤85% and <40% 1-year graft survival for its high-risk and \"futile\" groups, whereas observed rates were 93.7% and 86.8%. BAR low-risk predicted >60% 5-year survival but 94.2% was observed; the high-risk group predicted <60% and observed was 53.3%. Despite underestimations and generally poor C-statistics, in KM stratification, high-risk groups still showed statistical differences in the UK-DCD categories (p = 0.007), and in SOFT score groups (p < 0.001). No statistical difference was seen in BAR (p = 0.36), DRI (p = 0.36), EAD (p = 0.12), or L-GrAFT₇ (p = 0.75).</p><p><strong>Conclusion: </strong>Existing liver transplant risk scores show limited predictive value for donor-related risk factors in the NMP era, whereas recipient-related factors remain somewhat predictive, despite overestimating risk. Early allograft dysfunction metrics were not reliable predictors of short or long-term outcomes. Future risk models should integrate machine-perfusion parameters and refined donor variables to reflect outcomes more accurately in contemporary DCD liver transplantation.</p>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 8","pages":"e70645"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13494917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789154","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":"Cold Ischemia Time Is an Important Risk Factor for Prolonged Length of Stay Post-Lung Transplantation.","authors":"Elli Youngeun Lee, Michelle Miao, Adam Ard, John Miggins, Ashley Montgomery, Ramiro Fernandez, Abbas Rana","doi":"10.1111/ctr.70651","DOIUrl":"https://doi.org/10.1111/ctr.70651","url":null,"abstract":"<p><strong>Purpose: </strong>In lung transplantation (LTx), optimal cold ischemia time (CIT) is considered <6 h, but is often extended to maximize allograft utilization. Given the limited analysis of how variation in CIT impacts outcomes, we examined its correlation with graft survival, patient mortality, and prolonged length of stay (PLOS), defined as ≥30 days.</p><p><strong>Methods: </strong>Using the United Network for Organ Sharing database, we retrospectively analyzed 39 806 adult LTx between May 4, 2005, and December 1, 2025. Ex-vivo lung perfusion (EVLP) cases (n = 1378) were isolated for separate analysis. The remaining 39 161 were categorized into hourly CIT increments. We conducted univariate and multivariate analyses with three outcomes of interest: PLOS, graft survival, and patient mortality.</p><p><strong>Results: </strong>CIT correlated more strongly with PLOS than graft survival or patient mortality. CIT <5 h was protective against PLOS, while >6 h increased risk. A steady and significant increase in odds of PLOS with increasing CIT was observed, with risks lowest at 3-4 h (odds ratio [OR], 0.829; 95% confidence interval [CI], 0.755-0.911) and highest at 11-12 h (OR, 2.02; 95%CI, 1.61-2.54). Isolated EVLP analysis showed no such significant correlation.</p><p><strong>Conclusion: </strong>Nearly every hour increases in CIT showed a significant impact on odds of PLOS after LTx. Minimizing CIT is critical to reduce posttransplant PLOS and associated healthcare costs. Novel methods of preservation may be key to mitigate this risk.</p>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 8","pages":"e70651"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789159","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":"Evaluation of Global Immune Biomarkers to Predict Infections in Lung Transplant Recipients.","authors":"Quoc Nguyen, Michael J Lydeamore, Adina Dessauer, Gregory I Snell, Glen P Westall, Anton Y Peleg, Bradley J Gardiner","doi":"10.1111/ctr.70654","DOIUrl":"https://doi.org/10.1111/ctr.70654","url":null,"abstract":"<p><strong>Background: </strong>Immune biomarkers could assess levels of immunosuppression and predict infections in transplant recipients. We aimed to evaluate the absolute lymphocyte count (ALC), absolute neutrophil count (ANC), Quantiferon-Monitor and the mitogen component of the Quantiferon-CMV assay alone and combined to predict serious opportunistic infections (SOI) in lung transplant recipients.</p><p><strong>Methods: </strong>Patients were prospectively recruited from 2015-17, with blood collected at 3, 6 and 12 months post-transplant. Infections were classified as SOI if requiring hospitalization and caused by an opportunistic pathogen. Logistic regression was used to calculate odds ratios (OR).</p><p><strong>Results: </strong>Within 18 months post-transplant, 35/80 patients experienced 46 SOI's. Low ALCs were associated with SOI between 3-6 (median 1.4 vs. 1.0×1000 cells/µL, OR 5.38 per unit decrease, 95% CI 1.38-21.02, p = 0.02) and 6-12 (1.3 vs. 0.8×1000 cells/µL, OR 3.48, 95% CI 1.20-10.1, p = 0.02) months. Mitogen values were significantly lower with SOI between 3-6 months (5.8 vs. 0.3 IU/mL, OR 0.78, 95% CI 0.63-0.97, p = 0.02). Area under the ROC curve for all biomarkers combined were modestly higher compared to ALC alone. Negative predictive values were high.</p><p><strong>Conclusions: </strong>Immune biomarkers have the potential to measure net immunosuppression and identify transplant recipients at higher risk for SOI. ALC was the most useful single test although incorporating 3 other biomarkers modestly improved predictions. Negative predictive values were high indicating that patients with high ALC values were unlikely to experience SOI. While this approach could inform decision-making regarding immunosuppression dosing, intensity of monitoring and antimicrobial prophylaxis, further research is required before clinical implementation.