Current Opinion in Organ Transplantation最新文献_第4页

Evaluation of nephrolithiasis and its risk factors in living kidney donor candidates. 活体肾供体候选人肾结石及其危险因素的评估。

IF 2.5 4区医学

Current Opinion in Organ Transplantation Pub Date : 2026-06-01 Epub Date: 2026-03-17 DOI: 10.1097/MOT.0000000000001280

Stuart M Flechner

{"title":"Evaluation of nephrolithiasis and its risk factors in living kidney donor candidates.","authors":"Stuart M Flechner","doi":"10.1097/MOT.0000000000001280","DOIUrl":"10.1097/MOT.0000000000001280","url":null,"abstract":"Purpose of review: Living kidney donation is the preferred choice for renal transplantation due to superior short-tem and long-term recipient, patient, and graft survival. However, living donor safety is essential, and in-depth donor evaluation is required to minimize donor risk. Kidney stone disease is prevalent in the general population, and many kidney donor candidates have had recent or remote stone events. This review will explore the prevalence, causes, and required steps in donor evaluation for stones to maintain donor safety.Recent findings: In the United States, the prevalence of kidney stones is about 10% but reported to be about 2-8% among kidney donor candidates. These include asymptomatic, symptomatic, and incidental stones found on CT imaging, which can now detect small calcifications of 1-2 mm or less. These images may also over represent punctate calcifications, which are Randall's plaques in the renal papillae that do not represent active stone disease.Summary: Current data support donation when the donor does not have metabolic risk factors for stones and the retained kidney is stone free. Using the above guidelines, recurrent stone disease in donors or stone-related complications in recipients are uncommon, limited to a few percentage of patients.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":"117-122"},"PeriodicalIF":2.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147473002","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}

引用次数: 0

Psychosocial challenges faced by children who had a solid organ transplant: adherence, transition, and posttraumatic stress. 接受实体器官移植的儿童所面临的社会心理挑战：坚持、过渡和创伤后应激。

IF 2.5 4区医学

Current Opinion in Organ Transplantation Pub Date : 2026-06-01 Epub Date: 2026-03-30 DOI: 10.1097/MOT.0000000000001284

Mikela A Murphy, Eyal Shemesh

{"title":"Psychosocial challenges faced by children who had a solid organ transplant: adherence, transition, and posttraumatic stress.","authors":"Mikela A Murphy, Eyal Shemesh","doi":"10.1097/MOT.0000000000001284","DOIUrl":"10.1097/MOT.0000000000001284","url":null,"abstract":"Purpose of review: Behavioral and mental health challenges are important to understand in order to ensure that patients receive the anticipated benefits from organ transplantation. The present review centers on what we believe are the most important (and best researched) actionable challenges that may inform the care of transplant recipients - adherence to medical recommendations, transitions of care, and posttraumatic stress following transplantation.Recent findings: Recent research has moved from identifying (and quantifying) the problem and is now trying to investigate how to best recognize - and address - behavioral and mental health challenges in this population.Summary: While much remains unknown, it is increasingly becoming clear that early recognition is best done by increasing awareness amongst transplant team members, and objective surveillance methods. Subjective patient and parent reports should be considered if other methods are not available. It is becoming increasingly clear that psychosocial interventions are feasible and potentially effective. Transplant programs should try to be aware of such interventions, implement them when feasible, and create referral pathways that can be used when needed.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":"182-187"},"PeriodicalIF":2.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13310170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572664","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}

引用次数: 0

Managing the highly sensitized kidney transplant patient. 处理高度敏感的肾移植病人。

IF 2.5 4区医学

Current Opinion in Organ Transplantation Pub Date : 2026-04-01 Epub Date: 2026-01-29 DOI: 10.1097/MOT.0000000000001267

