American Journal of Transplantation最新文献_第10页

Lung transplant recipients with telomere-mediated pulmonary fibrosis have increased risk for hematologic complications 端粒介导的肺纤维化的肺移植受者发生血液系统并发症的风险增加。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2023-10-01 DOI: 10.1016/j.ajt.2023.06.014

Stefanie J. Hannan , Carlo J. Iasella , Rachel M. Sutton , Iulia D. Popescu , Ritchie Koshy , Robin Burke , Xiaoping Chen , Yingze Zhang , Joseph M. Pilewski , Chadi A. Hage , Pablo G. Sanchez , Annie Im , Rafic Farah , Jonathan K. Alder , John F. McDyer

{"title":"Lung transplant recipients with telomere-mediated pulmonary fibrosis have increased risk for hematologic complications","authors":"Stefanie J. Hannan , Carlo J. Iasella , Rachel M. Sutton , Iulia D. Popescu , Ritchie Koshy , Robin Burke , Xiaoping Chen , Yingze Zhang , Joseph M. Pilewski , Chadi A. Hage , Pablo G. Sanchez , Annie Im , Rafic Farah , Jonathan K. Alder , John F. McDyer","doi":"10.1016/j.ajt.2023.06.014","DOIUrl":"10.1016/j.ajt.2023.06.014","url":null,"abstract":"<div><p>Idiopathic pulmonary fibrosis lung transplant recipients (IPF-LTRs) are enriched for short telomere length (TL) and telomere gene rare variants. A subset of patients with nontransplant short-TL are at increased risk for bone marrow (BM) dysfunction. We hypothesized that IPF-LTRs with short-TL and/or rare variants would be at increased risk for posttransplant hematologic complications. Data were extracted from a retrospective cohort of 72 IPF-LTRs and 72 age-matched non-IPF-LTR controls. Genetic assessment was done using whole genome sequencing or targeted sequence panel. TL was measured using flow cytometry and fluorescence in-situ hybridization (FlowFISH) and TelSeq software. The majority of the IPF-LTR cohort had short-TL, and 26% of IPF-LTRs had rare variants. Compared to non-IPF controls, short-TL IPF-LTRs were more likely to have immunosuppression agents discontinued due to cytopenias (<em>P</em> = .0375), and BM dysfunction requiring BM biopsy was more prevalent (29% vs 4%, <em>P</em> = .0003). IPF-LTRs with short-TL and rare variants had increased requirements for transfusion and growth factor support. Multivariable logistic regression demonstrated that short-TL, rare variants, and lower pretransplant platelet counts were associated with BM dysfunction. Pretransplant TL measurement and genetic testing for rare telomere gene variants identified IPF-LTRs at increased risk for hematologic complications. Our findings support stratification for telomere-mediated pulmonary fibrosis in lung transplant candidates.</p></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"23 10","pages":"Pages 1590-1602"},"PeriodicalIF":8.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10210430","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: 1

The thymus hosts liver- and gut-like mimetic cells critical to immune self-tolerance 胸腺含有对免疫自我耐受至关重要的类似肝脏和肠道的细胞。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2023-10-01 DOI: 10.1016/j.ajt.2023.08.015

James M. Gardner M.D., Ph.D.

引用次数: 0

Diagnosis and treatment of allograft rejection in islet transplantation 胰岛移植排斥反应的诊断与治疗

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2023-09-01 DOI: 10.1016/j.ajt.2023.05.035

Cyril P. Landstra , Michiel F. Nijhoff , Dave L. Roelen , Aiko P.J. de Vries , Eelco J.P. de Koning

