American Journal of Transplantation最新文献

{"title":"IMPACT OF REPEAT HLA MISMATCHES ON KIDNEY GRAFT SURVIVAL: A CONTEMPORARY COLLABORATIVE TRANSPLANT STUDY (CTS) ANALYSIS.","authors":"Lissa Pipeleers, Christian Unterrainer, Marie-Paule Emonds, Karl Martin Wissing, Thuong Hien Tran","doi":"10.1016/j.ajt.2024.12.014","DOIUrl":"https://doi.org/10.1016/j.ajt.2024.12.014","url":null,"abstract":"<p><p>Repeat HLA mismatches (RMM) have been historically associated with an increased risk of graft loss after repeat kidney transplantation, in particular HLA-DR RMM in sensitized recipients. As routine use of sensitive assays can at present prevent the transplantation of RMM in hosts with donor-specific antibodies, we hypothesized that RMM would no longer be associated with graft loss. We performed a registry analysis of the Collaborative Transplant Study database including 6711 patients who received a second kidney transplant (2^nd KT) between 2010 and 2021, with at least one HLA-A, -B or -DR mismatch. No increased risk for graft loss was observed for 2^nd KT with a Class I RMM, regardless of sensitization status. For 2^nd KT with a HLA-DR RMM, the hazard ratio for graft loss in the first year after transplantation was 1.61 (95% CI 1.16 - 2.23; P=0.004) compared to recipients without a RMM, and increased to 2.21 (95% CI 1.24 - 3.63: P=0.002) in sensitized recipients (latest CDC-PRA>0%). Our observations suggest that Class I RMM do not need to be systematically avoided. In contrast, HLA-DR RMM still had a negative impact on graft survival in this contemporary cohort, despite the widespread availability of Luminex.</p>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142880827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tenofovir-associated Fanconi Syndrome in liver transplant recipients with hepatitis B: A retrospective case series.","authors":"Erica Loon, Nicholas Lim, Giovanni A Roldan, John Lake","doi":"10.1016/j.ajt.2024.12.015","DOIUrl":"https://doi.org/10.1016/j.ajt.2024.12.015","url":null,"abstract":"<p><p>Tenofovir-associated Fanconi Syndrome (TAFS) is a proximal renal tubule disorder rarely reported in patients after liver transplantation (LT) for hepatitis B (HBV). In a retrospective review of 79 HBV-LT recipients, 8/66 (12.1%) on tenofovir post-LT developed TAFS. Primary laboratory findings were hypophosphatemia (100%) and proteinuria (87.5%). No patients required renal replacement therapy or died from TAFS. The majority (85.7%) of surviving patients achieved tubular recovery after stopping tenofovir (mean 13 weeks). In conclusion, TAFS is likely underdiagnosed in LT recipients. Regular screening for hypophosphatemia, proteinuria, and glucosuria is recommended for HBV-LT recipients on tenofovir, as most responded well to discontinuation.</p>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142880849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Adjustment of Organ Donor Referrals is Insufficient to Determine Donor Potential and OPO Approach Rates.","authors":"Thomas Mone, J Thomas Rosenthal","doi":"10.1016/j.ajt.2024.12.012","DOIUrl":"https://doi.org/10.1016/j.ajt.2024.12.012","url":null,"abstract":"","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142880844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Macrophage-specific hypoxia inducible factor 2α expression promotes cardiac allograft tolerance.","authors":"Matthew P Arvedson, James M Gardner","doi":"10.1016/j.ajt.2024.12.010","DOIUrl":"https://doi.org/10.1016/j.ajt.2024.12.010","url":null,"abstract":"","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142880833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The concept of immunothrombosis in pancreas transplantation.","authors":"Christophe Masset, Nicolas Drillaud, Catherine Ternisien, Nicolas Degauque, Nathalie Gerard, Sarah Bruneau, Julien Branchereau, Gilles Blancho, Benoit Mesnard, Sophie Brouard, Magali Giral, Diego Cantarovich, Jacques Dantal","doi":"10.1016/j.ajt.2024.11.025","DOIUrl":"https://doi.org/10.1016/j.ajt.2024.11.025","url":null,"abstract":"<p><p>Early failure of a pancreatic allograft due to complete thrombosis has an incidence of approximately 10% and is the main cause of comorbidity in pancreas transplantation. Although several risk factors have been identified, the exact mechanisms leading to this serious complication are still unclear. In this review, we define the roles of the individual components involved during sterile immunothrombosis-namely endothelial cells, platelets, and innate immune cells. Further, we review the published evidence linking the main risk factors for pancreatic thrombosis to cellular activation and vascular modifications. We also explore the unique features of the pancreas itself: the vessel endothelium, specific vascularization, and relationship to other organs-notably the spleen and adipose tissue. Finally, we summarize the therapeutic possibilities for the prevention of pancreatic thrombosis depending on the different mechanisms such as anticoagulation, anti-inflammatory molecules, endothelium protectors, antagonism of DAMPs, and use of machine perfusion.