Kyle R Jackson, Ronald F Parsons

{"title":"Managing the highly sensitized kidney transplant patient.","authors":"Kyle R Jackson, Ronald F Parsons","doi":"10.1097/MOT.0000000000001267","DOIUrl":"10.1097/MOT.0000000000001267","url":null,"abstract":"Purpose of review: Highly sensitized kidney transplant candidates, particularly those with calculated panel reactive antibody (CPRA) ≥99.9%, face significant immunologic barriers to transplantation. This review highlights recent clinical strategies that have improved transplant access and outcomes in this population, with a focus on allocation policy, kidney-paired donation, and desensitization.Recent findings: Updates from national allocation systems and kidney-paired donation programs have demonstrated substantial gains in transplant access for many highly sensitized candidates. However, those with CPRA at least 99.9% remain difficult to match. Novel desensitization approaches, such as imlifidase, proteasome inhibitors, anti-CD38 mAbs, and early-phase CAR T-cell therapies have shown promise in selected patients. Increasingly, immunologic phenotyping or gene expression profiling may help tailor desensitization strategies to individual recipients.Summary: Most highly sensitized candidates now achieve transplant through allocation policy or paired donation. For those with CPRA at least 99.9%, desensitization will likely remain an important tool to facilitate transplantation. Emerging therapies and immunologic profiling may help individualize treatment and expand transplant access for this challenging group.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":"93-97"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146104146","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}

引用次数: 0

Evidence-based prehabilitation and rehabilitation in solid organ transplantation: current insights and clinical research priorities. 实体器官移植的循证康复：当前的见解和临床研究重点。

IF 2.5 4区医学

Current Opinion in Organ Transplantation Pub Date : 2026-04-01 Epub Date: 2026-01-28 DOI: 10.1097/MOT.0000000000001268

Juliet Briggs, Siobhán Freeman, Sharlene Greenwood

{"title":"Evidence-based prehabilitation and rehabilitation in solid organ transplantation: current insights and clinical research priorities.","authors":"Juliet Briggs, Siobhán Freeman, Sharlene Greenwood","doi":"10.1097/MOT.0000000000001268","DOIUrl":"10.1097/MOT.0000000000001268","url":null,"abstract":"Purpose of review: Rehabilitation before (prehabilitation) and after solid organ transplantation is gaining increasing interest as an important aspect of holistic treatment. Despite guidelines recommending clinical implementation, there are very few established prehabilitation or rehabilitation programmes routinely delivered within transplant centres. This review provides insight into the current landscape within this area.Recent findings: Prehabilitation and rehabilitation has demonstrated potential to improve clinical outcomes for individuals preparing and living with solid organ transplantation, particularly with regards to aerobic capacity, muscle strength and quality of life. These programmes can address important components of pre/posttransplant clinical outcomes, particularly frailty, length of hospital stay, cardiovascular risk and metabolic health. Research has to date been limited by small sample sizes and heterogeneous interventions. Further high-quality research is needed alongside clinical implementation.Summary: Research to date has demonstrated the potential of prehabilitation and rehabilitation across the solid organ transplantation pathway to improve clinical outcomes, as well as to support individuals to live well. Further research with large randomised controlled trials is warranted, with the aim to support the implementation of pre/rehabilitation as part of routine care in multiprofessional clinics.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":"31 2","pages":"67-74"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147354128","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}

引用次数: 0

Management of the kidney transplant candidate with obesity. 伴有肥胖的肾移植候选者的处理。

IF 2.5 4区医学

Current Opinion in Organ Transplantation Pub Date : 2026-04-01 Epub Date: 2026-01-28 DOI: 10.1097/MOT.0000000000001266

Ali B Abbasi, Babak J Orandi

{"title":"Management of the kidney transplant candidate with obesity.","authors":"Ali B Abbasi, Babak J Orandi","doi":"10.1097/MOT.0000000000001266","DOIUrl":"10.1097/MOT.0000000000001266","url":null,"abstract":"Purpose of review: Nearly half of all patients listed for kidney transplant now have obesity, which is associated with increased rates of perioperative complications and graft loss. Here, we provide an update on the management of obesity in patients with end-stage kidney disease (ESKD).Recent findings: Lifestyle interventions are the backbone of obesity therapy but may be challenging to implement in transplant candidates due to dietary and activity limitations associated with ESKD and hemodialysis. Antiobesity medications (AOMs) acting on the glucagon-like peptide-1 receptor can result in weight loss up to 22% of total body weight, but evidence in ESKD is limited and their long-term use is limited by a high burden of gastrointestinal side effects and inconsistent insurance coverage. In terms of metabolic and bariatric surgery (MBS), the procedure of choice in transplant candidates is sleeve gastrectomy, which can result in weight loss up to 23% at 1 year and is associated with a lower risk of malabsorption and late complications, and possibly improved mortality compared to Roux-en-Y gastric bypass.Summary: Lifestyle interventions, AOMs, and MBS are important options for transplant candidates with obesity, but more evidence is needed to define optimal treatment pathways involving AOMs and MBS in this population.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":"31 2","pages":"98-104"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147354105","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}