{"title":"Diagnosis and treatment of allograft rejection in islet transplantation","authors":"Cyril P. Landstra , Michiel F. Nijhoff , Dave L. Roelen , Aiko P.J. de Vries , Eelco J.P. de Koning","doi":"10.1016/j.ajt.2023.05.035","DOIUrl":"10.1016/j.ajt.2023.05.035","url":null,"abstract":"<div><p>Islet transplantation stabilizes glycemic control in patients with complicated diabetes mellitus. Rapid functional decline could be due to islet allograft rejection. However, there is no reliable method to assess rejection, and treatment protocols are absent. We aimed to characterize diagnostic features of islet allograft rejection and assess effectiveness of high-dose methylprednisolone treatment. Over a median follow-up of 61.8 months, 22% (9 of 41) of islet transplant recipients experienced 10 suspected rejection episodes (SREs). All first SREs occurred within 18 months after transplantation. Important features were unexplained hyperglycemia (all cases), unexplained C-peptide decrease (ΔC-peptide, 77.1% [−59.1% to −91.6%]; ΔC-peptide:glucose, −76.3% [−49.2% to −90.4%]), predisposing event (5 of 10 cases), and increased immunologic risk (5 of 10 cases). At 6 months post-SRE, patients who received protocolized methylprednisolone (n = 4) had significantly better islet function than untreated patients (n = 4), according to C-peptide (1.39 ± 0.59 vs 0.14 ± 0.19 nmol/L; <em>P</em> = .007), Igls score (good [4 of 4 cases] vs failure [3 of 4 cases] or marginal [1 of 4 cases]; <em>P</em> = .018) and β score (6.0 [6.0-6.0] vs 1.0 [0.0-3.5]; <em>P</em> = .013). SREs are prevalent among islet transplant recipients and are associated with loss of islet graft function. Timely treatment with high-dose methylprednisolone mitigates this loss. Unexplained hyperglycemia, unexpected C-peptide decrease, a predisposing event, and elevated immunologic risk are diagnostic indicators for SRE.</p></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"23 9","pages":"Pages 1425-1433"},"PeriodicalIF":8.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10623417","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: 3

Impact of allele-specific anti–human leukocyte antigen class I antibodies on organ allocation 等位基因特异性抗人白细胞抗原I类抗体对器官分配的影响

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2023-09-01 DOI: 10.1016/j.ajt.2023.05.021

Melissa Y. Yeung , Naoka Murakami , Maria L. Kafetzi , Daimon P. Simmons , Isabelle Wood , Peter Macaskill , Matthew Towle , Jamie DellaGatta , Jonathan Stevens , Edward Comeau , Jane Baronas , Nabil Mohsin , Mike Chen , Jar-How Lee , William J. Lane , Edgar L. Milford , Indira Guleria

{"title":"Impact of allele-specific anti–human leukocyte antigen class I antibodies on organ allocation","authors":"Melissa Y. Yeung , Naoka Murakami , Maria L. Kafetzi , Daimon P. Simmons , Isabelle Wood , Peter Macaskill , Matthew Towle , Jamie DellaGatta , Jonathan Stevens , Edward Comeau , Jane Baronas , Nabil Mohsin , Mike Chen , Jar-How Lee , William J. Lane , Edgar L. Milford , Indira Guleria","doi":"10.1016/j.ajt.2023.05.021","DOIUrl":"10.1016/j.ajt.2023.05.021","url":null,"abstract":"<div><p>Technological advances in the field of histocompatibility have allowed us to define anti–human leukocyte antigen (HLA) antibody specificity at the allelic level. However, how allele-specific antibodies affect organ allocation is poorly studied. We examined allelic specificities of class I HLA antibodies in 6726 consecutive serum samples from 2953 transplant candidates and evaluated their impact on the corresponding crossmatch and organ allocation. Out of 17 class I HLA antigens represented by >1 allele in the LABScreen single antigen bead assay, 12 had potential allele-specific reactivity. Taking advantage of our unbiased cohort of deceased donor-candidate testing (123,135 complement-dependent cytotoxicity crossmatches between 2014 and 2017), we estimated that the presence of allele-specific antibody detected using a single antigen bead assay (median fluorescence intensity, >3000) against only the rare allele was a poor predictor of a positive complement-dependent cytotoxicity crossmatch, with a positive predictive value of 0% to 7%, compared with 52.5% in allele-concordant class I HLA antibodies against A or B locus antigens. Further, we confirmed allele-specific reactivity using flow crossmatch in 3 scenarios: A11:01/A11:02, A68:01/A68:02, and B44:02/B44:03. Our results suggest that allele-specific antibodies may unnecessarily exclude transplant candidates (up to 10%) from organ offers by overcalling unacceptable antigens; incorporation of selective reactivity pattern in allocation may promote precision matching and more equitable allocation.</p></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"23 9","pages":"Pages 1388-1400"},"PeriodicalIF":8.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10313166","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