</p>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 8","pages":"e70654"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789137","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":"Predicting Acute Kidney Injury After Lung Transplantation: Development and Internal Validation of Perioperative Prediction Models.","authors":"Shogo Trevena, Gregory I Snell, Glen P Westall, Mohammad Asghari-Jafarabadi, Mark A Shulman, Tim G Coulson","doi":"10.1111/ctr.70649","DOIUrl":"https://doi.org/10.1111/ctr.70649","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is common following lung transplantation (LTx), and is associated with increased morbidity and mortality. Existing renal injury risk models have not systematically evaluated perioperative variables. We aimed to develop comprehensive preoperative and early postoperative prediction models for AKI and renal replacement therapy (RRT) following LTx.</p><p><strong>Methods: </strong>Adult LTx recipients at a single Australian tertiary center (January 2016-April 2025) were included in a retrospective cohort study. The KDIGO 2012 serum creatinine criteria were used to define AKI. Stable predictors identified via penalized regression with bootstrap resampling were incorporated into multivariable logistic regression models. Bootstrap internal validation provided optimism-adjusted performance estimates, and decision curve analysis evaluated net clinical benefit.</p><p><strong>Results: </strong>Of 534 patients, 216 (40.4%) developed AKI, and 47 (8.8%) required RRT. The preoperative AKI model, incorporating baseline demographics, comorbidities, and laboratory variables, achieved a C-statistic of 0.632 (95%CI: 0.589-0.679). The postoperative AKI model demonstrated improved discrimination (C-statistic 0.741, 95%CI: 0.697-0.795), incorporating preoperative variables such as chronic lung allograft dysfunction as a transplant indication, alongside procedure duration and novel early postoperative predictors: P/F ratio and cumulative noradrenaline dosage. The RRT models achieved C-statistics of 0.720 (95%CI: 0.643-0.796) and 0.847 (95%CI: 0.781-0.917). Calibration slopes ranged from 0.889-0.949. Decision curve analysis demonstrated net clinical benefit over treat-all strategies across clinically relevant threshold probabilities.</p><p><strong>Conclusions: </strong>Early postoperative models demonstrated superior discrimination and clinical utility, with timepoint-specific risk stratification capturing distinct perioperative determinants of renal injury. These models provide a foundation for external validation and targeted nephroprotective research in LTx.</p>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 8","pages":"e70649"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13484881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789166","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":"Is NRP Enough? Absence of Biliary Complications Following Normothermic Regional Perfusion Followed by Normothermic Machine Perfusion in DCD Liver Transplantation.","authors":"Sara Shahrestani, M Zeeshan Akhtar, Jang Moon, Antonios Arvelakis, Joseph DiNorcia, Marcelo E Facciuto, Parissa Tabrizian, Thomas D Schiano, Leona Kim-Schluger, Sander S Florman, Chiara Rocha","doi":"10.1111/ctr.70648","DOIUrl":"https://doi.org/10.1111/ctr.70648","url":null,"abstract":"","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 8","pages":"e70648"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764053","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":"Lung Transplant Patient Knowledge of Gastroesophageal Reflux Disease and Foregut Risk Factors Associated With Graft Rejection.","authors":"Annie L Wang, Jacob A Klapper, John M Reynolds, Lauren Rich, Sandra L Gerity, David A Leiman","doi":"10.1111/ctr.70650","DOIUrl":"https://doi.org/10.1111/ctr.70650","url":null,"abstract":"<p><strong>Introduction: </strong>Dysphagia, gastroesophageal reflux disease (GERD), and delayed gastric emptying (DGE) are foregut risk factors associated with worse lung transplant outcomes. Transplant education varies across centers, and patient awareness of these risk factors could impact treatment adherence and outcomes.</p><p><strong>Methods: </strong>Pre- and post-lung transplant patients attending pulmonary rehabilitation between 01/2025-06/2025 were invited to complete a questionnaire developed by a multidisciplinary team to assess knowledge, perceived importance, and self-confidence in understanding the evaluation and management of foregut risks. Knowledge and confidence of disease factors were evaluated and assessed. Patient demographics, transplant history, and education preferences were collected. Comparisons were made between pre- and post-transplant groups using Chi-square tests for categorical measures.</p><p><strong>Results: </strong>Among 67 eligible patients, 48 (71.6%) completed the survey. There were no significant differences in age, sex, race, education level, or household income between pre- and post-transplant groups. Recognition of GERD as a risk factor for graft rejection was similar between pre- and post-transplant groups (24, 85.7% vs. 19, 95.0%; p = 0.30), as was overall confidence in understanding DGE as a risk factor (19, 67.9% vs. 13, 65.0%; p = 0.84). Respondents preferred to receive information on risks from the lung transplant team, but most (n = 28, 58.3%) patients indicated gastroenterologists should be most responsible for educating about and managing foregut risks.</p><p><strong>Conclusion: </strong>Knowledge of foregut risks and corresponding confidence is high before and after transplant, which may reflect standardized education. Most patients preferred gastroenterology engagement in education on foregut disease, which is currently underutilized and could be an opportunity for multidisciplinary care.</p>","PeriodicalId":10467,"journal":{"name":"Clinical Transplantation","volume":"40 8","pages":"e70650"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789175","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}