American Journal of Transplantation最新文献_第10页

A scintigraphic look at the dead donor rule in donation after the circulatory determination of death with the use of normothermic regional perfusion: A single-center interventional trial. 使用恒温区域灌注对DCDD死亡供者规则的星形图观察：一项单中心介入试验。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2025-03-29 DOI: 10.1016/j.ajt.2025.03.029

Mario Royo-Villanova, Jose Moya Sánchez, Tatiana Moreno-Monsalve, José Contreras, Alejandro Ortín, Héctor Vargas, Clara Manso Murcia, Marta Mateos Llosa, Elisabeth Coll, Alicia Pérez-Blanco, Beatriz Domínguez-Gil

{"title":"A scintigraphic look at the dead donor rule in donation after the circulatory determination of death with the use of normothermic regional perfusion: A single-center interventional trial.","authors":"Mario Royo-Villanova, Jose Moya Sánchez, Tatiana Moreno-Monsalve, José Contreras, Alejandro Ortín, Héctor Vargas, Clara Manso Murcia, Marta Mateos Llosa, Elisabeth Coll, Alicia Pérez-Blanco, Beatriz Domínguez-Gil","doi":"10.1016/j.ajt.2025.03.029","DOIUrl":"10.1016/j.ajt.2025.03.029","url":null,"abstract":"Normothermic regional perfusion (NRP) has emerged as a transformative method for organ recovery in donation after the circulatory determination of death (DCDD). However, ethical concerns about brain reperfusion during NRP remain, despite the application of preventative measures, such as blocking the aorta in abdominal NRP or clamping and venting the supraaortic vessels in thoraco-abdominal NRP. In this single-center, nonrandomized interventional trial, we assessed brain perfusion during NRP in DCDD procedures, using perfusion scintigraphy with technetium-99m hexamethylpropyleneamine oxime as the radiotracer. All consecutive adult DCDD donors undergoing organ recovery via NRP were included. A portable gamma camera system was used in the operating room to acquire three 5-minute static images of the brain. The radiotracer was injected intravenously after initiating NRP. In total, 20 adult DCDD donors subject to NRP (15 abdominal NRP, 5 thoraco-abdominal NRP) were recruited. No radiotracer uptake was observed in the brainstem or hemispheres, affirming the absence of cerebral perfusion. Our results reinforce the ethical compliance of NRP with the dead donor rule, though larger-scale human studies are needed to conclusively address lingering uncertainties and support its widespread adoption.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750371","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

Author response to comments on "Economic evaluation of weight loss and transplantation strategies for kidney transplant candidates with obesity". 致编辑的信：作者对“肥胖肾移植候选人减肥和移植策略的经济评估”评论的回应。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2025-03-29 DOI: 10.1016/j.ajt.2025.03.024

Chethan M Puttarajappa, Michele Molinari

引用次数: 0

Predicting the success of antibody removal with therapeutic plasma exchange: The role of serum dilutions. 预测治疗性血浆置换抗体去除的成功：血清稀释度的作用。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2025-03-28 DOI: 10.1016/j.ajt.2025.03.022

Nidhi Vantair, Maria Leising, Matthew Najor, Yazan Juma, Dong Hyang Kwon, Bhaskar Kallakury, Alexander Gilbert, Jennifer E Verbesey, Maria E Rodrigo, Farooq H Sheikh, Alaa Ali, Anne Renteria, Matthew Cooper, Sandra Rosen-Bronson, Olga A Timofeeva

{"title":"Predicting the success of antibody removal with therapeutic plasma exchange: The role of serum dilutions.","authors":"Nidhi Vantair, Maria Leising, Matthew Najor, Yazan Juma, Dong Hyang Kwon, Bhaskar Kallakury, Alexander Gilbert, Jennifer E Verbesey, Maria E Rodrigo, Farooq H Sheikh, Alaa Ali, Anne Renteria, Matthew Cooper, Sandra Rosen-Bronson, Olga A Timofeeva","doi":"10.1016/j.ajt.2025.03.022","DOIUrl":"10.1016/j.ajt.2025.03.022","url":null,"abstract":"Therapeutic plasma exchange (TPE) remains a primary therapy for addressing circulating donor-specific antibodies against mismatched human leukocyte antigens, which pose a significant challenge to successful transplantation of solid organs and hematopoietic cells. In this study, we aimed to evaluate the response to 5 TPE sessions in patients undergoing desensitization, as well as in patients who developed antibody-mediated rejection posttransplant. Sera collected before and after each TPE session was treated with EDTA and tested using the single-antigen bead assay as undiluted or 1:4, 1:16, 1:64, and 1:256 diluted. The reduction in human leukocyte antigen antibodies correlated with previously established total immunoglobulin G reduction levels. However, we observed that class I antibody levels were reduced by 85% to 90% while class II antibodies were reduced by only 75% to 80% after 5 TPE sessions. We also found that dilutions performed on pretreatment serum were predictive of the response to TPE. This approach was used to design TPE-based desensitization protocols for highly sensitized patients across various organ and tissue types, as well as for treating patients with antibody-mediated rejection. Our data suggest that serum dilution may be an effective method for assessing the likelihood of response to TPE, thereby aiding in the guidance of treatment strategies.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750383","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