</p>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142870601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of hepatitis A immunisation after paediatric liver transplantation: A retrospective observational analysis.","authors":"Tobias Laue, Norman Junge, Christoph Leiskau, Frauke Mutschler, Johanna Ohlendorf, Ulrich Baumann","doi":"10.1016/j.ajt.2024.12.009","DOIUrl":"https://doi.org/10.1016/j.ajt.2024.12.009","url":null,"abstract":"<p><p>This retrospective study aimed to investigate the response to hepatitis A virus (HAV) immunisation following liver transplantation. We analysed, 234 vaccination records of 284 children who underwent liver transplantation between January 2003 and July 2021, including annual serological results. Of the 120 HAV-naïve patients, approximately 71% and 83% showed seroconversion after receiving one and two vaccine doses, respectively. The third dose increased the seroconversion rate to 93%. In multivariable logistic regression analysis, the number of vaccine doses and age at first vaccine dose were independently associated with seroconversion. In contrast, additional immunosuppression with mycophenolate mofetil (MMF) was negatively associated with seroconversion. In Cox regression analysis of all 96 seroconverted children, younger age at first vaccination and additional immunosuppression with either MMF or prednisolone were identified as independent risk factors for the early loss of HAV immunity. In summary, HAV immunisation with the three-dose vaccination series is recommended for paediatric liver transplant recipients. Antibody testing and booster vaccinations, if necessary, are recommended, especially for those living in endemic areas or with additional immunosuppressive treatments.</p>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142870597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomized trial investigating the utility of a liver tissue transcriptional biomarker in identifying adult liver transplant recipients not requiring maintenance immunosuppression.","authors":"Julien Vionnet, Jorge Torres-Yaguana, Rosa Miquel, Juan G Abraldes, Jurate Wall, Elisavet Kodela, Juan-Jose Lozano, Pablo Ruiz, Miguel Navasa, Aileen Marshall, Frederik Nevens, Will Gelson, Joanna Leithead, Steven Masson, Elmar Jaeckel, Richard Taubert, Phaedra Tachtatzis, Dennis Eurich, Kenneth J Simpson, Eliano Bonaccorsi-Riani, James Ferguson, Alberto Quaglia, Anthony J Demetris, Andrew J Lesniak, Maria Elstad, Marc Delord, Abdel Douiri, Irene Rebollo-Mesa, Marc Martinez-Llordella, Juliete A F Silva, James F Markmann, Alberto Sánchez-Fueyo","doi":"10.1016/j.ajt.2024.12.002","DOIUrl":"https://doi.org/10.1016/j.ajt.2024.12.002","url":null,"abstract":"<p><p>The maintenance of stable allograft status in the absence of immunosuppression, known as operational tolerance, can be achieved in a small proportion of liver transplant recipients, but we lack reliable tools to predict its spontaneous development. We conducted a prospective, multi-center, biomarker-strategy design, immunosuppression withdrawal clinical trial to determine the utility of a predictive biomarker of operational tolerance. The biomarker test, originally identified in a patient cohort with high operational tolerance prevalence, consisted of a 5-gene transcriptional signature measured in liver tissue collected before initiating immunosuppression weaning. 116 adult stable liver transplant recipients were randomized 1:1 to either Arm A (immunosuppression withdrawal regardless of biomarker status) or Arm B (immunosuppression withdrawal in biomarker-positive recipients). Immunosuppression withdrawal was initiated in 82 participants, rejection occurred in 54 (67.5%), successful discontinuation of immunosuppression was achieved in 22 (27.5%), but only 13 (16.3%) met operational tolerance histological criteria (10 in Arm A, 3 in Arm B). The biomarker test did not yield useful information in selecting patients able to successfully discontinue immunosuppression. Operational tolerance was associated with time post-transplantation, recipient age, presence of circulating exhausted CD8⁺ T cells, and a reduced number of immune synapses within the graft. TRIAL REGISTRATION: ISRCTN 47808000 and EudraCT 2014-004557-14.