引用次数: 0

Normothermic machine perfusion applications in kidney transplantation. 常温灌注机在肾移植中的应用。

IF 2.5 4区医学

Current Opinion in Organ Transplantation Pub Date : 2026-04-01 Epub Date: 2026-02-09 DOI: 10.1097/MOT.0000000000001275

Matthew L Holzner, Chris Jaynes, Jacqueline Garonzik-Wang

{"title":"Normothermic machine perfusion applications in kidney transplantation.","authors":"Matthew L Holzner, Chris Jaynes, Jacqueline Garonzik-Wang","doi":"10.1097/MOT.0000000000001275","DOIUrl":"10.1097/MOT.0000000000001275","url":null,"abstract":"Purpose of review: Normothermic machine perfusion (NMP) has emerged as technology for organ preservation and assessment. While NMP has been widely adopted for liver, lung, and heart transplantation, kidney NMP has faced slower clinical integration. Normothermic perfusion may potentially improve kidney transplant through improved preservation, graft viability assessment, mitigation of ischemia reperfusion injury, and treatment prior to transplant. The purpose of this review is to highlight the applications of NMP in kidney transplantation.Recent findings: Kidney NMP has been proven well tolerated and feasible in multiple studies. Two recent randomized controlled trials did not demonstrate a benefit of NMP compared to cold storage. The use of NMP may increase utilization through improved logistics. Graft assessment during perfusion may allow for well tolerated transplantation of marginal kidneys. Successful long-term perfusion up to 4 days of discarded kidneys has been performed. Gene therapies and treatments, including immune modification, have been carried out during kidney NMP.Summary: Normothermic perfusion has several applications to kidney transplantation including preservation, assessment, and treatment. Perfusion protocols viability criteria need to be defined. A portable, commercially available device is needed to increase clinical use. Further studies are needed to compare NMP to current preservation methods.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":"86-92"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149142","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}

引用次数: 0

Better in, better out: advancing transplant care through prehabilitation and rehabilitation: towards a multimodal continuum of care before and after solid organ transplantation. 进得更好，出得更好：通过预适应和康复推进移植护理：实现实体器官移植前后的多模式连续护理。

IF 2.5 4区医学

Current Opinion in Organ Transplantation Pub Date : 2026-04-01 Epub Date: 2026-02-18 DOI: 10.1097/MOT.0000000000001271

Hanne Van Criekinge, Sofie Leunis, Robert A Pol, Diethard Monbaliu

{"title":"Better in, better out: advancing transplant care through prehabilitation and rehabilitation: towards a multimodal continuum of care before and after solid organ transplantation.","authors":"Hanne Van Criekinge, Sofie Leunis, Robert A Pol, Diethard Monbaliu","doi":"10.1097/MOT.0000000000001271","DOIUrl":"10.1097/MOT.0000000000001271","url":null,"abstract":"Purpose of review: Solid organ transplantation is life-saving but imposes substantial physical and psychological demands across the pre, peri-, and posttransplant trajectory. Emerging evidence highlights the potential of prehabilitation and rehabilitation to enhance resilience before surgery, support recovery afterward, and reduce surgical and medical complications, ultimately improving long-term health after transplantation. Despite growing evidence of their benefits, these strategies remain underutilized in transplant care. This review aims to introduce multimodal continuum of care that integrates prehabilitation and rehabilitation into a unified pathway before and after transplantation to optimize outcomes in solid organ transplantation.Recent findings: Multimodal programs combining exercise, nutrition, and psychosocial support have demonstrated reductions in complications, shorter hospital stays, and improved survival and quality of life in surgical populations, with emerging evidence in transplantation. Consensus statements advocate individualized, adaptive interventions across the transplant continuum, delivered by interdisciplinary teams. Leveraging the same multidisciplinary team before and after transplantation fosters consistency, efficiency, and patient engagement-critical for adherence and empowerment.Summary: Although high-quality transplant-specific evidence remains limited, targeted, multimodal prehabilitation and rehabilitation represent promising strategies to enhance functional capacity and long-term health. We therefore propose \"better in, better out\" as a guiding principle for transplant care, calling for its adoption as a new standard supported by emerging evidence across kidney, liver, lung, and heart transplantation.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":"53-59"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257417","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}