The endothelial whisperer: Rapamycin's second act in immune regulation-beyond T cells to endothelium. 内皮低语者：雷帕霉素在免疫调节中的第二项作用——超越T细胞到内皮细胞。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2025-03-28 DOI: 10.1016/j.ajt.2025.03.023

Shuang Li, Dawei Zou

引用次数: 0

Outcomes and motivations in unspecified (nondirected altruistic) kidney donation: Results from a United Kingdom prospective cohort study. 未指明（非定向利他）肾脏捐赠的结果和动机：来自英国前瞻性队列研究的结果。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2025-03-28 DOI: 10.1016/j.ajt.2025.03.021

Hannah Maple, Petrut Gogalniceanu, Mira Zuchowski, Heather Draper, Lisa Burnapp, Paul McCrone, Joseph Chilcot, Sam Norton, Nizam Mamode

{"title":"Outcomes and motivations in unspecified (nondirected altruistic) kidney donation: Results from a United Kingdom prospective cohort study.","authors":"Hannah Maple, Petrut Gogalniceanu, Mira Zuchowski, Heather Draper, Lisa Burnapp, Paul McCrone, Joseph Chilcot, Sam Norton, Nizam Mamode","doi":"10.1016/j.ajt.2025.03.021","DOIUrl":"10.1016/j.ajt.2025.03.021","url":null,"abstract":"Unspecified kidney donors (UKDs) increase the number of high-quality kidneys available for transplantation. This study aimed to determine whether the practice was acceptable, based on the noninferiority of donor physical and psychosocial outcomes when compared to specified kidney donors (SKDs). This longitudinal, prospective cohort study investigated potential living kidney donors from across all 23 UK adult kidney transplant centers. Participants completed validated questionnaires at 4 time points (recruitment, 2-4 weeks predonation, 3- and 12-months postdonation). Clinical outcome data were collected from National Health Service Blood and Transplant. Three hundred seventy-three (of 837 recruited; 45.7%) went on to donate (November 2016 to January 2021). There were no differences in donation rates (204 SKDs [54.7%] vs 169 UKDs [45.3%]; P = .944). Both groups reported being motivated by the desire to help someone (P = .157). Tests for noninferiority indicated that UKDs do no worse than SKDs on psychosocial or clinical outcomes over 12 months, and costs are similar (P > .05). This is the world's largest prospective observational study comparing SKDs and UKDs. It demonstrates no differences in primary motivation, donation rates, regret, cost, or psychosocial and physical outcomes. These data should reassure transplant professionals and potential donors and can bolster confidence in the practice around the world.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750378","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

The impact of sodium-glucose cotransporter-2 inhibitors on dialysis risk and mortality in kidney transplant patients with diabetes. 钠-葡萄糖共转运蛋白-2抑制剂对肾移植糖尿病患者透析风险和死亡率的影响

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2025-03-21 DOI: 10.1016/j.ajt.2025.03.019

Fu-Shun Yen, Chih-Cheng Hsu, Yun-Kai Yeh, Wan-Yin Cheng, Pei-Lun Liao, Chii-Min Hwu, James Cheng-Chung Wei

{"title":"The impact of sodium-glucose cotransporter-2 inhibitors on dialysis risk and mortality in kidney transplant patients with diabetes.","authors":"Fu-Shun Yen, Chih-Cheng Hsu, Yun-Kai Yeh, Wan-Yin Cheng, Pei-Lun Liao, Chii-Min Hwu, James Cheng-Chung Wei","doi":"10.1016/j.ajt.2025.03.019","DOIUrl":"10.1016/j.ajt.2025.03.019","url":null,"abstract":"Kidney transplantation is the optimal treatment for end-stage kidney disease, but many patients also have diabetes mellitus. This study compares long-term outcomes between new users of sodium-glucose cotransporter-2 inhibitors (SGLT2i) and dipeptidyl peptidase-4 inhibitors (DPP-4i) in kidney transplant recipients with diabetes mellitus. Data from the TriNetX Collaborative Network, including 89,710 patients with diabetes mellitus who underwent kidney transplantation between January 1, 2015, and June 30, 2023, were analyzed. From this cohort, 1410 matched pairs of SGLT2i and DPP-4i users were selected based on propensity scores. The results showed that SGLT2i users had a lower risk of dialysis (hazards ratio: 0.694) and all-cause mortality (hazards ratio: 0.687) compared with DPP-4i users. There were no significant differences in the risk of posttransplant infections, transplant rejection, or hospitalization between the 2 groups. Additionally, SGLT2i users had significantly lower cumulative incidences of dialysis and mortality. In conclusion, this study, using data from TriNetX, demonstrated that SGLT2i treatment in kidney transplant recipients with diabetes mellitus is associated with lower risks of dialysis and mortality, suggesting it may help preserve kidney function and improve survival in this population.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690511","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