Rapamycin antagonizes angiogenesis and lymphangiogenesis through myeloid-derived suppressor cells in corneal transplantation 在角膜移植中，雷帕霉素通过髓源性抑制细胞拮抗血管生成和淋巴管生成

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2023-09-01 DOI: 10.1016/j.ajt.2023.05.017

Yuerong Ren , Xiaonan Dong , Yingyi Liu , Huanmin Kang , Lingling Guan , Yumin Huang , Xinqi Zhu , Jing Tian , Baihua Chen , Bing Jiang , Yan He

{"title":"Rapamycin antagonizes angiogenesis and lymphangiogenesis through myeloid-derived suppressor cells in corneal transplantation","authors":"Yuerong Ren , Xiaonan Dong , Yingyi Liu , Huanmin Kang , Lingling Guan , Yumin Huang , Xinqi Zhu , Jing Tian , Baihua Chen , Bing Jiang , Yan He","doi":"10.1016/j.ajt.2023.05.017","DOIUrl":"10.1016/j.ajt.2023.05.017","url":null,"abstract":"<div><p>Rapamycin is an immunosuppressive drug that is widely used in the postsurgery management of transplantation. To date, the mechanism by which rapamycin reduces posttransplant neovascularization has not been fully understood. Given the original avascularity and immune privilege of the cornea, corneal transplantation is considered as an ideal model to investigate neovascularization and its effects on allograft rejection. Previously, we found that myeloid-derived suppressor cells (MDSC) prolong corneal allograft survival through suppression of angiogenesis and lymphangiogenesis. Here, we show that depletion of MDSC abolished rapamycin-mediated suppression of neovascularization and elongation of corneal allograft survival. RNA-sequencing analysis revealed that rapamycin dramatically enhanced the expression of arginase 1 (<em>Arg1</em>). Furthermore, an Arg1 inhibitor also completely abolished the rapamycin-mediated beneficial effects after corneal transplantation. Taken together, these findings indicate that MDSC and elevated Arg1 activity are essential for the immunosuppressive and antiangiogenic functions of rapamycin.</p></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"23 9","pages":"Pages 1359-1374"},"PeriodicalIF":8.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10605691","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: 2

The expanded role of the transplant pharmacist: A 10-year follow-up 移植药剂师的扩展作用:10年随访

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2023-09-01 DOI: 10.1016/j.ajt.2023.04.032

Alicia Beth Lichvar , Mary Moss Chandran , Elizabeth A. Cohen , Barrett R. Crowther , Christina Teeter Doligalski , Amanda J. Condon Martinez , Lisa M.M. Potter , David J. Taber , Rita R. Alloway

