American Journal of Transplantation最新文献

Real-world registry evidence beware: Old-world risk analysis may not be applicable to new-world belatacept utilization. 真实世界的注册证据注意：旧世界的风险分析可能不适用于新世界的延迟接受利用。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-04-19 DOI: 10.1016/j.ajt.2025.04.010

I Raul Badell

引用次数: 0

Developing machine learning-driven multidisease diagnostic platforms using immune repertoire sequencing. 利用免疫复合物测序技术开发机器学习驱动的多疾病诊断平台。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-04-18 DOI: 10.1016/j.ajt.2025.04.014

Simon N Chu,Joe Germino,James M Gardner

引用次数: 0

Revisiting racial/ethnic disparities in the deceased organ donor referral process. 重新审视已故器官捐献者转介过程中的种族/民族差异。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-04-18 DOI: 10.1016/j.ajt.2025.04.013

Macey L Levan,Kelly Terlizzi,Matilin Rigsby,Samantha Klitenic,Jonathan Hewlett,Bradley L Adams,Jade Barnes,Geoffrey Funk,Dorry L Segev,Allan B Massie

{"title":"Revisiting racial/ethnic disparities in the deceased organ donor referral process.","authors":"Macey L Levan,Kelly Terlizzi,Matilin Rigsby,Samantha Klitenic,Jonathan Hewlett,Bradley L Adams,Jade Barnes,Geoffrey Funk,Dorry L Segev,Allan B Massie","doi":"10.1016/j.ajt.2025.04.013","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.04.013","url":null,"abstract":"Racial/ethnic disparities in the deceased organ donor referral process may contribute to the organ shortage and place minority communities at a greater disadvantage. Prior literature cites substantial inequalities, though methodological concerns may bias estimates. Using Organ Retrieval and Collection of Health Information for Donation data, we conducted a simulation study and re-analysis of 132,968 referrals 2015-2021 across six organ procurement organizations (OPOs). We excluded brain death declaration and cause/mechanism/circumstances of death from the approach model and conducted Poisson regression with robust standard errors. We found Black patients were approached at a more similar rate relative to White patients, although disparities remained (incidence rate ratio (IRR): 0.910.940.97). Black patients provided authorization at a 31% lower rate than White patients (IRR: 0.670.690.71). Slight disparities were observed at procurement (IRR: 0.940.960.99). Our findings are directionally similar to prior literature but suggest substantially less inequality (vs 23% and 65% higher risk of approach and authorization, for non-Black vs Black referrals). Accurate quantification of racial/ethnic disparities in transplantation impacts public perception of those involved, particularly OPOs, and is paramount to any study. Importantly, continued measures are needed to promote equality among Black and minority patients in our national organ donation and transplant system.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"43 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857421","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}

引用次数: 0

Global Variation in Living Donor Liver Transplantation Practices Impacts Donor and Recipient Short-Term Outcomes: Initial Insights from the International LDLT Registry. 活体肝移植实践的全球差异影响供体和受体的短期结果：来自国际LDLT注册的初步见解。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-04-17 DOI: 10.1016/j.ajt.2025.04.008

{"title":"Global Variation in Living Donor Liver Transplantation Practices Impacts Donor and Recipient Short-Term Outcomes: Initial Insights from the International LDLT Registry.","authors":"","doi":"10.1016/j.ajt.2025.04.008","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.04.008","url":null,"abstract":"Living donor liver transplantation (LDLT) is crucial for addressing organ scarcity and improving survival and quality of life. Variations in practices and outcomes are influenced by geographic, economic, and cultural factors. This study examined the association between short-term LDLT outcomes and the Human Development Index (HDI), a composite metric ranking countries by life expectancy, education, and income. Data from September 2023 to June 2024 were prospectively collected through the International LDLT Registry, involving 70 institutions from 26 countries. This prospective global cohort included 1,575 pairs (3,150 cases). Donors from very high HDI regions had a higher prevalence of comorbidities (17.4%) than those from low HDI regions (1.2%, p<0.001). High HDI regions showed lower donor complication rates (9.8%) compared to lower HDI regions (21.4%, p<0.001). Multivariable analysis indicated significantly reduced short-term postoperative donor morbidity in very high HDI regions (OR 0.32, 95% CI 0.23-0.44, p<0.001). Failure-to-rescue rates were substantially higher in low HDI regions (83.3% vs. 2.3%, p<0.001). The study highlights the significant disparities in LDLT practices and short-term outcomes across HDI levels, emphasizing the need for global cooperation to standardize practices and enhance care quality to ensure equitable access to liver transplantation worldwide.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"28 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143853081","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}