The questions not addressed: Who should be performing the virtual crossmatch, how should it be classified, and how to obtain reimbursement? 没有解决的问题是：谁应该执行虚拟交叉匹配，应该如何分类，以及如何获得报销？

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2025-03-21 DOI: 10.1016/j.ajt.2025.03.020

H Cliff Sullivan, Andrés Jaramillo, Sujata Gaitonde, Cathi Murphey, Soumya Pandey, Chang Liu, Peter Jindra, Luis G Hidalgo, Eric T Weimer, Caroline R Alquist, Gerald P Morris, Robert A Bray

引用次数: 0

10 degree C static storage of porcine donation after circulatory death livers improves biliary viability and mitigates ischemia-reperfusion injury. 循环死亡猪捐献肝脏10°C静态储存可提高胆道活力，减轻缺血再灌注损伤。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2025-03-20 DOI: 10.1016/j.ajt.2025.03.018

Kaitlyn M Tracy, Yutaka Shishido, Mark Petrovic, Alexandria Murphy, TiOluwanimi Adesanya, Avery K Fortier, Timothy R Harris, Michael Cortelli, William D Tucker, Sean A François, Brandon Petree, Kimya Raietparvar, Victoria Simon, Carl A Johnson, Elizabeth Simonds, John Poland, Gabriella A Glomp, Christian Crannell, Jiancong Liang, Andrea Marshall, Antentor Hinton, Ciara M Shaver, Caitlin T Demarest, Rei Ukita, Ashish S Shah, Michael Rizzari, Martin Montenovo, Muhammad Ameen Rauf, Melanie McReynolds, Matthew Bacchetta

{"title":"10 degree C static storage of porcine donation after circulatory death livers improves biliary viability and mitigates ischemia-reperfusion injury.","authors":"Kaitlyn M Tracy, Yutaka Shishido, Mark Petrovic, Alexandria Murphy, TiOluwanimi Adesanya, Avery K Fortier, Timothy R Harris, Michael Cortelli, William D Tucker, Sean A François, Brandon Petree, Kimya Raietparvar, Victoria Simon, Carl A Johnson, Elizabeth Simonds, John Poland, Gabriella A Glomp, Christian Crannell, Jiancong Liang, Andrea Marshall, Antentor Hinton, Ciara M Shaver, Caitlin T Demarest, Rei Ukita, Ashish S Shah, Michael Rizzari, Martin Montenovo, Muhammad Ameen Rauf, Melanie McReynolds, Matthew Bacchetta","doi":"10.1016/j.ajt.2025.03.018","DOIUrl":"10.1016/j.ajt.2025.03.018","url":null,"abstract":"Optimized static cold storage has the potential to improve the preservation of organs most vulnerable to ischemia-reperfusion injury. Data from lung transplantation suggest that storage at 10 °C improves mitochondrial preservation and subsequent allograft function compared with conventional storage on ice. Using a porcine model of donation after circulatory death, we compared static storage of livers at 10 °C to ice. Livers (N = 5 per group) underwent 10 hours of storage followed by 4 hours of normothermic machine perfusion (NMP) for real-time allograft assessment. Allografts were compared using established NMP viability criteria, tissue immunostaining, and tissue metabolomics. Livers stored at 10 °C demonstrated lower portal venous vascular resistance and greater hepatic artery vasoresponsiveness. Lactate clearance during NMP was similar between the groups. Livers stored at 10 °C showed favorable biochemical parameters of biliary viability, including greater bile volume, pH, and bicarbonate. Metabolomics analysis revealed increased aerobic respiration, improved electron transport chain function, and less DNA damage after reperfusion of livers stored at 10 °C. Static storage of donation after circulatory death livers with extended cold ischemic time at 10 °C demonstrates superior allograft function with evidence of improved biliary viability and mitochondrial function compared with ice. These data suggest that storage at 10 °C should be considered for translation to clinical practice.","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690447","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

Out-of-sequence, out of alignment, and out of time: Why the Organ Procurement Organization measures are at the root of this problem 乱序、乱对齐、乱时间；为什么OPO措施是这个问题的根源。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2025-03-19 DOI: 10.1016/j.ajt.2025.03.017

Alexandra K. Glazier

引用次数: 0

Corrigendum to ‘Establishing targets for goal-directed anesthesia in renal transplantation: A cohort analysis of high-saliency surgical time courses’ [American Journal of Transplantation. Volume 24, Issue 11 (2024) Pages 2055–2065] 《在肾移植中建立目标导向麻醉的靶标：高显著性手术时间的队列分析》的更正[美国移植杂志]。第24卷，第11期（2024）页2055-2065]。

IF 8.9 2区医学

American Journal of Transplantation Pub Date : 2025-03-18 DOI: 10.1016/j.ajt.2025.03.013

Rohit Malyala , Anna-Lisa Tam-Vi Nguyen , Erika Escamilla , Alex Ng , Lucie Hammond , Sasha Vozynuk , Alireza Habibi , Amirreza Habibi , Hana Mehdic , Christopher Nguan

引用次数: 0