{"title":"The expanded role of the transplant pharmacist: A 10-year follow-up","authors":"Alicia Beth Lichvar , Mary Moss Chandran , Elizabeth A. Cohen , Barrett R. Crowther , Christina Teeter Doligalski , Amanda J. Condon Martinez , Lisa M.M. Potter , David J. Taber , Rita R. Alloway","doi":"10.1016/j.ajt.2023.04.032","DOIUrl":"10.1016/j.ajt.2023.04.032","url":null,"abstract":"<div><p>The role of the transplant pharmacist is recognized by transplant programs, governmental groups, and professional organizations as an essential part of the transplant multidisciplinary team. This role has evolved drastically over the last decade with the advent of major advances in the science of transplantation and the growth of the field, which necessitate expanded pharmacy services to meet the needs of patients. Data now exist within all realms of the phases of care for a transplant recipient regarding the utility and benefit of a solid organ transplant (SOT) pharmacist. Furthermore, governing bodies now have the opportunity to use Board Certification in Solid Organ Transplant Pharmacotherapy as a mechanism to identify and recognize specialty knowledge and expertise within the field of SOT pharmacotherapy. The purpose of this paper is to provide an overarching review of the current and future state of SOT pharmacy while also identifying major changes to the profession, forthcoming challenges, and expected areas of growth.</p></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"23 9","pages":"Pages 1375-1387"},"PeriodicalIF":8.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10623372","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: 1

Demystifying tolerance 揭秘宽容

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2023-09-01 DOI: 10.1016/j.ajt.2023.05.018

Kenneth A. Newell

引用次数: 0

Automation of Banff rules for precision diagnosis 自动化班夫规则进行精确诊断

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2023-09-01 DOI: 10.1016/j.ajt.2023.07.005

Michael Mengel , Xian C. Li

引用次数: 0

The impact of donor diabetes on corneal transplant immunity 供体糖尿病对角膜移植免疫的影响。

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2023-09-01 DOI: 10.1016/j.ajt.2023.05.027

Tomás Blanco , Aytan Musayeva , Rohan Bir Singh , Hayate Nakagawa , Seokjoo Lee , Hamid Alemi , Bruno Gonzalez-Nolasco , Gustavo Ortiz , Shudan Wang , Francesca Kahale , Thomas H. Dohlman , Yihe Chen , Reza Dana

{"title":"The impact of donor diabetes on corneal transplant immunity","authors":"Tomás Blanco , Aytan Musayeva , Rohan Bir Singh , Hayate Nakagawa , Seokjoo Lee , Hamid Alemi , Bruno Gonzalez-Nolasco , Gustavo Ortiz , Shudan Wang , Francesca Kahale , Thomas H. Dohlman , Yihe Chen , Reza Dana","doi":"10.1016/j.ajt.2023.05.027","DOIUrl":"10.1016/j.ajt.2023.05.027","url":null,"abstract":"<div><p>Corneal transplantation is the most common form of solid tissue grafting, with an approximately 80% to 90% success rate. However, success rates may decline when donor tissues are derived from patients with a history of diabetes mellitus (DM). To evaluate the underlying immunopathologic processes that cause graft rejection, we used streptozotocin-induced type 1 DM (DM1) and transgenic Lep<sup>ob/ob</sup> type 2 DM (DM2) diabetic murine models as donors and nondiabetic BALB/c as recipients. DM resulted in an increased frequency of corneal antigen-presenting cells (APCs) with an acquired immunostimulatory phenotype. Following transplantation, recipients that received either type of diabetic graft showed increased APC migration and T helper type 1 alloreactive cells, impaired functional regulatory T cells, and graft survival. Insulin treatment in streptozotocin-induced diabetic mice led to an increased tolerogenic profile of graft APC, lower T helper type 1 sensitization, and a higher frequency of functional regulatory T cells with high suppressive capacity, reflected in increased graft survival. We conclude that both DM1 and DM2 in donors can impact corneal APC functional phenotype, rendering the tissue more immunogenic and thereby increasing the risk of graft failure.</p></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"23 9","pages":"Pages 1345-1358"},"PeriodicalIF":8.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10527508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10606164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

Temporal changes in procurement of pancreata for research 研究中胰腺获取的时间变化

IF 8.8 2区医学

American Journal of Transplantation Pub Date : 2023-09-01 DOI: 10.1016/j.ajt.2023.05.002

David Goldberg, Darius Chyou, Rachael Wulf, Matthew Wadsworth

引用次数: 1