引用次数: 0

Donor-derived cell-free DNA is associated with the degree of immunosuppression in lung transplantation. 供体来源的无细胞DNA与肺移植中免疫抑制的程度有关。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-04-17 DOI: 10.1016/j.ajt.2025.04.011

Ananth V Charya,Moon K Jang,Hyesik Kong,Woojin Park,Xin Tian,Michael Keller,Kellie Phipps,Auriel Sanders,Pali Shah,Joby Mathew,Shambhu Aryal,Gerald J Berry,Charles Marboe,Jonathan B Orens,Steven D Nathan,Sean Agbor-Enoh

{"title":"Donor-derived cell-free DNA is associated with the degree of immunosuppression in lung transplantation.","authors":"Ananth V Charya,Moon K Jang,Hyesik Kong,Woojin Park,Xin Tian,Michael Keller,Kellie Phipps,Auriel Sanders,Pali Shah,Joby Mathew,Shambhu Aryal,Gerald J Berry,Charles Marboe,Jonathan B Orens,Steven D Nathan,Sean Agbor-Enoh","doi":"10.1016/j.ajt.2025.04.011","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.04.011","url":null,"abstract":"Donor-derived cell-free DNA is increasingly used in clinical practice to monitor lung transplant patients for acute rejection. However, its association with conventional approaches to monitor immunosuppression remains unclear. This multicenter observational cohort study examines the association of donor-derived cell free DNA with surrogate measures of immunosuppression. Serial plasma samples were collected for quantification of donor-derived cell-free DNA and anellovirus abundance via shotgun and metagenomic sequencing. Adjudication committees reviewed clinical data to define acute cellular and antibody-mediated rejection. The association between ddcfDNA, anellovirus abundance, and serum tacrolimus trough concentrations over the study period and during episodes of acute rejection were examined via linear mixed effects modeling. Donor-derived cell-free DNA demonstrated a significant inverse association with tacrolimus troughs (p=0.027) and anellovirus abundance (p<0.001) over time. Acute rejection episodes were associated with significantly decreased anellovirus abundance (median, 0.042 vs. 0.708, p<0.001) and higher ddcfDNA levels (1.49% vs. 0.26%, p<0.001) compared to stable control timepoints. However, tacrolimus levels were similar between acute rejection and controls (10.1 ng/ml vs 10.3 ng/ml, p = 0.13). Our findings suggest donor-derived cell-free DNA correlates with measures of immunosuppression in lung transplant patients. Additional studies are needed to assess the utility of donor-derived cell-free DNA to assess immunosuppression adequacy.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"267 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143853082","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}

引用次数: 0

BEST PRACTICES OF HEART TRANSPLANTATION IN MICE. 小鼠心脏移植的最佳实践。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-04-17 DOI: 10.1016/j.ajt.2025.04.012