</p>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142870599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ATP-mediated signaling of P2X7 receptors controls donor extracellular vesicle release and MHC cross-decoration after allotransplantation.","authors":"Bruno Gonzalez-Nolasco, Hyshem H Lancia, Natacha Carnel-Amar, Xianding Wang, Aurore Prunevieille, Loïc Van Dieren, Alexandre G Lellouch, Curtis L Cetrulo, Gilles Benichou","doi":"10.1016/j.ajt.2024.12.008","DOIUrl":"https://doi.org/10.1016/j.ajt.2024.12.008","url":null,"abstract":"<p><p>After skin allotransplantation, intercellular transfer of donor MHC molecules mediated primarily by extracellular vesicles (EVs) released by the allograft is known to contribute to semi-direct and indirect activation of alloreactive T cells involved in graft rejection. At the same time, there is ample evidence showing that initiation of adaptive alloimmunity depends on early innate inflammation caused by tissue injury and subsequent activation of myeloid cells (macrophages and dendritic cells) recognizing danger associated molecular patterns (DAMPs). Among these DAMPs, extracellular ATP plays a key role in innate inflammation through binding to P2X7 receptors. Indeed, this process leads to the activation of the NLRP3 inflammasome and subsequent production and release of inflammatory cytokines and EVs. This prompted us to evaluate the influence of innate inflammation triggered by ATP-mediated signaling of P2X7 receptors on EV release by donor cells after skin transplantation in mice. In this article, we show that inhibition of P2X7R signaling suppresses both EV release and MHC cross-decoration of leukocytes and prolongs skin allograft survival in mice. This study reveals a novel aspect of the role of innate immunity in allotransplantation.</p>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142851591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transfusion specific alloimmune responses following blood transfusion pre-kidney transplantation.","authors":"Katrina J Spensley, Sevda Hassan, David J Roberts, Malgorzata Przybysiak, Fiona Regan, Colin Brown, Michelle Willicombe","doi":"10.1016/j.ajt.2024.12.006","DOIUrl":"https://doi.org/10.1016/j.ajt.2024.12.006","url":null,"abstract":"<p><p>It is widely accepted that blood transfusions can cause allosensitisation, but it is often reported that new HLA antibodies are non-specific and transient. This study explores the effect of blood transfusion on allosensitisation in waitlisted transplant patients including the development of transfusion specific antibodies (TSAs), whilst they remain on the waiting list and longitudinally following subsequent transplantation. A total of 105 blood donors of transfusions received by 50 patients on the transplant waiting list were HLA typed. De novo HLA antibodies developed in 62% of patients following transfusion, with 34% of patients having at least one TSA. TSAs developed in 23% of patients with no circulating HLA antibodies at the time of transfusion and in 50% of patients with circulating HLA antibodies. This was associated with an average increase in calculated reaction frequency of 16.4%. Of the 34 patients who were transplanted the majority received a kidney with at least 1 shared HLA specificity with a transfusion donor. After transplantation 14.7% had a newly detected TSA within 3 months. These patients had higher rates of rejection, specifically antibody mediated rejection, at 3 years. The use of HLA-selected blood for waitlisted patients, where transfusion is unavoidable, could therefore improve transplant outcomes.</p>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating the efficacy of felzartamab to treat antibody-mediated rejection using the iBox prognostication system.","authors":"Yannis Lombardi, Marc Raynaud, Martina Schatzl, Katharina A Mayer, Matthias Diebold, Uptal D Patel, Eva Schrezenmeier, Aylin Akifova, Klemens Budde, Alexandre Loupy, Georg A Böhmig","doi":"10.1016/j.ajt.2024.12.004","DOIUrl":"https://doi.org/10.1016/j.ajt.2024.12.004","url":null,"abstract":"","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}