引用次数: 0

Editorial introduction. 编辑介绍。

IF 2.5 4区医学

Current Opinion in Organ Transplantation Pub Date : 2026-04-01 Epub Date: 2026-03-05 DOI: 10.1097/MOT.0000000000001273

引用次数: 0

Mens sana in corpore non semper sanum: nurturing mind-body harmony in transplant prehabilitationand rehabilitation. 在移植前康复中培养身心和谐。

IF 2.5 4区医学

Current Opinion in Organ Transplantation Pub Date : 2026-04-01 Epub Date: 2026-02-18 DOI: 10.1097/MOT.0000000000001274

Tania Rogach, Jana Woleská, Chiara Cavalli, Coby Annema

{"title":"Mens sana in corpore non semper sanum: nurturing mind-body harmony in transplant prehabilitationand rehabilitation.","authors":"Tania Rogach, Jana Woleská, Chiara Cavalli, Coby Annema","doi":"10.1097/MOT.0000000000001274","DOIUrl":"10.1097/MOT.0000000000001274","url":null,"abstract":"Purpose of review: To review and summarize the literature published between May 2024 and November 2025 on the role of mental health professionals in the multidisciplinary transplant team and interventions to improve psychological health.Recent findings: The literature increasingly emphasizes integrating psychological expertise into multidisciplinary transplant teams; however, the practical implementation and standardization of this approach remain inconsistent. Despite clear evidence linking mental health to adherence, recovery, and long-term outcomes, structured psychosocial screening and follow-up are still not routine in many centers. The field is shifting toward proactive, prevention-oriented models, including telepsychology and caregiver involvement, reflecting a broader understanding of transplantation as a biopsychosocial process. Future research should focus on unified protocols and equity-based frameworks that ensure fair access and continuity of psychological care for all transplant candidates and recipients.Summary: Although mental health is recognized as an integral component of multidisciplinary transplantation programs, research on its systematic implementation and the effectiveness of mental health interventions within multidisciplinary teams remains limited. Consequently, many transplant candidates and recipients continue to have unmet psychological needs. Integrating psychological expertise into transplant medicine strengthens patient-centered care and improves long-term outcomes.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":"60-66"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257461","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}

引用次数: 0

Xenotransplantation and the organ shortage: evaluating policy priorities. 异种移植和器官短缺：评估政策重点。

IF 2.5 4区医学

Current Opinion in Organ Transplantation Pub Date : 2026-04-01 Epub Date: 2026-02-03 DOI: 10.1097/MOT.0000000000001270

Jessica S Kopew, Jarrod Bailey, Catharine E Krebs

{"title":"Xenotransplantation and the organ shortage: evaluating policy priorities.","authors":"Jessica S Kopew, Jarrod Bailey, Catharine E Krebs","doi":"10.1097/MOT.0000000000001270","DOIUrl":"10.1097/MOT.0000000000001270","url":null,"abstract":"Purpose of review: Xenotransplantation has emerged as a popular potential solution for increasing organ supply, but it comes with formidable public health risks and ethical harms. The purpose of this review is to evaluate xenotransplantation and other strategies for addressing the organ shortage, pointing toward the most promising policy priorities.Recent findings: Advances in genetic engineering, paired with increasing financial support, have positioned xenotransplantation in its first ever clinical trials. Rejection remains a formidable challenge, and caution prevails as the full breadth of zoonotic infectious potential remains to be determined. Meanwhile, strategies have been implemented around the world to bolster allotransplant organ supply and practices and to better treat chronic diseases to reduce demand for organs.Summary: With more support and broader global adoption, these alternative strategies can address the organ shortage more effectively, safely, and ethically than xenotransplantation and should be prioritized by policymakers.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":"31 2","pages":"105-109"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147354130","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}

引用次数: 0