Maria-Luisa Alegre,Carl Atkinson,Fadi Issa,Anna Valujskikh,Zheng Jenny Zhang

{"title":"BEST PRACTICES OF HEART TRANSPLANTATION IN MICE.","authors":"Maria-Luisa Alegre,Carl Atkinson,Fadi Issa,Anna Valujskikh,Zheng Jenny Zhang","doi":"10.1016/j.ajt.2025.04.012","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.04.012","url":null,"abstract":"Heart transplantation in mice has served as a reliable in vivo model in transplant research worldwide for more than half a century. It is not only useful for addressing cardiac graft-specific questions but also provides mechanistic insights and therapeutic strategies that have broad impact across all solid organ transplants. Compared to other mouse models of solid organ transplantation, such as kidney, lung, or small intestine transplants, the surgical techniques to perform mouse heart transplantation (mHT) are relatively easy to master, and the graft heartbeat offers a simple means to evaluate transplant viability. However, as with other in vivo mouse models, mHT has distinct strengths and limitations. Multiple factors can influence the accuracy and reproducibility of the results, including microsurgical techniques and microsurgeons' skills, post-op monitoring methodologies, mouse strain combinations, sex/age. As innovative biotechnologies continue to emerge, the future holds many opportunities for preclinical research utilizing the mHT model. It is therefore imperative to provide the field with optimized mHT protocols and maintain standard reporting requirements. This minireview provides a concise summary and recommendations for standardized practices to ensure the accuracy, reproducibility, and translational value of findings generated from mHT model.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"10 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143853080","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}

引用次数: 0

Antigen quantity is responsible for the discrepancy between phenotype and single antigen beads for the detection of HLA-DQ antibody: potential clinical implications. 抗原数量是导致表型与单抗原珠检测HLA-DQ抗体差异的原因：潜在的临床意义。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-04-12 DOI: 10.1016/j.ajt.2025.04.007

N Remi Shih,Thoa Nong,Robert A Bray,Cathi Murphey,Ina Skaljic,Howard M Gebel,Mayra Lopez-Cepero,Peter W Nickerson,Jar-How Lee

{"title":"Antigen quantity is responsible for the discrepancy between phenotype and single antigen beads for the detection of HLA-DQ antibody: potential clinical implications.","authors":"N Remi Shih,Thoa Nong,Robert A Bray,Cathi Murphey,Ina Skaljic,Howard M Gebel,Mayra Lopez-Cepero,Peter W Nickerson,Jar-How Lee","doi":"10.1016/j.ajt.2025.04.007","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.04.007","url":null,"abstract":"De novo donor-specific HLA-DQ antibodies detected by single antigen beads (SAB) are significantly associated with chronic antibody-mediated rejection and lower overall graft survival. However, some DQ antibodies identified by SAB cannot be confirmed by phenotype antigen-bearing Class II bead assays, raising concerns about the validity of SAB data. The inability to detect these antibodies on phenotype antigen beads could be due to a lower quantity of DQ antigens present on the surface of the beads compared to DR antigens. In this study, we demonstrate that DQ-enriched phenotype antigens exhibit the same reactivity with DQ antibodies detected by SAB, confirming the hypothesis that it is antigen quantity and, not structural differences, that account for discrepancies in HLA DQ antibody detection between phenotype antigen beads and SABs. In addition, we show that the expression of individual DQ antigens in heterozygous cells can vary significantly, further confounding correlation studies. Therefore, the common clinical practice of using the phenotype antigen beads as a screening assay, reflexing to SAB testing only when positive, may inadvertently fail to detect DQ-specific antibodies. Such errors could impact organ acceptance practices, immunosuppression treatment decisions and/or the need for additional diagnostic testing to rule out antibody-mediated rejection.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"5 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143836518","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}

引用次数: 0

Liver transplantation in Candida endocarditis-induced acute-on-chronic liver failure. 念珠菌心内膜炎引起的急性慢性肝衰竭的肝移植。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-04-11 DOI: 10.1016/j.ajt.2025.04.009

Julian Allgeier,Nicholas Zeuzem,Paul Jamme,Manfred Stangl,Felix Kur,Markus Guba,Jan Melichar,Michael Irlbeck,Rika Draenert,Christian M Lange

{"title":"Liver transplantation in Candida endocarditis-induced acute-on-chronic liver failure.","authors":"Julian Allgeier,Nicholas Zeuzem,Paul Jamme,Manfred Stangl,Felix Kur,Markus Guba,Jan Melichar,Michael Irlbeck,Rika Draenert,Christian M Lange","doi":"10.1016/j.ajt.2025.04.009","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.04.009","url":null,"abstract":"This case report details the clinical course of a 35-year-old patient with decompensated liver cirrhosis due to primary sclerosing cholangitis awaiting liver transplantation. The patient developed recurrent candidemia due to biliary candidiasis complicated by endotipsitis, leading to repeated hospitalizations and an eventual diagnosis of tricuspid valve Candida endocarditis. In the setting of active Candida infection and severe acute-on-chronic liver failure and lacking other suitable alternatives for infection control, an interdisciplinary team of hepatologists, transplant surgeons, and cardiologists decided to proceed with liver transplantation during a window of opportunity with repeat negative blood cultures. The patient experienced an unremarkable post-transplant recovery despite having repeated positive blood cultures for Candida albicans and underwent successful tricuspid valve replacement five months later. Our goal is to underscore the critical role of multidisciplinary collaboration in managing high-risk transplant candidates, highlighting in particular the potential benefits of liver transplantation in infection-induced acute-on-chronic liver failure, where full recovery from complex infections might not be possible before transplantation in a setting of severe cirrhosis-associated immune deficiency.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"16 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831682","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}

引用次数: 0

Benznidazole and Tacrolimus Drug-Drug Interaction in a Patient with Chagas Cardiomyopathy following Heart Transplantation. 心脏移植后Chagas心肌病患者的苯并硝唑和他克莫司药物相互作用。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-04-11 DOI: 10.1016/j.ajt.2025.04.006

Emily Kefer,Minoosh Sobhanian,Maria Patarroyo-Aponte,Phillip Weeks

引用次数: 0

Multiplex bead immunoassay in ABO-A2-incompatible kidney transplantation. abo - a2不相容肾移植的多重头免疫分析。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2025-04-09 DOI: 10.1016/j.ajt.2025.04.003

Anne M Halpin,Cathi Murphey,Bruce Motyka,Caishun Li,Jean Pearcey,Maria Ellis,I Esme Dijke,Simon Urschel,Adam Bingaman,Tess Van Ong,Matthias Kapturczak,Todd L Lowary,Christopher W Cairo,Lori J West

{"title":"Multiplex bead immunoassay in ABO-A2-incompatible kidney transplantation.","authors":"Anne M Halpin,Cathi Murphey,Bruce Motyka,Caishun Li,Jean Pearcey,Maria Ellis,I Esme Dijke,Simon Urschel,Adam Bingaman,Tess Van Ong,Matthias Kapturczak,Todd L Lowary,Christopher W Cairo,Lori J West","doi":"10.1016/j.ajt.2025.04.003","DOIUrl":"https://doi.org/10.1016/j.ajt.2025.04.003","url":null,"abstract":"Kidney transplantation from ABO-A2 donors into ABO-O and -B recipients can alleviate inequitable transplant access created by ABO demographics. ABO-A2-incompatible eligibility is determined by anti-A hemagglutination titres. However, titres do not distinguish antibodies specific for A-II glycans, the sole A-antigen subtype in vascular endothelium, from other anti-A antibodies. We examined whether reliance on anti-A titres unnecessarily limited ABO-A2-incompatible transplants for candidates with low anti-A-II levels. We created a single-antigen-bead immunoassay for ABO antibodies, confirmed the specificity and reproducibility, and demonstrated the ability to detect anti-A and -B glycan-subtype-specific antibodies in healthy control sera. We then measured subtype-specific anti-A antibodies in original sera from ABO-B and -O candidates who had been previously evaluated for ABO-A2-incompatible eligibility. Anti-A-II levels in candidates who had been deemed ineligible (anti-A titres >4) were compared to eligible candidates (anti-A titres ≤4) who had subsequently received ABO-A2-incompatible kidneys. Of 141 candidates, 75(53%) were ineligible; 66(47%) were eligible and received ABO-A2 kidneys. Re-testing original sera, 55%(41/75) of ineligible candidates had anti-A-II levels comparable to eligible candidates. Anti-A titres did not reflect anti-A-II levels. Our ABO antibody assay reproducibly measures graft-specific anti-A-II antibodies, providing information beyond anti-A titres that may increase transplant access for ABO-B and -O candidates.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"50 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824819","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}

引用次数: 0